Description: Covid patient’s “black fungus”

A rare but serious fungal infection, commonly known as “black fungus”, is detected relatively frequently as mucormycosis. COVID-19 Patients in some states. The disease often appears on the skin and affects the lungs and brain.In the number of A case of mucormycosis was detected In Delhi, Maharashtra and Gujarat, experts from the Covid-19 Task Force across the country issued evidence-based recommendations for the disease on Sunday.

What is the illness?

It is a rare but serious infection. It is caused by a group of molds known as mucormicetes that are naturally present in the environment. Covid-19 Task Force According to Task Force experts, this primarily affects people taking health medications and reduces their ability to fight environmental pathogens.

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The sinuses or lungs of such individuals are affected after inhaling fungal spores from the air. Doctors in some states have pointed out an increasing number of cases of mucormycosis among people hospitalized or recovering from Covid 19, and some states require emergency surgery. Mucolmycetes usually does not pose a major threat to people with a healthy immune system.

What happens if I sign a contract?

Signs of warning include pain and redness around the eyes and nose, fever, headache, cough, shortness of breath, vomiting of blood, and changes in mental status. According to the advisory, you should suspect an infection with Mucormaisetes in the following cases:

* Sinusitis — stuffy nose or congestion, runny nose (dark / blood).
* Local pain in the cheekbones, pain in one side of the face, numbness or swelling;
* Blackish discoloration on the nasopalatine bridge;
* Loose teeth, jaw involvement;
* Blurred vision or diplopia and pain;
* Thrombosis, necrosis, skin lesions;
* Chest pain, pleural effusion, worsening respiratory symptoms.

Experts advise that all cases of nasal congestion should not be counted as cases of bacterial sinusitis, especially in the context of Covid-19 patients who are using immunosuppressive and / or immunomodulators. Do not hesitate to seek active investigation to detect fungal infections, they advise.

What is the treatment?

Although treated with antifungal agents, mucormycosis may eventually require surgery. Doctors say it is of utmost importance to control diabetes, reduce steroid use, and discontinue immunomodulators. To maintain proper systemic hydration, treatment includes regular saline (IV) injections prior to amphotericin B injections and antifungal therapy for at least 4-6 weeks.

Task force experts emphasize the need to control hyperglycemia, post-discharge after Covid-19 treatment, and monitor blood glucose levels in diabetics. Steroids should be used with caution — the right timing, the right dose, and the duration are important.

Managing Covid patients with Mucor’s disease is a team effort involving microbiologists, physicians, intensivists, otolaryngologists, ophthalmologists, dentists, surgeons (maxillofacial / plastic) and others.

What kind of surgery do you need?

Mucormycosis can lead to loss of the maxilla and sometimes the eyes. “Patients must agree to lose function due to the lack of a jaw. It is difficult to chew, swallow, facial aesthetics, and lose self-esteem,” says the doctor. Whether eyes or maxilla, these can be replaced with suitable artificial substitutes or prostheses. Prosthetic replacement of lost facial structures can begin when the patient stabilizes after surgery, but doctors reassure him about the availability of such interventions rather than panicking with sudden and unexpected loss. It is important to let them do it. It’s already a reality, “said Dr. B Srinivasan, a maxillofacial prosthodontic dentist. “Prosthesis reconstruction can be done after surgery, but for better long-term results, provisional solutions need to be planned even before jaw surgery. Prosthesis reconstruction is a treatment. Can be assured that is less scary than the illness itself, “he said.

How can I prevent it?

It should be remembered that it is a rare illness. However, some groups are more vulnerable than others. Patients are predisposed to uncontrolled diabetes, steroid immunosuppression, prolonged ICU stay, and comorbidities—post-transplant / malignancies, voriconazole therapy.

Experts are advised to use masks when visiting dusty construction sites. Wear shoes, long trousers, long-sleeved shirts and gloves when handling soil (gardening), moss and fertilizer. Maintain personal hygiene, including a thorough scrub bath.

How often are cases detected?

There were no major outbreaks while the number of cases increased. Dr. VK Paul, a member of Niti Aayog (health), said at a media briefing that there were no outbreaks and that he was monitoring reported cases.

In Maharashtra, Dr. Tatiarao Rahane, director of medical education and research, said the number of cases of mucormycosis is increasing. Dr. Parixit Gogate, who consults with an ophthalmologist at the Ruby Hall Clinic in Pune, said: “But in the last couple of weeks, I’ve seen almost 25-30 of them, mostly at Ruby Hall, and some at DY Patil Hospital.”

Mucor disease, which develops in the post-Covid-19 setting, breaks the backs of families of patients who have barely recovered from this viral infection, Pune infection consultant Dr Rajeev Soman wrote in the Indian Medical Association in January this year. I have.

Dr. Soman is one of the expert members who drafted the recommendations as part of the National Covid-19 Task Force. The task force also includes Dr Arunaloke Chakraborti, Dean of the Department of Medical Microbiology at PGIMER. ChandigarhDr. Atule Patel, an infectious disease specialist in Ahmedabad. And some others.

Patients who are most vulnerable to mucormycosis are those who have been treated with steroids or other medications for Covid19 to reduce inflammation. Efforts are underway to collect data for large-scale studies being conducted by the Fungal Infectious Diseases Research Forum and the Clinical Infectious Diseases Association, Dr. Soman said.

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What is Mucormycosis?

Mucor disease, commonly referred to as black fungus, is a rare but serious fungal infection caused by a type of fungus called mucormaisete that is abundant in the environment. This primarily affects people with health problems and those taking medications that reduce the body’s ability to fight bacteria and illness.

Symptomatology
These include pain and redness around the eyes and nose, fever, headache, cough, shortness of breath, vomiting of blood, and changes in mental status. Signs of warning include toothache, loose teeth, blurred vision, or painful diplopia.

Who is vulnerable
Vulnerable groups include those with health problems and those taking medications that reduce the body’s ability to fight bacteria and illness.These include diabetics cancer, Or a person who has had an organ transplant.

Prevention
Use a mask when visiting a dusty construction site. Wear shoes, long trousers, long-sleeved shirts and gloves during gardening. Maintain personal hygiene, including a thorough scrub bath.

Diagnosis
It depends on where the infection is suspected. Liquid samples from the respiratory system may be collected for laboratory testing. Otherwise, a tissue biopsy or CT scan of the lungs, sinuses, etc. may be done.

processing
Mucormycosis should be treated with prescribed antifungal drugs. In some cases, surgery may be required. It can eventually lead to loss of the upper jaw and sometimes the eyes.