The Vijay Rupani-led Gujarat administration has announced that all government-run hospitals reporting incidents of mucormycosis, a fungal infection more commonly known as “black fungus”, will set up separate wards to treat these patients, The Indian Express reported on Sunday.
The rare infection is caused by a fungus named mucor, which is found on wet surfaces. General symptoms of the black fungus infection include headache, fever, pain under the eyes, nasal or sinus congestion, and partial loss of vision among others.
The fungal infection has been reported among Covid-19 patients in Delhi, Maharashtra and Gujarat.
Eight recovered Covid-19 patients have died in Maharashtra after developing the fungal infection, according to PTI. More than 100 patients are being treated in Gujarat and the infection has also been detected among Covid-19 patients recuperating in Delhi’s hospitals.
Tatyarao Lahane, who heads the Directorate of Medical Education and Research, told PTI that the disease was not new, but cases of it were increasing due to Covid-19 complications. He said the infection may occur as the use of a humidifier potentially increased the risk of the fungal infection among Covid-19 patients given oxygen support.
Among other potential causes of the fungal infection was use of steroids for Covid-19 treatment, which increases the blood sugar levels. Lahane added that some medicines also caused suppression of immunity among patients that could lead to the infection.
Steroids reduce inflammation in the lungs for Covid-19 and the body’s immune system goes into overdrive to fight off the virus. However, they also may reduce immunity and push up blood sugar levels in both diabetic and non-diabetic Covid-19 patients, according to doctors quoted by the BBC. The drop in immunity might then lead to the “black fungus”.
“If the fungus reaches the brain of the infected person, it can prove fatal,” according to Lahane. “In one such case, one of the eyes of a patient had to be removed permanently to save his life.”
Akshay Nair, a Mumbai-based eye surgeon told BBC that he had come across 40 cases of the fungal infection since April. Many of them were diabetics, who had recovered from Covid-19, while 11 of them had to have an eye surgically removed.
Nair added that between December and February, six of his colleagues in five cities – Mumbai, Bangalore, Hyderabad, Delhi and Pune – reported 58 cases of the infection. Most of these patients had contracted the fungal infection between 12 to 15 days after recovery from Covid-19.
Manish Munjal, senior ENT surgeon at Delhi’s Sir Ganga Ram Hospital also said that they were witnessing a rise in black fungus cases in the national Capital, PTI reported. “Last year, this deadly infection caused a high mortality with many patients suffering from loss of eyesight and the removal of the nose and the jaw bone,” Munjal said.
ICMR issues advisory
Meanwhile, the Indian Council of Medical Research on Sunday issued an advisory for cases of black fungus.
Here are some important pointers from the advisory:
- Sinusitis – nasal blockade or congestion, nasal discharge
- One sided facial pain, numbness or swelling
- Blackish discoloration over bridge of nose/palate
- Toothache, loosening of teeth, jaw involvement
- Blurred or double vision with pain
What you can do
- Control blood sugar levels
- Monitor blood glucose level post Covid-19 discharge and also in diabetics
- Use steroids judiciously – correct timing, correct dose and duration
- Use clean, sterile water for humidifiers during oxygen therapy
- Use antibiotics/antifungals judiciously
What you should not do
- Do not miss warning signs and symptoms
- Do not consider all the cases with blocked nose as cases of bacterial sinusitis
- Do not lose crucial time to initiate treatment for mucormycosis
- Do not hesitate to seek aggressive investigations, as appropriate, for detecting fungal etiology