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….
