General News

What is Black fungus – Mucormycosis – symptoms of black fungus

As per the ICMR guidelines people should follow the quarantine guidelines, social distancing, doctors guidelines to relief from this pandemic.

Mucormycosis is a fungal infection that mainly affects people who are on medication for otherhealth problems that reduces their ability to fightenvironmental pathogens.

Sinuses or lungs of such individuals get affectedafter fungal spores are inhaled from the air.

This can lead to serious disease with warning sign and symptomsas follows:

Pain and redness around eyes and/or nose

Fever

Headache

Coughing

Shortness of breath

Bloody vomits

Altered mental status

What predisposes

Uncontrolled diabetes mellitusImmunosuppression by steroidsProlonged ICU stayCo-morbidities – post transplant/malignancyVoriconazole therapy

How to prevent

Use masks if you are visiting dusty construction sites

Wear shoes, long trousers, long sleeve shirts and gloves

while handling soil (gardening), moss or manure

Maintain personal hygiene including thorough scrub bath

When to Suspect(in COVID-19 patients, diabetics or immunosuppressed indiviuals )

Sinusitis – nasal blockade or congestion, nasal discharge(blackish/bloody), local pain on the cheek bone

One sided facial pain, numbness or swelling

Blackish discoloration over bridge of nose/palate

Toothache, loosening of teeth, jaw involvement

Blurred or double vision with pain; fever, skin lesion;thrombosis & necrosis (eschar)

Chest pain, pleural effusion, haemoptysis, worsening ofrespiratory symptoms

Do’S

Control hyperglycemia

Monitor blood glucose level post COVID-19 discharge andalso in diabetics

Use steroid judiciously – correct timing, correct dose anddurationUse

clean, sterile water for humidifiers during oxygentherapyUse

antibiotics/antifungals judiciously

Don’ts

Do not miss warning signs and symptoms

Do not consider all the cases with blocked nose as cases of bacterial sinusitis, particularly in the context ofimmunosuppression and/or COVID-19 patients onimmunomodulators

Do not hesitate to seek aggressive investigations, asappropriate (KOH staining & microscopy, culture, MALDI-TOF), for detecting fungal etiology

Do not lose crucial time to initiate treatment formucormycosis

How To Manage

Control diabetes and diabetic ketoacidosis

Reduce steroids (if patient is still on) with aim todiscontinue rapidly

Discontinue immunomodulating drugs

No antifungal prophylaxis needed

Extensive Surgical Debridement – to remove all necroticmaterials

Medical treatment

– Install peripherally inserted central catheter (PICCline)

– Maintain adequate systemic hydration

– Infuse Normal saline IV before Amphotericin Binfusion

– Antifungal Therapy, for at least 4-6 weeks (see theguidelines below )

Monitor patients clinically and with radio-imaging forresponse and to detect disease progression

Kindly Refer Your Doctor… Wear Mask… Stay Safe.. Stay at home….

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