AUSTIN (KXAN) – The Texas Department of State Health Services said Tuesday one person has died and four others were hospitalized for suspected cases of fungal meningitis after getting surgery in Matamoros, Mexico.

According to TDSHS, all five traveled from Texas to Matamoros to get surgical procedures that involved an epidural, which is anesthetic injected into the area around the spinal column.

Health authorities in the United States and Mexico are investigating what caused the infections, whether the cases are linked, and whether there are more cases.

“It is very important that people who have recently had medical procedures in Mexico monitor themselves for symptoms of meningitis,” said DSHS Commissioner Jennifer Shuford on Tuesday “Meningitis, especially when caused by bacteria or fungus, can be a life-threatening illness unless treated promptly.”

DSHS said people should consider canceling or postponing any elective surgeries, including liposuction, involving epidural anesthesia in Matamoros until there is evidence those procedures do not pose a significant risk of infection.

DSHS said if you had surgery involving an epidural in Matamoros at any time this year, tell your doctor about the risk of fungal infection, and seek care if you develop meningitis symptoms.

Meningitis is swelling of the protective covering of the brain and spinal cord. It can be caused by bacteria, virus, fungus or trauma.

DSHS says common symptoms include fever, headache, stiff neck, nausea, vomiting, confusion and sensitivity to light.

According to DSHS, symptoms began three days to six weeks after surgery in Matamoros. The patients range in age from their 30s to their 50s.