Hummingbird News Desk
NEW DELHI, 10 MAY: Even as a deadly second wave of Covid-19 ravages India, doctors are now reporting a rash of cases involving a rare infection – also called the “black fungus” – among recovering and recovered Covid-19 patients.
Doctors at a leading healthcare facility in Hyderabad have come across Covid-19 positive patients who are suffering from mucormycosis, a deadly fungal infection, and a silent killer.
In the past 3-4 weeks, a total of five patients have been reported with this infection at Continental Hospitals, indicating rise in the condition among the Covid-hit, the hospital said on Monday.
It has been reported that between December and February, doctors have found 58 cases of the infection in five cities – Mumbai, Bangalore, Hyderabad, Delhi and Pune. Most of the patients contracted it between 12 to 15 days after recovery from Covid-19.
This apart, 40 cases of mucormycosis, also known as black fungus, have been reported from Gujarat’s Surat among those who have recovered from Covid-19. Of the 40 patients identified, eight have lost their eyesight, and it is being attributed to this secondary infection.
Doctors believe mucormycosis, which has an overall mortality rate of 50%, may be being triggered by the use of steroids, a life-saving treatment for severe and critically ill Covid-19 patients.
Steroids reduce inflammation in the lungs for Covid-19 and appear to help stop some of the damage that can happen when the body’s immune system goes into overdrive to fight off coronavirus. But they also reduce immunity and push up blood sugar levels in both diabetics and non-diabetic Covid-19 patients.
It’s thought that this drop in immunity could be triggering these cases of mucormycosis.
Mucormycosis is a very rare infection. It is caused by exposure to mucor mould which is commonly found in soil, plants, manure, and decaying fruits and vegetables. It is ubiquitous and found in soil and air and even in the nose and mucus of healthy people.
It affects the sinuses, the brain and the lungs and can be life-threatening in diabetic or severely immunocompromised individuals, such as cancer patients or people with HIV/AIDS.
Patients suffering from the fungal infection typically have symptoms of stuffy and bleeding nose; swelling of and pain in the eye; drooping of eyelids; and blurred and finally, loss of vision. There could be black patches of skin around the nose.
Doctors say most of their patients arrive late, when they are already losing vision, and doctors have to surgically remove the eye to stop the infection from reaching the brain.
Advisory:
The Centre on Sunday released advisory on mucormycosis, a fungal infection being found in COVID-19 patients with uncontrolled diabetes and prolonged intensive care unit (ICU) stay, and said it may turn fatal if care is not taken.
Uncontrolled diabetes mellitus, immunosuppression by steroids, prolonged ICU stay, malignancy and voriconazole therapy may lead to the infection, the advisory said
In COVID-19 patients with diabetes and immuno-suppressed individuals, one must suspect mucormycosis if there is sinusitis, one-side facial pain or numbness or swelling, blackish discoloration over the bridge of the nose or palate, toothache, loosening of teeth, blurred or double vision with pain, skin lesion, thrombosis and necrosis, chest pain and worsening respiratory symptoms, it said.
ICMR advised use of masks while visiting dusty construction sites; wearing shoes, long trousers, long sleeve shirts and gloves while handling soil (gardening), moss or manure; and maintaining personal hygiene through scrub bath to prevent mucormycosis.
The infection can be managed by controlling diabetes, reducing steroids, discontinuing immunomodulating drugs, and extensive surgical debridement to remove all necrotic materials, the advisory said.
To prevent the disease, blood glucose level should be monitored post-COVID discharge and also in diabetic patients; steroids should be used judiciously in correct timing, dose and duration; clean sterile water should be used in humidifiers during oxygen therapy; and antibiotics and antifungal medicines should be used correctly, it said.
Image Courtesy:@Healthline
