One of the Michigan deaths occurred in a patient who had not responded to treatment for bacterial meningitis at St. Joseph Mercy Ann Arbor and was later transferred to a hospice facility, hospital officials said Tuesday. Hospital officials could not say if the woman who died after treatment at St. Joe is the woman from Washtenaw County. She was treated at St. Joe before the fungal meningitis outbreak was discovered.

One of the two deaths reported Monday occurred at the University of Michigan Hospital, a spokesman said Monday. It's not clear where the other patient died.

Meanwhile, Michigan Pain Specialists in Brighton announced Tuesday that clinicians there treated about 875 patients between Aug. 7 and Oct. 2, with lots of the contaminated steroids from the New England Compounding Center in Framingham, Mass. Two of the three patients who died were treated at the facility, according to a statement.

The facility is instructing its patients who were treated with injections between those dates to go to the emergency room at St. Joseph Mercy Hospital in Superior Township if they are experiencing any of the following symptoms: Fever, new or worsening headache, sensitivity to light, increasing pain, redness or swelling at the injection site and stiffness of the neck.

Across the country, 119 cases of fungal meningitis - including 11 deaths - have been reported in 10 states, the Centers for Disease Control and Prevention said Tuesday. All are linked to a batch of steroids contaminated with fungus that were manufactured at the New England Compounding Center.

In Michigan, four facilities received shipments of the contaminated steroid, including Michigan Pain Specialists in Brighton.

A number of physicians that practice at St. Joseph Mercy Ann Arbor also privately practice at the Brighton facility, said Dr. Lakshmi Halasyamani, chief medical officer for St. Joseph Mercy.

Any pain injections the physicians may have given were administered at the Brighton facility, Halasyamani said.

"We at MPS express our deepest sorrow regarding this tragedy and are greatly saddened that some of our patients have been affected. ... Our primary concern is patient safety," the clinic said in a statement. "All injections were administered in a sterile environment under strict protocols. We had no reason to believe the medication we administered was tainted."

Hospitals in the Ann Arbor area have treated the majority of the fungal meningitis cases in Michigan linked to the nationwide outbreak connected to the batch of contaminated steroids.

“We continue to admit patients that we suspect may be connected,” Halasyamani said.

The patient who died after treatment at St. Joseph Mercy Hospital died in hospice care after not responding to treatments for bacterial meningitis, Halasyamani said. The patient was admitted to St. Joe before hospital doctors were aware of the fungal meningitis outbreak, Halasyamani said.

“The fungi that are being isolated are very rare to cause human meningitis,” Halasyamani said. “Our collective medical experience nationally is very limited. This is a type of meningitis almost no one nationally has ever cared for.”

Halasyamani said doctors at St. Joseph Mercy are reaching out to national experts for guidance.

Meningitis is the inflammation of the tissues surrounding the brain and spinal cord. Fungal meningitis is rare and is not contagious.

Patients could only contract meningitis from the contaminated steroid if it was an epidural administered for back pain. Patients who suspect they may have received such injections of the contaminated steroid should seek evaluation immediately, Halasyamani said.

Patients who received injections of the contaminated steroid for joint pain are only at risk for a fungal infection and do not require emergency evaluation. The notification for those patients is still ongoing, health officials said.

The University of Michigan Health System is continuing to treat one patient whose illness is linked to the fungal meningitis outbreak, said Pete Barkey, director of public relations for the health system.

The patient was admitted last week, Barkey said. The number of cases at the health system has not increased as of Tuesday, Barkey said.

One of the deaths in Michigan occurred at the U-M hospital in late September, Barkey said Monday. Though U-M would not identify the person that died, the Associated Press reported Lilian Cary, 67, of Howell Township died Sept. 30 from fungal meningitis at the U-M hospital.

The third person who died is a 56-year-old Genessee County woman.

Amy Biolchini covers Washtenaw County, health and environmental issues for AnnArbor.com. Reach her at (734) 623-2552, amybiolchini@annarbor.com or on Twitter. The Associated Press contributed to this report.