AIIMS has released new guidelines for detection and care for cases of black fungus or mucormycosis that has claimed the lives of several Covid patients across the country. The AIIMS Covid ward has also said that those with uncontrolled diabetes, patients who are on high doses of steroid are at high risk of catching the black fungus infection.
After Rajasthan, the Telangana government has declared mucormycosis or ‘black fungus’ as a notifiable disease under the Epidemic Diseases Act, 1897. In a notification, the Telangana government said, “Fungal infection mucormycosis is hereby declared as a notifiable disease under Epidemic Diseases Act 1897.”
“All government and private health facilities shall follow guidelines for screening, diagnosis and management of mucormycosis issued by Ministry of Health and Family Welfare, Government of India and Indian Council of Medical Research,” it added.
In Maharashtra, 90 people have died of mucormycosis, a rare but fatal fungal infection. While in Rajasthan, there are over 100 cases of black fungus infection. The Rajasthan government has declared black fungus and epidemic in the state and also set up a separate ward for its treatment.
Who are high-risk patients?
1. AIIMS has said patients with uncontrolled diabetes, diabetic ketoacidosis, diabetics on steroids or tocilizumab are at high risk to contract mucormycosis.
2. Patients on immunosuppressant or anticancer treatment, chronic debilitating illness are also at high risk.
3. Patients on high dose steroids or on long duration of steroids, tocilizumab.
4. Severe Covid cases, those who are on oxygen support through nasal prongs or mask, ventilator.
AIIMS has advised doctors and especially ophthalmologists to advise patients with a risk of black fungus infection to do regular checkups with doctors even after discharge.
How to identify?
The AIIMS has issued a set of guidelines in case of detection of black fungus in a patient. Watch out for:
- Abnormal black discharge or crust or blood from the nose.
- 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.
- Facial numbness or tingling sensation.
- Difficulty in chewing or opening mouth.
- 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.
- 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 to do?
Those caring for Covid recovered patients should do the following things as per AIIMS new guidelines:
- Immediate consultation with an ENT doctor, ophthalmologist, or the doctor who is treating the patient in case of any abnormal findings.
- Regular treatment and follow-up. Strict control and monitoring of blood sugar in diabetics.
- Regular medications and follow-up for other comorbidities.
- No self-medication with steroids or antibiotics or antifungal drugs.
- MRI or CT scan with contrast – paranasal sinuses and orbit, if needed, on doctor’s advice.
