How to deal with ‘black fungus’: ICMR guidelines

Image Source: BBC

Amidst the Coronavirus crisis in India, a new fatal enemy has emerged- Mucormycosis, commonly known as ‘Black Fungus’. It is a rare infection caused by exposure to a type of mold found all around us in plants, soil, manure and decaying objects. It affects the sinuses, the brain and the lungs and can prove fatal in patients with acute diabetes or those with compromised immune systems.

“Mucormycosis is a fungal infection that mainly affects people who are on medication for other health problems that reduce their ability to fight environmental pathogens.” — ICMR

Common pre-dispositions

As per the ICMR health advisory, the major risk factors for this infection include acute diabetes, suppressed immunity by prescribed steroids, prolonged ICU stays, voriconazole therapy and any form of co-morbidities.

Doctors believe the steroids (prescribed to most moderate-serious cases of coronavirus) being prescribed to covid patients to reduce chest inflammation is triggering this infection. These steroids end up affecting the body’s insulin levels and lower its natural immunity, reducing its ability to fight against such pathogens.

Warning signs/symptoms

Common symptoms that are experienced during Mucormycosis include pain, redness and blackish discoloration around the nasal tract, swelling in eyes, droopy eyelids with compromised vision, fever, headache, coughing, among others.

Critical symptoms include Sinusitis (inflamed nasal cavity), toothache and loosening of the jaw, skin lesions (damage); thrombosis (blood clots) & necrosis (dying of body tissue), chest pain, shortness of breath, pleural effusion (fluid in the chest cavity), hemoptysis (bloody vomits) and worsening of respiratory symptoms.

Do’s

  • Control Hyperglycemia: monitor & control blood sugar levels post-discharge, especially if diabetic
  • Properly Administer Steroids: the dosage, timing & duration
  • Keep your environment sterile, including oxygen therapy systems & humidifiers
  • Judiciously administer antibiotics and antifungal medicines
  • Maintain personal hygiene & avoid direct contact with potential carriers of dust & mold

Don’ts

  • Do not ignore if you experience stated symptoms
  • Do not hesitate from aggressive evaluation/testing towards a conclusive diagnosis
  • Discontinue immunomodulating drugs that suppress your immune system
  • Avoid extensive surgical debridement- removal of dead tissues caused by necrotic materials

Early detection, proper clinical testing and carefully monitored antifungal therapy can prevent the progression of this infection. Preventing the spread of this infection becomes an integral step in our existing war against Coronavirus.

Detailed ICMR guidelines & advisory

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