A fungus-contaminated batch of steroidal medicine injected into patients to treat back pain has resulted in a nationwide outbreak of meningitis that has caused severe illnesses, including strokes and a number of deaths.

In all, 17,676 vials of the unsafe drug made by a Massachusetts compounding pharmacy was sold to 75 clinics performing spinal injections in 23 states. The latest report counted 391 cases of infection and 28 fatalities, with the toll continuing to rise.

In one case, the firm obtained a confidential settlement in the highly publicized case of a 19-year-old University of Pennsylvania student who died after hospital physicians failed to admit her despite classic symptoms of meningitis. (See news coverage)  In other cases, Kline & Specter won settlements of $17 million, $7.9 million and $6 million in cases involving meningitis illnesses.

Meningitis caused by a fungus (rather than more common forms caused by viruses or bacteria) is considered the hardest to treat and the most serious because it can cause strokes. Indeed, some of the victims have reported suffering strokes.

The injectable medication in question, methylprednisolone acetate, was made by the New England Compounding Center. Health officials said they believed the bad batch contained a fungus, according to news reports.

One clinic which had 186 patients injected with the suspect steroid compound reported having about two dozen cases with symptoms indicative of meningitis. Those patients underwent spinal taps to test for the disease.

Symptoms of meningitis include high fever, stiff neck, neck and shoulder pain, sensitivity to light, nausea and vomiting, confusion, sleepiness and seizures.

At this time, Kline & Specter is not accepting cases involving contaminated spinal injections from the New England Compounding Center.