NASHVILLE, Tenn. » A fifth person has died in a growing outbreak of a rare form of meningitis that has sickened more than two dozen people in five states.

Dr. Robert Latham, chief of medicine at Saint Thomas Hospital in Nashville, said today a patient died there late Wednesday or early today, bringing the number of deaths in Tennessee to three.

Deaths have also been reported in Virginia and Maryland. All received steroid injections used mostly for back pain that have been traced back to a specialty pharmacy in Massachusetts. The pharmacy issued a recall last week and has shut down operations.

The type of meningitis is not contagious and health officials believe that more new cases are almost certain to appear in the coming days.