The Maryland Department of Health and Mental Hygiene, which announced the cases late Wednesday, would not release details about either victim.
The outbreak was first identified when patients in a Tennessee ambulatory care clinic developed meningitis or stroke symptoms within a month of receiving an epidural spinal injection with the steroid methylprednisolone acetate, or Solumedrol.
There are different types of meningitis. One of the patients was determined to have Aspergillus meningitis, but no organism was identified in the others. North Carolina has also identified a possible association between patients who received the steroid and development of meningitis.
The source of the illnesses is not known, but methylprednisolone acetate from a single manufacturer was used for all the infected patients.
The company, which state health officials did not name, has voluntarily recalled the product.
DHMH has contacted Maryland health facilities where the product was distributed and told them to get rid of it. The facilities have also been told to notify patients who may have been exposed to the drug between July 30 and Sept. 28.
The facilities notified were: Berlin Interventional Pain Management in Berlin, Box Hill Surgery Center in Abingdon, Greenspring Surgery Center in Baltimore, Harford County Ambulatory Surgery Center in Edgewood, Maryland Pain Specialists in Towson, SurgCenter of Bel Air, and Zion Ambulatory Center in Baltimore.
State health officials are telling patients who received a spinal injection at one of these facilities and have symptoms of meningitis or stroke to contact their doctor.
Symptoms of meningitis include fever, headache, neck stiffness, photophobia, nausea, or vomiting. Stroke symptoms include double vision, slurred speech, weakness on one side of the body, or difficulty walking.