Ujjain: Shedding light on the hitherto rare, brutal and ruthless Rhino-orbito-cerebral mucormycosis (ROCM) Dr V K Mahadik Medical director RDG Hospitals & secretary UCT and Dr Shankar Haripriya director RDG Super Speciality termed the fungal disease as a curse of God.
As the world grapples with novel†coronavirus, we now contend with another scourge in the form of Mucormycosis. Free Press interacted with the Dr Mahadik and Dr Shankar to learn about this fungal infection. Excerpts
How does it affect its victim?
Dr Shankar: These fungi live throughout the environment, particularly in soil. Mucormycosis infects people with weakened immunity like victims of coronavirus with comorbidities like diabetes.†
Other groups of people who are more likely to contract mucormycosis are the ones who:
1. Use corticosteroid for long time
2. Have undergone organ transplant
3. Are victims of cancer specialy blood malignancies
4. Are using immunosuppressants
5. Are suffering from neutropenia†(low number of white blood cells)
6. Have excess of iron and Zinc in the body†
7. Have history of trauma, skin injury due to surgery, burns, or wounds
8. And babies who are born prematurity and have low birth weight
Also Read: Maharashtra govt struggles with Black Fungus, Amphotericin B dearth
Why is it called Black fungus?
Dr Shankar: Mucormycosis fungi invade the surrounding blood vessels and destroy them resulting in tissue necrosis and death. The damaged tissues turn black, so the condition is called black fungus infection
Is it contagious?
The disease itself is not contagious and doesnít spread from one person to another. Dr Shankar said.
How do we diagnose the infection?
Dr Mahadik: Nasal blockage, bleeding, discharge from the nose are initial features of mucormycosis. Medical history, symptoms, physical examination and laboratory tests help in establishing diagnosis. Analysis of fluid from sinuses and lungs, tissue biopsy, imaging tests like MRI and CT scan of the nasal cavity, sinuses, lungs and brain and endoscopy gives way to the diagnosis.
Also Read: Bhopal: Striking GMC junior doctors demonstrate covering themselves with coffin shrouds
Can there be other fungal infections in COVID 19 patients?
Dr Mahadik: In western countries there has been an increased incidence of other fungal infections like aspergillosis and candidiasis in COVID-19 patients.
What is the reason for its high incidence in the country?
Dr Mahadik: We need to conduct epidemiological studies to assess why these cases are rising now
How is this treated?
Dr Shankar: Immediate surgical debulking is a must and should be undertaken a couple of hours of the diagnosis. In tandem, medical management with antifungal drugs, namely injection Liposomal amphotericin-B needs to be instituted. The surgery can be radical and disfiguring but is acceptable considering the existential crisis.
Are these infections life-threatening?
Unfortunately, Yes. The mortality ranges between 25 to 90%, as of now it is quoted more than 50% in our country.
Dr. Shankar: The key to survival is early diagnosis and prompt institution of treatment.
Message for people and health care providers
1. Wear masks compulsorily
2. Isolate mucormycosis patients from others
3. Strict monitoring
4. Timely intervention and treatment
5. The judicious & justified use of steroids†
6. Tight Blood Sugar control in Covid patient.
7. Strict and proper hygiene of Covid patient in Hospital during Covid care like
8. Oral hygiene
9. Cleaning and replacement of humidifiers in 48 hour
10. Care of endotracheal tube Ventilator / BIPAP circuit humidifier care.
11. Only Medical grade oxygen to be used
12. Sterile normal saline or sterile Water should be used in humidifiers and Oxygen flow meter and have to be changed daily.
13. The blanket use of zinc in the treatment of Covid patients must stop, or to be used judicially.
14. Initial studies have indicated presence of metals such as zinc and iron in the body provides a suitable environment for the fungi to grow faster that cause Black Fungus. studies are still going on.
Admin fails to provide the count of black fungus patients
CM Shivraj Singh has expressed concern about the 987 people of the state are undergoing treatment for black fungus. However, the officials of district administration including the collector and CMHO failed to respond to the queries about the number of patients under treatment for black fungus in Ujjain.
Also Read: Indore: Will vaccinate all in the city with two doses by November, says MP Shankar Lalwani
source https://www.freepressjournal.in/indore/ujjain-mucormycosis-a-curse-of-god
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