Health officials now say nine people have died from a fungal meningitis outbreak linked to a steroid injection.
The same medication was used at a surgical center in the South Valley.
Staff at the Sequoia Surgical Center in Visalia has already reached out to 150 patients.
Action News has learned 50 of those people were treated with an injection matching the lot number for the contaminated steroid.
What's unclear is whether those shots contained the fungus spreading the potentially deadly meningitis.
Local and federal health officials are working medical staff at the Sequoia Surgical Center in Visalia.
They say a tainted steroid injection made in Massachusetts was distributed there. The steroid has been recalled by the Centers for Disease Control and Prevention.
It's said to contain a fungus now spreading meningitis to at least 64 people in nine states.
"We have not identified any patients who have symptoms," Dr. Alex Lechtman of Sequoia Surgical Center said.
Lechtman is the co-managing partner for that surgical center.
He says the steroids are injected into the spine to treat people with chronic back pain.
His staff is now talking with 150 patients that could have been injected with the shot linked to the meningitis outbreak.
"Because of our concern we want to make sure these patients are at least aware. And if they are having any symptoms associated with the infection, that they either present to the emergency room or to their primary care physician," Lechtman said.
The remaining batch of steroid injections from the Sequoia Surgical Center has been sent back to the manufacturer in Massachusetts.
Doctors say signs to watch out for include headaches, fatigue and unexplained fever. The CDC says the fungal meningitis is not contagious.
Lechtman says one person in the South Valley went to the hospital last night with similar symptoms. That person was cleared by doctors.
The Surgical Center is still trying to reach a handful of patients who have not responded to the clinic's calls.