NE NEWS SERVICE
NEW DELHI, AHMEDABAD, MAY 9
Mucormycosis, a fungal infection being found in COVID-19 patients with uncontrolled diabetes and prolonged intensive care unit (ICU) stay, may turn fatal if uncared for, the Centre said on Sunday.
In an advisory, it also said the fungal infection mainly affects people who are on medication that reduces their ability to fight environmental pathogens.
The evidence-based advisory for screening, diagnosis and management of the disease was released by the Indian Council of Medical Research (ICMR) and the Union health ministry.
“Mucormycosis, if uncared for, may turn fatal. Sinuses or lungs of such individuals get affected after fungal spores are inhaled from the air,” it said.
Warning symptoms include pain and redness around eyes and nose, fever, headache, coughing, shortness of breath, bloody vomits and altered mental status, the advisory stated.
In COVID-19 patients with diabetes and immuno-suppressed individuals, one must suspect of mucormycosis if there is sinusitis, one-side facial pain or numbness, blackish discoloration over the bridge of the nose or palate, toothache, blurred or double vision with pain, skin lesion, thrombosis, chest pain and worsening respiratory symptoms, it said.
Major risk factors for this disease include uncontrolled diabetes mellitus, immunosuppression by steroids, prolonged ICU stay, malignancy and voriconazole therapy, the ICMR-health ministry advisory stated.
To prevent the disease, blood glucose level should be monitored post-COVID discharge and also in diabetic patients; steroids should be used judiciously in correct timing, dose and duration; clean sterile water should be used in humidifiers during oxygen therapy; and antibiotics and antifungal medicines should be used correctly, it said.
The disease can be managed by controlling diabetes, discontinuing immunomodulating drugs, reducing steroids and extensive surgical debridement- to remove all necrotic materials, according to the advisory.
Medical treatment includes installing peripherally inserted central catheter, maintaining adequate systemic hydration, infusion of normal saline intravenously before Amphotericin B infusion and anti-fungal therapy for at least six weeks besides monitoring the patient clinically with radio imaging for response and to detect disease progression, it said.
Gujarat sets up spl wards in hospitals, procures anti-fungal drug vials
Similar facilities will also be set up at civil hospitals in Vadodara, Surat, Rajkot, Bhavnagar, Jamnagar and other places
Amid the rise in cases of mucormycosis or ”black fungus” infection among COVID-19 survivors, the Gujarat government has started setting up separate wards in hospitals for such patients and has procured 5,000 vials of a medicine used in its treatment.
Gujarat has so far reported over 100 cases of mucormycosis, a serious but rare fungal infection which has left many patients blind and is also causing other serious issues.
Currently, 19 patients are undergoing treatment for it at the Ahmedabad Civil Hospital, as per the state government.
Two separate dedicated wards having 60 beds each have been set up at the Ahmedabad Civil Hospital for treating such patients, it said.
Similar facilities will also be set up at civil hospitals in Vadodara, Surat, Rajkot, Bhavnagar, Jamnagar and other places, the government said in a release on Saturday after a core-committee meeting on COVID-19 situation in Gujarat under the chairmanship of Chief Minister Vijay Rupani.
The state health department has also purchased 5,000 vials of Amphotericin B 50 mg injections at a cost of Rs 3.12 crore for its treatment, the release said.
In neighbouring Maharashtra, at least eight COVID-19 survivors have lost vision in an eye due to mucormycosis and 200 others are being treated, Dr Tatyarao Lahane, who heads the state government”s Directorate of Medical Education and Research, said on Saturday.
Niti Aayog Member (Health) V K Paul on Friday said mucormycosis is being found in patients with COVID-19 disease.
“The infection is caused by a fungus named mucor, which is found on wet surfaces. To a large extent, it is happening to people who have diabetes. It is very uncommon in those who are not diabetic. There is no big outbreak and we are monitoring it,” he had said.
According to Dr Paul, mucor attacks people with uncontrolled sugar.
If a diabetes patient is taking immuno-suppressive medicines, steroids, or has cancer, then the impact of mucormycosis is more on him/her.
The chances of getting this disease increase in such patients if they have been exposed to wet surfaces, he had said.
