Union Health Minister Dr. Harsh Vardhan on Friday advised people on the early detection and management of Mucormycosis – commonly known as Black Fungus, a rare but serious condition that has been reported in several coronavirus patients, especially in Maharashtra.
As COVID-19 cases are increasing, it's of paramount importance that we follow protocols of infection control practices at hospitals. It is been seen that secondary infections — fungal & bacterial — are causing more mortality: AIIMS Director Randeep Guleria pic.twitter.com/xQ85pKFTNO
— ANI (@ANI) May 15, 2021
What is Mucormycosis (Black Fungus)?
Mucormycosis or black fungus is a complication caused by a sort of fungal infection. People capture mucormycosis by coming into contact with fungal spores in the environment. It can also develop on the skin after entering the skin through bites, scratches, burns, or other types of skin trauma.
The disease is being detected in patients who have recovered or are cured with COVID-19. Also, anyone who is a diabetic and whose immune system is not functioning properly needs to be cautious.
What type of conditions of COVID-19 patients increases the risk of Mucormycosis (Black Fungus)?
According to ICMR, the following in COVID-19 patients increase the risk of Mucormycosis infection-
- Uncontrolled Diabetes.
- The immune system is weak because of excessive use of steroids.
- Longer ICU/Hospital stay.
- Post Organ Transplant
- Cancer Patients.
- Voriconazole therapy (used to treat serious fungal infection).
How is Black Fungus related to COVID-19?
The disease is caused by a group of micro-organisms known as micromycetes, which are naturally present in the environment mostly in soil, and the decay of organic materials such as leaves, compost, and piles.
In general, our body’s immune system successfully fights such fungal infections. However, covid-19 affects our immune system. In addition, treatment of covid-19 involves the intake of drugs such as dexamethasone, which suppresses the response of our immune system. Because of these factors, COVID-19 patients face a new risk of failing in the fight against attacks by organisms such as micromycetes.
In addition, where a humidifier is used, covid patients undergoing oxygen therapy in the ICU are at risk of fungal infection due to exposure to moisture.
But this does not mean that every covid patient will be infected with mucormycosis. The disease is uncommon among people who do not have diabetes, but it can be fatal if not treated immediately. The likelihood of recovery depends on early diagnosis and treatment.
What are the common symptom of Mucormycosis (Black Fungus)
- Mucormycosis begins to manifest as skin infection in the pockets located behind our forehead, nose, cheekbones, and in between the eyes and teeth.
- It then spreads to the eyes, lungs and can even spread to the brain.
- Pain or redness around the eyes, fever, headache, coughing, shortness of breath, bloody vomit, and altered mental status are possible symptoms of the infection, the minister added.
- Don’t consider all cases of the blocked nose as cases of bacterial sinusitis, especially in the cases of immunosuppression and/ or COVID-19 patients on immunomodulators,” the minister advised in his tweet.
How Mucormycosis (Black Fungus) is treated?
- While the infection can begin with just one skin infection, it can spread to other parts of the body.
- Treatment involves surgically removing all dead and infected tissue.
- In some patients, this results in loss of the upper jaw or sometimes even the eye.
- Treatment may also include a 4-6 week course of intravenous antifungal therapy.
- Since it affects different parts of the body, treatment requires a team of microbiologists, internal medicine specialists, intensive neurologists, ENT specialists, ophthalmologists, dentists, surgeons, and others.
- Controlling diabetes is one of the major prevention methods suggested by the ICMR.
- Therefore, COVID-19 patients who are diabetic need to take extreme caution.
- Self-medication and high doses of steroids can result in fatal events and therefore doctor’s prescriptions should be strictly followed.
What did Dr. V K Paul member of Niti Ayog said on the usage of Steroids?
- VK Paul member of Niti Ayog said the Steroids shouldn’t be provided at the early stage of COVID-19 disease.
- It should be given and taken after the 6th day of COVID-19 infection.
- Covid-19 patients should take the drugs for a particular number of days and stick the appropriate doses of the drug as prescribed by the doctor.
- Other than steroids, the use of Covid-19 drugs such as Tocilizumob, Itolizumab also suppresses the immune system. When these drugs are not used appropriately, it increases the risk the immune system fails to fight the fungal infection- Dr. Paul adds.
It should be ensured that the water in the humidifier is clean and refilled regularly for patients on oxygen therapy. Care should be taken to ensure that water does not leak (to avoid wet surfaces where the fungus can breed). Patients should maintain proper hygiene by keeping their hands as well as the body clean.
As many as 111 patients, all COVID-19 survivors, are undergoing treatment for mucormycosis in hospitals in the state capital Mumbai, according to the Brihanmumbai Municipal Corporation (BMC). A 44-year-old man in Mumbai lost his eyesight due to a fungal infection.
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