Sign & symptoms of black fungus; What should you do? What should you not do?

New Delhi, May 25: The Central government on Sunday released an advisory for screening, diagnosis and management of mucormycosis or ‘black fungus’ infection that is being widely reported among COVID-19 survivors in the country. According to the Union Health Ministry, mucormycosis is a fungal infection that mainly affects people who are on medication and reduces their ability to fight environmental pathogens. Sinuses or lungs of such individuals get affected after fungal spores are inhaled from air and it may turn fatal if not cared for.

 

The Health Ministry and ICMR that have been in the frontline of the government’s battle against the pandemic have prepared guidelines to prevent or manage the disease.

 

 

 

 

1. Pain and redness around eyes and/or nose

2. Fever

3. Headache

4. Coughing

5. Shortness of breath

6. Bloody vomits

7. Altered mental status

 

 

1. Uncontrolled diabetes mellitus

2. Immunosuppression by steroids

3. Prolonged ICU stays

4. Co-morbidities – post-transplant/malignancy

5. Voriconazole therapy

 

 

 

1. Control hyperglycemia

2. Monitor blood glucose level after COVID-19 recovery and also in diabetics

3. Use steroid judiciously – correct timing, correct dose and duration

4. Use clean, sterile water for humidifiers during oxygen therapy

5. Use antibiotics/antifungals judiciously

 

 

1. Do not miss warning signs and symptoms

2. Do not consider all the cases with a blocked nose as cases of bacterial sinusitis, particularly in the context of immunosuppression and/or COVID-19 patients on immunomodulators

3. Do not hesitate to seek aggressive investigations, as appropriate (KOH staining & microscopy, culture, MALDITOF), for detecting fungal aetiology

4. Do not lose crucial time to initiate treatment for mucormycosis

 

 

 

 

1. Use masks if you are visiting dusty construction sites

2. Wear shoes, long trousers, long sleeve shirts and gloves while handling soil (gardening), moss or manure

3. Maintain personal hygiene, including thorough scrub bath

 

 (in COVID-19 patients, diabetics or immunosuppressed individuals)

 

1. Sinusitis – nasal blockage or congestion, nasal discharge (blackish/bloody), local pain on the cheekbone or one-sided facial pain, numbness or swelling

2. Blackish discolouration over the bridge of nose/palate

3. Toothache, loosening of teeth, jaw involvement

4. Blurred or double vision with pain; fever, skin lesion; thrombosis & necrosis (eschar)

5. Chest pain, pleural effusion, haemoptysis, worsening of respiratory symptoms

 

ALSO READ- 'Ensure robust practices and hygiene in hospitals', says Centre to states amid Black Fungus spread 

 

 

1. Control diabetes and diabetic ketoacidosis

2. Reduce steroids (if the patient is still on) with the aim to discontinue rapidly

3. Discontinue immunomodulating drugs

4. No antifungal prophylaxis needed

5. Extensive Surgical Debridement - to remove all necrotic materials

6. What is the medical treatment for mucormycosis?

7. Install peripherally inserted central catheter (PICC line)

8. Maintain adequate systemic hydration

9. Infuse normal saline IV before Amphotericin B infusion

10. Antifungal therapy, for at least 4-6 weeks (follow guidelines)

11. Monitor patients clinically and with radio-imaging for response and to detect disease progression

 

ALSO READ- As surge of Black Fungus increases in Haryana, state makes requisition of 12,000 Amphotericin-B

 

1. Microbiologist

2. Internal Medicine Specialist

3. Intensivist Neurologist

4. ENT Specialist

5. Ophthalmologist

6. Dentist Surgeon (maxillofacial/plastic)

7. Biochemist

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