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it was really a mini-pharmaceutical manufacturer, not the pharmacy it was licensed to be.

1,200 different drugs

Apparently, all of this has been caused by contamination of drugs by a black mold called Exserohilum rostratum, which is common in the environment but almost unheard of as a cause of human disease.

For instance, on 13 occasions, they said, New England Compounding shipped out vials of drugs in three suspect lots before getting back results of their own tests confirming the drugs were sterile.

"indicated a failure ... to sterilize products for even the minimum amount of time necessary to ensure sterility,"

The firm's premises were not clean

medications were not labeled with individual patients' names

he may harbor a fungal infection that could kill him, there's no proof that he does — and there may never be.

many anxious patients are undergoing painful spinal taps and some are getting antifungal drugs that can damage the kidneys and liver.

The caution is warranted. This type of fungal infection can smolder for weeks and months before exploding into meningitis or causing massive strokes.

"It causes a quandary for the infectious disease doc to figure out, well, should this patient receive treatment at all?" O'Connell says. "Should they receive full-boat treatment, which would be an IV? Could they instead just be watched very closely with daily phone calls and visits to the office? We just don't know."

"Should we do lumbar punctures on those kinds of people so that we can anticipate those that are going to get symptomatic later and beat the fungus to it?" Schaffner wonders. "That is, initiate treatment much earlier, thus averting tissue damage, particularly those devastating strokes."

When to stop is also uncertain.

six months, maybe longer.

But in transplant recipients, yeast infections can be hard to control, because the drugs that prevent rejection also prevent the immune system from fighting the infection. If a yeast infection spreads into the bloodstream, it can be extremely difficult to treat, and can be fatal.

Doctors rushed Ms. McFarland into surgery and discovered that an infection — they did not know then what kind — had extended into an artery they had connected to provide blood flow to the uterus. It had damaged the vessel and caused clots. The transplant had to be removed immediately. A week later, Ms. McFarland needed another operation, to treat more bleeding.

Once the cause of the infection was identified, she was treated with antifungal medicines. With the transplant removed, she was able to stop taking antirejection drugs and give her immune system a chance to recover and help control the infection.

She spent about five weeks in the hospital. Dr. Tzakis said she was still taking antifungal medicine, but was well.

The goal of the surgery is to make pregnancy and childbirth possible for women who were born without a uterus or lack one because of illness or injury.

They said they were considering various options, like using antifungal medicines preventively and washing the tissues of both the donor and recipient to reduce the risk of infection.

The only successful uterus transplants have been performed in Sweden, at the University of Gothenburg. Nine women have had the transplants there, and five have given birth.

Two of the nine transplants failed during the first year after the surgery and had to be removed

the other because of a bacterial infection.

Unlike the Cleveland team, doctors in Sweden used live uterus donors rather than cadavers for the transplants.

He also said that the Baylor team had adjusted its screening procedures to take into account possible exposure to the Zika virus