The new scare: Post Covid Mucormycosis
As though recovering from Covid was not enough, some are falling prey to another lifethreatening infection, this time with a fungus, called Mucormycosis, often being called the Black fungus disease.
Mr PS (name change) a 50-yearold who had recovered from Covid barely a months ago, rushed here with an unusual one-sided headache and facial swelling of five days that had kept getting worse.
His Covid attack had been moderately severe, with fever, cough and slight fall in oxygen saturation. He had required oxygen therapy in his hometown in Bihar where his doctor had prescribed him steroids (Dexamethasone) that had miraculously settled both his temperature and cough at the cost of pushing up his blood sugars. As he had felt better, he had continued dexamethasone for a month.
His left sided headache, nasal blockage and facial swelling, especially over the left eyelid had continued to worsen, compelling him going to a hospital for help.
Dr Gursimran Kaur, who attended on him at Fortis Hospital, Gurgaon had noticed a strange asymmetry of his upper face and had ordered a CET scan of the head. An ENT consultation later, he was subjected to a surgical exploration and drainage of his bulging sinuses. They were found to be full of blackish pus that had reached the brain. And sure enough, the pus removed showed hyphae of Mucormycosis under the microscope.
He is now undergoing treatment with the injectable anti-fungal drug called Amphotericin B, and feeling better, but the treatment is expected to be long and is not without side effects.
Mucor is a fungus that is present in the soil, and very rarely causes disease in the human body…only when its immune system is very weak and lets it in. The recent outbreak in India where over 800 cases have been reported have mostly happened in the setting of Covid + steroids. Many have been diabetic as well.
Steroids have been found to be lifesaving in patients of severe or critical Covid infections: they suppress the cytokine storm that destroys lung and other tissues and can pull a sick patient back to life.
They however also have another edge: they suppress body’s immunity, increase sugar levels, and allow germs to invade the body with ease…sometimes giving a green card to even the Mucor fungus.
Mucormycosis used to be rare, in patients who had been through organ transplantation, had AIDS, lymphomas or had been on immuno-suppressive drugs for long. The present wave of increasing numbers seems to be in the setting of a Covid patient receiving steroids, especially if he has diabetes, and was given oxygen therapy from questionable source.
Greater awareness and timely action can save many who have just wriggled out from a bad viral infection and are now being attacked by a doughty fungus!