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Patients with poor control of blood sugar and immunocompromised systems are most vulnerable to this infection, says Dr ( Lt General) Ved Chaturvedi, MD.DM, Rheumatologist and Immunologist, Sir Gangaram Hospital

When Indians were still learning to cope with the newly discovered double and triple mutant strains of Covid-19, another thunderous news added to their fears – cases of Mucormycosis, or the black fungus.

As many as 100 cases of black fungus were reported in Gujarat, while Maharashtra’s health minister Rajesh Tope hinted at almost 2,000 unconfirmed cases in the state. Though this infection isn’t new, its rapid increase spotted amongst Covid patients is a cause of worry. Money9 spoke to Dr ( Lt General) Ved Chaturvedi, MD DM, Rheumatologist and Immunologist, Sir Gangaram Hospital, New Delhi about the disease. Read excerpts:

What is mucormycosis and which organs can it primarily attack?

Fungus infection is not a new discovery. One of the most common forms of fungal infection is caused around sweat releasing body parts – thighs and axilla. People living in tropical zones suffer from itching which is also caused due to fungal infection. However, such infections are easily curable. Meanwhile, Mucormycosis is a serious fungal infection caused by a group of molds called ‘Mucormycetes’. It is known as Rhino-oculo cerebral mucormycosis (ROCM).

It affects body parts from where it can get inhaled into the system – nose, paranasal sinuses extending to orbit, brain, and palate. Patients with poor control of blood sugar and immunocompromised systems are most vulnerable to this infection. What makes it lethal is its invasive nature. The fungus drills itself inside the human body and settles in the eye orbit and later into the brain.

What are the symptoms?

Most common symptoms include – nose bleeding, coughing, swollen face and eyes, severe pain in the nasal passage, etc. If not treated on time, the fungus can travel from the eyes to the brain.

Sometimes this fungus enters inside the blood vessels and stops the blood supply to the particular organ. What happens if it enters the vessels transporting blood to the lips? The lips turn black. Hence the popular name ‘black fungus’.

What is the reason behind the sudden rise in the cases of black fungus? Is there are a direct link to Covid-19?

Pre-pandemic, cases of black fungus were few. Now, at least 100 cases are identified each day. The factors that cause this infection include old age, high blood sugar, unhygienic surroundings, etc. It is important to note that the steroids being given to patients for Covid treatment also trigger the blood sugar levels and hence must be used very cautiously.

The possibility of a linkage between Covid-19 and black fungus cannot be ruled out. But I’d say a combination of factors are responsible for the sudden spike in numbers. Impure water used in oxygen cylinders to humidify the air entering the user’s nasal cavity, mouth, and throat can also be responsible for spreading this disease.

How can this disease be prevented?

The most important thing is to note down the blood sugar level of any Covid patient being admitted to the hospitals. Controlling sugar levels and blood glucose of diabetic and other immunocompromised people is mandatory. Maintaining personal hygiene in the hospital bed is very crucial. Make sure the oxygen mask is sanitised before usage and distilled water is used for artificial oxygen support for the patient.

Before administering any steroids or medicines, doctors and nurses must review the patient’s medical history and take note of any pre-existing illness. Awareness is the key.

How can it be treated?

Amphotericin B is the medicine used for the treatment of black fungus. It is still not readily available in the market and we request the government to provide it for proper treatment of the disease.

Once the patient is infected, an eye specialist and ear-nose-throat (ENT) specialist would be required to supervise the treatment. If the case is severe and the infection reaches the brain, a neurologist may be required as well.

Published: May 18, 2021, 18:17 IST
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