How do I recognise cases of black fungus? AIIMS is issuing new guidance
AIIMS has announced new guidelines for the detection and treatment of incidences of black fungus or mucormycosis in numerous Covid patients across the country. The AIIMS Covid ward has also indicated that uncontrolled diabetes is at greater risk for black fungus infection in patients with high steroid dosage.
90 individuals have died in Maharashtra from mucormycosis, an uncommon but severe fungal condition. There are around 100 cases of black fungal illness in Rajasthan. The government of Rajasthan has declared the state black fungus and an epidemic and has established a separate treatment centre.
Who are high-risk patients?
- AIIMS has said patients with uncontrolled diabetes, diabetic ketoacidosis, diabetics on steroids or tocilizumab are at high risk to contract mucormycosis.
- Patients on immunosuppressants or anticancer treatment, chronic debilitating illness are also at high risk.
- Patients on high dose steroids or on the long duration of steroids, tocilizumab.
- Severe Covid cases, those who are on oxygen support through nasal prongs or mask, ventilator.
AIIMS has encouraged physicians and ophthalmologists in particular to recommend that even after discharge, individuals at risk of black fungus infection undergo regular testing with physicians.
How to detect black fungus infection?
Those caring for Covid recovered patients should look out for the danger signs. Watch out for:
1. Abnormal black discharge or crust or blood from the nose.
2. Nasal blockage, headache or eye pain, swelling around the eyes, double vision, redness of eye, loss of vision, difficulty in closing eye, inability to open the eye, prominence of the eye.
3. Facial numbness or tingling sensation.
4. Difficulty in chewing or opening mouth.
5. Regular self-examination: Full face examination in daylight, for facial swelling (especially nose, cheek, around the eye) or black discolouration, hardening, and pain on touch.
6. Loosening of teeth. Black areas and swelling inside the mouth, palate, teeth or nose (oral and nasal examination using torchlight, as far as possible you can see).
What can be done?
The AIIMS has issued a set of guidelines in case of detection of the black fungus in a patient. These are:
1. Immediate consultation with an ENT doctor, ophthalmologist, or the doctor who is treating the patient in case of any abnormal findings
2. Regular treatment and follow-up. Strict control and monitoring of blood sugar in diabetics
3. Regular medications and follow-up for other comorbidities
4. No self-medication with steroids or antibiotics or antifungal drugs