A potentially lethal fungal disease is creeping into recovering Covid-19 patients, and the prognosis is not good

• Mucormycosis, also known as Black Fungus, is a rare fungal infection primarily contracted in the Intensive Care Unit (ICU) of a hospital and can be pretty fatal — from losing vision to losing your life.
• Early symptoms include greyish-black crusting/pigmentation in the nose or oral cavity that may enlarge and block the nasal cavity.
• “We must educate healthcare workers, paramedics, and ICU technicians to frequently change flow meters’ water and sterilise oxygen tubing. Most importantly, only distilled water must be used, no tap/filter/RO water.” - Dr Vipin M. Vashishtha.

Disclaimer: This should not be considered medical advice. Please check with your doctor on medical procedures.

While the mortifying effects of the pandemic continue to hold our country to ransom, there is another rather fatal infection lingering in the background that doctors are witnessing in dozens of COVID-19 patients, and that is called Mucormycosis.

Also known as Black Fungus, this rare fungal infection is primarily contracted in the Intensive Care Unit (ICU) of a hospital and can be pretty fatal — from losing vision to losing your life. But this is not a new phenomenon. Dr Vipin M. Vashishtha — former convener, IAP Committee on Immunisation, and paediatrician at Mangla Hospital and Research Centre, Bijnor, UP — tells Business Insider that “Many ICUs where prolonged oxygen is being used with improper sterilisation and where tap water instead of distilled water is used, this and other fungal infections can emerge.”

Forty cases of the life-threatening infection have been detected in Surat, Gujarat, of which eight have lost their eyesight. In Delhi’s Sir Ganga Ram Hospital (SGRH), six patients with Mucormycosis have been admitted in the past few days.

Sometimes called Zygomycosis, this infection caused by fungi belonging to the order Mucorales, targets patients whose immunity is low. It is caused by various kinds of fungi that are often found in decaying organic matter like spoiled bread, fruit, and vegetables, and in this case, the devices that are providing much-required oxygen to patients. And despite aggressive therapy, the overall mortality rate is high.

The symptoms usually start revealing themselves a day or two after recovery. Early symptoms include greyish-black crusting/pigmentation in the nose or oral cavity that may enlarge and block the nasal cavity. Another symptom could be spores of fungus depositing near the eyes that leads to ocular swelling. Some patients may get lesions over the cheeks. At a later stage, this fungus can make its way to the brain. It is quite a severe disease, and fatality can go up to 50%. Treatments include antifungal drugs like Amphotericin-B that are given intravenously and other supportive therapy.

The fungus thrives in hospitals where there is improper sterilisation of ventilator circuits and oxygen pipes. “Since, in the treatment of severe covid patients who need prolonged oxygen therapy through high-flow oxygen given through nostrils, via a ventilator, Bilevel Positive Airway Pressure (BiPAP), non-rebreathing mask (NRM), etc., the risk of getting this opportunistic infection increases,” Dr Vashishtha adds.

At a place where our healthcare situation is grim, to say the least, contracting this rare fungal infection that could be avoided is yet another reminder that our healthcare system has entirely collapsed. Dr Vashishtha stresses that “we must educate healthcare workers, paramedics, and ICU technicians to frequently change flow meters’ water and sterilise oxygen tubing. Most importantly, only distilled water must be used, no tap/filter/RO water.”

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