Microorganisms poorly pathogenic for man may become significant causes of morbidity and mortality when inadvertently inoculated into normally sterile sites. Compounding pharmacies in the USA, not strictly overseen by the US Food and Drug Administration but by individual states, have been implicated in a number of clusters of such events. Recognized in the fall of 2012, fungus-tainted corticosteroid manufactured by a Massachusetts compounding pharmacy has caused the largest outbreak of this kind, affecting 751 people with, to date, 64 deaths. The etiology of the cases of meningitis, perispinal infection and septic arthritis was found to be, mostly, Exserohilum rostratum, a very uncommon human fungal pathogen. Prevention of future outbreaks such as this one will require an overhaul of the control over these industrialized compounding pharmacies and, until then, making both clinicians and patients alike aware of this issue in order for them to make informed decisions about these products and the risk of their use. © 2014 The Author.
Lutwick, L. I. (2014). Exserohilum and the compounding pharmacy: Pushing the envelope of virulence. International Journal of Infectious Diseases, 21, 10–12. https://doi.org/10.1016/j.ijid.2014.02.001