Treatment protocol for Mucormycosis/Black Fungus released

 Shimla : A Spokesperson of the health department here today said that the State Covid Clinical Committee has taken out a detailed treatment protocol for Mucormycosis/ Black Fungus. He informed that Mucormycosis is a fungal disease which generally affects the nose, eyes and cerebral area in a human body. The reasons for surge of black fungus disease during the pandemic of Covid-19 infection is that Covid-19 infection has a tendency to worsen diabetes, precipitate new diabetes in the patients and sometimes develops deficiency of White Blood Cells. Also the immunosuppressive treatments such as steroids being used in Covid-19 patients result in decrease in immunity. He said that the chronic respiratory disease, intubation, mechanical ventilation and coexistence of other infections during COVID-19 also increase chances of mucormycosis. He further informed that uncontrolled diabetes mellitus, immunosuppression by steroids, prolonged ICUs stay, comorbidities like malignancy, post transplant are the major risk factors for this fungal disease.The spokesperson said that nose and sinuses are the relatively early sites of Mucormycosis infection. The major symptoms that a person can be vigilant for this infection are headache, nasal obstruction which is persistent and not responding to medicines, nasal crusting and discharge, pain or loss of sensation over face, discolouration of skin, loosening of teeth, ulceration of palate or bridge of nose, black necrotic eschar in the nasal cavity and sinusitis.

The intra oral symptoms include intra oral pus discharge, ulceration of mucosa, loosening of teeth and unhealed tooth socket, mobility of maxilla. This fungal disease also affects eyes which can result in swelling and redness of eyes, double vision, loss of vision, pain in the eye, drooping eyelid.He informed that there are certain laboratory investigations that are done to confirm the disease like blood investigations, nasal endoscopic examination, X-ray, CT scan, biopsy, nasal crust sampling, bronco alveolar lavage etc. The medical management of mucormycosis is known and the disease is completely curable if detected early. This disease can be treated by injectable Antifungal amphotericin B and other medicines. This therapy continues until there is a clinical resolution of signs and symptoms of the infection as well as radiographic resolution of signs of active disease. The treatment also includes surgical debridement of the involved tissue. He said that a regular follow-up should be ensured in the initial three months. For the general public, it is informed that this disease is preventable and controlling hyperglycaemia, monitoring blood glucose level in post Covid phase, using steroid judiciously, using mask, wearing shoes, long trousers, long sleeves, gloves while handling soil, moss or manure can ensure prevention of this disease. He also urged that the patients who are on oxygen therapy or are using humidifiers should ensure to use clean sterile and boiled tap water for humidifiers. The mineral water should not be used and the water should be changed in the humidifier on daily basis. He also urged that the people should be vigilant on all the signs and symptoms of black fungus so that a timely medical aid can be sorted for.