Black fungus: Top doctors answer all FAQs about new threat in Covid times

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Mucormycosis, or black fungus, is caused by a group of molds known as mucormycetes that are naturally found in the environment. (File photo)

At the Doctors’ Roundtable with India Today, the editor of TV Consulting, Rajdeep Sardesai, top experts answer all your FAQs as Black fungus or mucormycosis are becoming a new threat about states in Covid times.

Q: Can you demystify black mushroom? And why did it raise its head in Covid times?

DR.SUBRAMANIAN SWAMINATHAN, DIRECTOR, INFECTIOUS DISEASES, GLENEAGLES GLOBAL HEALTH CITY, CHENNAI:

We are aware of such fungal infections in the most at risk, including diabetics with poorly controlled sugar levels or kidney failure, patients undergoing severe cancer treatment, and organ transplants. Outside of this, black mushroom is quite rare. It can affect any part of the body. Typical presentation includes sinuses that extend to the eyes, areas of teeth, and up into the brain. It can happen very quickly. It can be fatal if not picked up early.

Also read | Explained: What is Black Mushroom?

Covid 1.0 affected elderly people who are more likely to have diabetes, have weak immune systems, and are receiving steroids. But we didn’t see many mucormycosis cases in round one. The question is: what has changed? The fungus entered the equation this round and we have to wonder what we did wrong. If you have a yeast infection, why doesn’t it go to the lungs? Because that’s the most damaged part. The reason is: it’s in the air. Refilled cylinders and other such reused devices have very high levels of fungal contamination. And when you start blasting people’s nostrils, you put it right in their sinuses. It’s a tinderbox waiting to go. My strongest suspicions are: This time it is the air quality that affects the balance.

Q: What should you look out for?

DR.RAHUL MODI, -ENT & HEAD AND NECK SURGEON, DR.LH HIRANANDANI HOSPITAL, MUMBAI:

Studies have shown that many healthy people may have fungus in their nose, but the fungus does not begin to invade the system until after immunity drops. It’s a combination of overuse of steroids and high blood sugar, especially when a patient is discharged from the hospital and has poor follow-up care. Symptoms can include nasal blockage, nasal irrigation, facial pain, and toothache. We need to be very suspicious, especially in the first 60 days when the patient has been given excessive steroids and oxygen and has been using a ventilator for a long time.

Also read | Black mushroom: tracing the existence of rare diseases back to before Covid

Q: Is there a direct link between your failure to control sugar levels and black fungus?

DR.SUJEET JHA, PRINCIPAL DIRECTOR, ENDOCRINOLOGY, MAX HEALTHCARE, SAKET:

A third of the Indian population is prone to diabetes. We always use steroids too. But we never had Covid, nasal cannula, steroids and diabetes together. We also used a lot of antibiotics. Steroids are stored in every home. Our body has a strong immune system. Usually this fungus only invades our bodies when you are vulnerable. Unless your immunity is compromised.

Q: Many patients complain of double vision, blurred vision, and total blindness. What has changed so suddenly?

DR.NAVIN SAKHUJA, LEADING OPHTHALMOLOGIST:

It’s a combination of factors. People with diabetes are more prone to black fungus. They are the ones who stay in hospitals longer because of the more severe Covid they get. Reduced immunity and steroid use are other factors. The oxygen has to pass through a liquid that may or may not be clean enough.

Q: What precautions should people take when they have Covid and a lot of sugar? Can the use of wet masks also be a reason?

DR.SUBRAMANIAN SWAMINATHAN:

The initial deposition of fungi in patients is very high. Masks do not harbor such large amounts of mushrooms. This doesn’t go from person to person.

Q: What treatment do you recommend?

DR.RAHUL MODI:

If you’ve had Covid and been given oxygen or steroids, or both, you should be on high alert for any symptoms. You should contact a local ENT doctor or your family doctor. Once diagnosed, an early MRI or a simple nasal endoscopy can provide good clues. We urgently need to get these patients to have surgery, give them life-saving drugs, and control their sugar levels.

Also read | The home test kit for Covid-19 receives an ICMR nod. Watch how you test yourself




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