AP Photo/Hannah Foslien

Laboratory technician Ruth Rutledge packages cerebrospinal fluid of the three confirmed meningitis cases in Minn., to send to the Centers for Disease Control and Prevention in Atlanta for further testing, at the Minnesota Department of Health in St. Paul, Minn., on Tuesday, Oct. 9, 2012. The number of people sickened by a deadly meningitis outbreak has now reached 119 cases, including 11 deaths, according to the CDC. The states involved in the outbreak are Tennessee, Michigan, Virginia, Indiana, Florida, Maryland, Minnesota, North Carolina, New Jersey and Ohio. Officials have tied the outbreak of rare fungal meningitis to steroid shots for back pain. (AP Photo/Hannah Foslien) (October 11, 2012)

INDIANAPOLIS (AP) -The family of a Cass County woman says it believes she died of fungal meningitis after receiving two injections of a tainted back pain medication at an Elkhart health clinic.

Lisa Ann Durbin says her 89-year-old grandmother Pauline Burema of Cassopolis died Wednesday at a daughter's home in Bristol.

Durbin says the family is waiting for autopsy results to confirm the cause of death. However, doctors told the family they believe Burema had contracted meningitis from shots she received Aug. 22 and Sept. 8 at OSMC Outpatient Surgery Center in Elkhart. Durbin says Burema was found unconscious in her home Oct. 3.

The Centers for Disease Control has confirmed an Indiana fungal meningitis death Thursday, and a Michigan Community Health Department spokeswoman says it was a Cass County resident.

Six Indiana clinics received the tainted steroid, including the South Bend Clinic and the OSMC Outpatient Surgery Center in Elkhart. A Massachusetts pharmacy has recalled the medicine.

The government says 170 people now have been sickened in the meningitis outbreak linked to tainted steroid shots, and 14 of them have died.

As of Thursday, the CDC said Indiana had 21 cases of fungal meningitis and one death, while Michigan had 39 meningitis cases and 3 deaths. The person identified by Michigan health officials received the steroid shot in the ankle and has an infection there. While the biggest concern is for people given the shots for back pain, the CDC said people who received the injections in joints should also be alert to signs of localized infection, including redness, pain, swelling and fever.

Idaho becomes the 11th state to report at least one illness. The others are Indiana, Michigan, Florida, Maryland, Minnesota, New Jersey, North Carolina, Ohio, Tennessee and Virginia.

Federal health officials said they've tracked down more than 90% of the roughly 14,000 people who may have received contaminated steroid shots, urging anyone with early symptoms of potentially deadly meningitis to seek help fast.

Of the 170 people sickened in the outbreak, all but one have a rare fungal meningitis, and 14 have died, the Centers for Disease Control and Prevention said Thursday.

More than 50 vials of the steroid produced by a specialty pharmacy in Massachusetts, the New England Compounding Center, have been found contaminated with some sort of fungus, said Deborah Autor of the Food and Drug Administration. The investigation is continuing into how the contamination could have occurred.

But a Massachusetts official said Thursday that it appears the company violated state law governing how compounding pharmacies are supposed to work. They are not supposed to do large-scale production like a drug manufacturer, but to produce medication for patient-specific prescriptions, said Dr. Madeleine Biondolillo of the Massachusetts Department of Public Health.

"This organization chose to apparently violate the licensing requirements under which they were allowed to operate," she told reporters Thursday.

The pharmacy has recalled the steroid that was sent to clinics in 23 states, as well as everything else it makes.