Doctors from a city hospital have seen an increase in cases of a rare fungal infection with immune-compromised coronavirus disease (Covid-19) patients getting it. If not detected early, the infection – Mucormycosis also known as black fungus – can kill half the patients and lead to loss of vision or jaw in others.
Sir Ganga Ram hospital has seen 10 cases of Mucormycosis in the last 15 days in patients who either had Covid-19 or had recently recovered from it. In comparison, the hospital sees about five cases of the infection in a year.
“Like any fungal infection, Mucormycosis is opportunistic and happens in mostly immune-compromised patients like those with diabetes, kidney disease, or those who have had transplants. Even in the cases that we have seen recently, the patients had other comorbid conditions but Covid-19 seems to have weakened their immunity further. Also, many Covid-19 patients are given steroids and other drugs that might lower their immunity further,” said Dr. Shaloo Bageja, senior eye surgeon at Sir Ganga Ram hospital.
A 32-year-old businessman from West Delhi was diagnosed with Covid-19 on November 20. His fever did not break for four days and he started getting excessive cough and breathing difficulty. He was admitted to a hospital and was given antiviral drugs, steroids, oxygen and other supplements. He was discharged after seven days.
He returned to the hospital with a nagging left-side nose obstruction and eye swelling. He did not respond to antibiotics and pain killers and started losing vision rapidly on the affected side. The entire left-side of the face had become numb. His tests revealed that he had Mucormycosis.
The infection had affected his left sinus, eye, upper jaw bone and muscles, and even the brain. Surgeons had to remove the affected tissue. He was given antiviral medications and critical care support. He survived but was disfigured.
“Early clinical suspicion on symptoms such as nose obstruction, swelling in the eye or cheeks, and black dry crusts in the nose should immediately prompt the conduct of a biopsy in the OPD and start of the antifungal therapy as early as possible,” said Dr Manish Munjal, senior ENT surgeon at Sir Ganga Ram Hospital. “Especially if a patient has a history of Covid-19 and other comorbidities,” said Dr Bagheja.
The symptoms may take a couple of weeks to just a couple of days to become grave. “The spread of the infection depends on how your immune system is working. It may take up to two weeks for the situation to become grave where we might need to remove the eyes of the patients. However, in the current cases we saw that the infection got worse even within a couple of days and it also happened in young patients – 30 to 40 year olds,” said Dr Bagheja.
