MUCORMYCOSIS – THE NEW THREAT IN COVID TIMES
As we are in the middle of a COVID 19 crisis there is another deadly disease being increasingly seen in a select group of hospitalised and even recovered patients – Mucormycosis or “The Black Fungus”
What is Mucormycosis?
• It is a serious but rare type of fungal infection caused by molds called “mucormycetes” most commonly affecting the sinuses, skin, eyes, lungs and brain.
• It mainly affects people who have a reduced ability to deal with infections like Diabetics or are on certain medications like Steroids which increase blood sugar levels and lower immunity.
Why is it a concern in COVID patients?
• Long hospital stay
• Use of immunosuppresant drugs like Steroids/Tocilizumab
• Prolonged use of humidified oxygen
All these factors make such patients more vulnerable to develop opportunistic infections like mucormycosis.
What are the signs and symptoms?
• Headache, Facial pain, numbness or swelling
• Stuffy nose or bloody/brownish nasal discharge
• Blurring of vision or double vision
• Dental pain or loosening of teeth
• Red eye
• Swelling or drooping of eyelid
• Restriction of eye movements
• Blackish pigment deposition over palate
• Chest pain, persistent fever or cough
How to prevent it?
• Control blood sugar level of all admitted patients and also post covid discharged patients.
• Use steroids judiciously – correct timing, dose and duration.
• Use sterile distilled water for humidifiers during oxygen therapy.
• Timely cleaning and replacement of masks, tubes and cannulae.
• Maintain oral and nasal hygiene of all patients with betadine gargles and nasal saline drops.
• Be vigilent and don’t neglect any early sign or symptom suggestive of such infection.
How to treat it?
Mucormycosis is a life threatening infection and needs an urgent multidisciplinary approach with a team of Microbiologist, Ophthalmologist, ENT specialist and Neurologist to manage.
• Get all investigations done – CBC, Blood sugar, Renal funtion tests, KOH staining of nasal swab
• CT scan or MRI Orbit and PNS to know extent of involvement.
• Strict control of Blood sugar with Insulin
• Tapering of steroids
• Antifungals :-
Inj. Amphotericin B (Liposomal/Lipid complex) 2-5mg/kg/day for 4-6 weeks.
Tab. Posconazole loading dose 300mg BD followed by 300mg OD for 4-6 weeks.
• Early surgical debridement of necrotic tissue.
For more details contact :-
Dr. Manbir Singh
Hi-Tech Eye Care & Laser Center
B-12, Vidya Nagar, Hoshangabad Road, Bhopal