Mucormycosis isn’t a new disease. It’s caused by a group of molds, called mucormycetes. Individuals are infected after inhaling fungal spores found naturally in India’s environment and soil. Sinuses or lungs of such individuals get affected after they inhale fungal spores from the air. Doctors in some states have noted a rise in cases of mucormycosis among people hospitalized or recovering from Covid 19, with some requiring urgent surgery. Usually, mucormycetes does not pose a major threat to those with a healthy immune system.
Symptoms of rhinocerebral (sinus and brain) mucormycosis include:
- One-sided facial swelling
- Headache
- Nasal or sinus congestion
- Black lesions on nasal bridge or upper inside of mouth that quickly become more severe
- Fever
Symptoms of pulmonary (lung) mucormycosis include:
- Fever
- Cough
- Chest pain
- Shortness of breath
Symptoms of gastrointestinal mucormycosis include:
- Abdominal pain
- Nausea and vomiting
- Gastrointestinal bleeding
Treatment
Although treated with antifungals, mucormycosis may eventually require surgery. Doctors said it was of the utmost importance to control diabetes, reduce steroid use, and stop immunomodulatory drugs. To maintain adequate systemic hydration, treatment includes an infusion of normal saline (IV) before the amphotericin B infusion and antifungal therapy, for at least 4 to 6 weeks. Experts in the task force stressed the need to control hyperglycemia and monitor blood sugar after discharge after treatment with Covid-19, as well as in diabetics. Steroids need to be used wisely – the right timing, the right dose, and the length of time are important. The management of Covid patients with mucormycosis is a team effort involving microbiologists, internal medicine specialists, intensive neurologists, ENT specialists, ophthalmologists, dentists, surgeons (maxillofacial / plastic) and other.
