It would be unjustifiable for me to not chronicle this issue as a microbiologist.
Mucormycosis (formerly known as zygomycosis) is a severe but uncommon fungal illness caused by mucormycetes, a kind of mould. Molds may be found in many kinds of places. Mucormycosis is a fungal infection that mostly affects persons who have health issues or who use medications that reduce the body's capacity to resist infections and illness. After breathing fungal spores from the air, it most often affects the sinuses and lungs. It can also happen after a cut, a burn, or any other form of skin damage.
While we work to defend ourselves against COVID-19 and live with it, there is another threat posed by a fungus that we must be aware of and respond to. During or after recovery, a few COVID-19 patients have been diagnosed with mucormycosis, a fungal illness. According to a statement issued by Maharashtra's Health Minister few days ago, the fungal infection has afflicted over 2000 people in the state, with ten people succumbing to it. Some of the patients even went blind.
Mucormycosis is a fungal infection that affects people of all ages.
A consequence of fungal infection is mucormycosis or black fungus. Mucormycosis is contracted when a person comes into touch with fungus spores found in the environment. It can also appear on the skin if the fungus enters through a cut, scrape, burn, or another kind of skin damage.
Patients who are recuperating or have recovered from COVID-19 have been diagnosed with the illness. Furthermore, anyone with diabetes who has a weak immune system should be cautious.
The following factors enhance the likelihood of mucormycosis infection in COVID-19 patients, according to a warning published by the Indian Council of Medical Research:
Diabetes that is uncontrolled
Due to the usage of steroids, the immune system is weakened.
Intensive care unit (ICU) or hospitalization for an extended period of time
Co-morbidities, organ transplantation, and cancer
Voriconazole treatment (used to treat serious fungal infections)
What does it have to do with COVID-19?
The illness is caused by a group of microorganisms called mucormycetes, which are found in nature, mostly in soil and decaying organic waste such as leaves, compost, and heaps.
In the usual order of things, our bodies immune systems effectively combat fungal infections. COVID-19, on the other hand, is known to have an impact on our immune system. Furthermore, COVID-19 patients are treated with medicines like dexamethasone, which inhibits our immune system's reaction. COVID-19 patients are at an increased risk of succumbing to assaults by organisms such mucormycetes as a result of these variables.
Furthermore, COVID patients receiving oxygen treatment in an ICU with a humidifier are vulnerable to fungal infection due to moisture exposure.
However, this does not guarantee that every COVID patient will develop Mucormycosis.
Although the condition is rare in those who do not have diabetes, it can be deadly if not treated quickly. Early identification and therapy are crucial to a person's recovery.
What are some of the most prevalent signs and symptoms to look out for?
Mucormycosis starts as a skin infection in the air pockets behind our eyes, nose, cheeks, and between our teeth. The infection then spreads to the eyes, lungs, and ultimately the brain. It causes nasal discoloration, impaired or double vision, chest discomfort, breathing problems, and bloody coughing.
Not all cases of blocked nose should be considered cases of bacterial sinusitis, according to the Indian Council of Medical Research, especially during and after Covid-19 therapy. To recognize a fungal infection, you should get medical treatment.
What is the treatment for it?
Although the illness may start as a skin infection, it has the potential to spread to other regions of the body. Surgical removal of all dead and diseased tissue is required for treatment. This can lead to the loss of the upper jaw or possibly the eye in certain cases. A 4-6 week course of intravenous antifungal treatment may also be required to cure the infection. Treatment involves a team of microbiologists, internal medicine experts, intensivist neurologists, ENT experts, ophthalmologists, dentists, surgeons, and others since it affects many regions of the body.
One of the most important preventive measures proposed by the ICMR is diabetes control. As a result, diabetic COVID-19 patients must take care of.
ICMR in its guidelines has also advised COVID-19 patients to discontinue immunomodulating drugs, a substance that stimulates or suppresses the immune system. The National COVID-19 Task Force has revised the dosage of Tocilizumab to prevent any such adverse effects. Maintaining proper hygiene can also help keep the fungal infection away.
For patients on oxygen therapy, it should be ensured that the water in the humidifier is clean and is refilled regularly. Attention should be paid to ensure there is no leakage of water (to avoid wet surfaces where the fungus can breed). Patients should maintain proper hygiene by keeping their hands as well as a body clean.
COVID-19 medicines like Tocilizumob and Itolizumab suppress the immune system in addition to steroids. And when these medications aren't utilized properly, our immune system can't fight the fungal infection, which raises the risk.” Adds Dr. Paul.
Immunomodulating medications, which activate or inhibit the immune system, should be avoided by COVID-19 patients, according to the ICMR's guidelines. To avoid any such side effects, the National COVID-19 Task Force reduced Tocilizumab's dose. Maintaining good hygiene can also aid in the prevention of fungal illness.
It is important to keep the water in the humidifier clean and replenished on a regular basis for patients on oxygen treatment. Water leaking must be avoided (to avoid wet surfaces where the fungus can breed). Patients must keep their hands and bodies clean to ensure good hygiene.
After COVID Recovery, be extra cautious.
After healing from COVID-19, it's important to keep a careful eye on any of the warning signs and symptoms listed above, as the fungal infection might resurface weeks or months later. To reduce the danger of infection, one should use steroids only as directed by a doctor.
The treatment of the fungal infection might be made easier if the condition is detected early.
The treatment of mucormycosis necessitated a multi-disciplinary approach involving eye surgeons, ENT specialists, general surgeons, neurosurgeons, and dental maxilo facial surgeons, as well as the use of Amphotericin B as an anti-fungal medicine, according to Lav Agarwal, Joint Secretary, Health Ministry.
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