The patients recovered from Covid 19 in India have started to show a rare infection of mucormycosis or Black Fungus, which may turn fatal.
Mucormycosis is a rare but serious fungal infection caused by a kind of fungus called mucormycete. this is now mostly seen in Covid 19 patients. It mainly affects people who have health problems or take medicines that lower the body’s ability to fight germs and sickness.
In an advisory, the Indian Council of Medical Research and the Government of India said that the fungal attack might turn fatal if not treated.
Warning Signs and Symptoms
- Pain and redness around eyes and/or nose
- Fever
- Headache
- Coughing
- Shortness of breath
- Bloody vomits
- Altered mental status
- Toothache, loosening of teeth
- Blurred or double vision with pain
What predisposes
- Uncontrolled diabetes mellitus
- Immunosuppression by steroids
- Prolonged ICU stay
- Co-morbidities – post transplant/malignancy
- Voriconazole therapy
Prevention
- Use masks if you are visiting dusty construction sites.
- Wear shoes, long trousers, long-sleeved shirts and gloves while gardening.
- Maintain personal hygiene including a thorough scrub bath.
Diagnosis
It depends on the location of the suspected infection. A sample of fluid from the respiratory system may be collected for testing in the lab; otherwise a tissue biopsy or a CT scan of the lungs and sinuses may be conducted.
Treatment
Mucormycosis needs to be treated with prescription antifungal medicine. In some cases, it can require surgery. It can lead to eventual loss of the upper jaw and sometimes even an eye.
It is of utmost importance to control diabetes, reduce steroid use, and discontinue immunomodulating drugs. To maintain adequate systemic hydration, the treatment includes infusion of normal saline (IV) before infusion of amphotericin B and antifungal therapy, for at least 4-6 weeks.
Dos
- Control hyperglycemia
- Monitor blood glucose level post COVID-19 discharge and also in diabetics
- Use steroid judiciously – correct timing, correct dose and duration
- Always use clean, sterile water for humidifiers during oxygen therapy
- Use antibiotics/antifungals judiciously
Don’ts
- Do not miss warning signs and symptoms
- Never consider all the cases with blocked nose as cases of bacterial sinusitis, particularly in the context of immunosuppression and/or COVID-19 patients on immunomodulators
- Do not hesitate to seek aggressive investigations, as appropriate (KOH staining & microscopy, culture, MALDITOF), for detecting fungal etiology
- Do not lose crucial time to initiate treatment for mucormycosis