City based doctors have stepped up awareness about mucormycosis which is emerging as a significant challenge in the second wave of Covid 19 infections. This is a rare but serious fungal infection, and usually poses no serious threat to those with a healthy immune system. However, doctors are now noticing a rise in mucormycosis amongst people hospitalised for or recovering from COVID-19.
High blood sugar and low immune function are the strongest risk factors for mucormycosis. Patients most vulnerable to mucormycosis are those who have been treated with steroids and other drugs for COVID-19, to reduce inflammation, Dr Rajeev Soman, Consultant Infectious Diseases Physician, Jupiter Hospital said.
Although, cases of mucormycosis are being seen across the country, doctors are stepping up efforts to collect data for large studies being done by the Fungal Infections Study Forum & Clinical Infectious Diseases Society, Dr Soman said.
Caused by a group of molds called mucormycetes, they live throughout the environment. Mucormycosis mainly affects people who have a weakened immune system. Some of the drugs used to treat Covid 19, can also suppress the immune system, eye surgeons have said. Steroids can affect blood glucose levels, especially in those who already have diabetes. These are conditions that support the growth of this fungus, doctors said.
The most commonly affected areas by mucor include nose, sinuses, eyes and brain. Patients discharged after COVID-19 should be taught to seek immediate medical attention, should they notice any symptoms such as: facial swelling, pain, numbness, eye swelling, bloody or black- brown discharge from the nose. In addition, since most doctors have only a passing knowledge about mucormycosis, they need to be made aware about how to suspect it and proceed with the diagnostic and therapeutic strategies, Dr Soman pointed out.
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Some of the drugs used to treat Covid 19, can also suppress the immune system, eye surgeons have said. Steroids worsen blood glucose levels, especially in those who already have diabetes. These are conditions that support the growth of this fungus
Dr Ramesh Murthy, eye surgeon at Deenanath Mangeshkar hospital said that symptoms like pain behind the eyes, a headache that is persistent should not be ignored. He admitted that in the last two months they have seen approximately 45 such cases. According to Dr Parikshit Gogate, consulting ophthalmologist at Ruby Hall Clinica, these are rare cases and one would see one case in a month. However since they are managed under ENT physicians – some days ago there were four at a time. In some cases we had to remove the eyes as the fungus spreads to the brain and can be life threatening.
This is an opportunistic infection, Dr Aditya Kelkar, Director of National Institute of Opthalmology said who admitted to treating two cases last month. “Mucor grows behind the eye and can compress the optic nerve and lead to a lot of damage. It can also potentially spread to the brain if immediate intervention is not provided,” Dr Kelkar said.