Authorities are reporting 44 Michigan cases of fungal meningitis in the national outbreak, along with four non-meningitis infection cases related to the same contaminated steroids.
The U.S. Centers for Disease Control and Prevention said Wednesday's Michigan count of 48 total infections was up by 20 from one week earlier.
Michigan's death toll remains at four, including the death of a Cass County woman whose meningitis was linked to treatments for back pain across the state border at an Indiana clinic. Her case is included in Indiana's count.
A steroid made by a Massachusetts pharmacy has been tied to a national outbreak of the rare fungal form of meningitis. It has killed 19 people nationwide.