Several states in India are seeing a rise in cases of black fungus – or ‘Mucormycosis’ – infection in people diagnosed with COVID-19. Such infections are emerging two weeks after a person has recovered from COVID-19. Recently, the Indian Council of Medical Research (ICMR) released guidelines for screening, diagnosing and managing this infection. Mucormycosis, according to the ICMR, is a fungal infection that mainly affects people who are on medication for other health problems that hamper their ability to fight environmental pathogens.
In an interview with Firstpost, Dr Mala V Kaneria, infectious diseases consultant at Jaslok Hospital and Research Centre, Mumbai, said “Mucormycosis is an uncommon infection, which is caused by mold from the family called Mucorales. This fungus is present everywhere and occurs mostly by inhalation where it enters the sinuses and lungs, or it can enter the body if a person has a burn, cut or abrasion on the skin.”
She added that the correlation between COVID-19 and Mucormycosis isn’t surprising, as the biggest risk factors for the black fungus infection are uncontrolled diabetes, and steroids, which are known to suppress immunity but are also being used to treat COVID-19 patients.
To eliminate this infection, it is important to quickly diagnose the patient as it can be aggressive and life-threatening. It affects the sinuses, eyes and can even spread to the brain. If it affects the eyes, the patient may have to undergo evisceration (disembowelment of the eye), in spite of treatment. A patient is given a combination therapy of antifungal medication and cerebral or surgical debridement.
You could have Mucormycosis if you experience a blackish or bloody discharge from your nose, pain in your cheekbones or pain/numbness/swelling on your face; toothache, chest pain and blurred vision are some of the other Mucormycosis symptoms.
What are the symptoms?
Pain and redness around eyes and/or noseFeverHeadacheCoughingShortness of breathBlood in vomitAltered mental status
Who is most at risk?
Uncontrolled diabetesImmunosuppression by steroidsProlonged ICU stayComorbidities post-transplant/malignancyKidney diseaseCancerHeart disease
How to prevent the infection
Use a mask if visiting a dusty construction siteWear shoes, long trousers, long sleeve shirts and gloves while handling soil.Maintain personal hygiene
ICMR’s things to-do
Control hyperglycemiaMonitor blood glucose level post-COVID-19 dischargeUse steroids judiciously – correct timing, dose and durationUse clean, sterile water for humidifiers during oxygen therapyUse antibiotics/antifungals judiciously
ICMR’s things not-to-do
Do not miss warning signs and symptomsDo not consider all cases with blocked nose to be bacterial sinusitis, especially in the context of immunosuppressors and/or COVID-19 patients on immunomodulatorsDo not hesitate to seek aggressive interventionsTests like KOH staining, microscopy, culture, MALDI-TOF can be done to detect fungal aetiologyDon’t lose crucial time by hesitating to initiate treatment