While India continues to fight COVID-19 and has finally overcome the worst of the second wave, cases of various fungal infections in patients who have recovered from COVID-19 are now rising.
These fungal infections have been attributed to excessive steroid use in the treatment of COVID-19, which leaves patients with a compromised immunity and therefore, exposes them to a plethora of diseases which they would have otherwise not contracted. This is concerning on many levels, as our healthcare system is already overburdened with COVID-19 cases, the fungal infections are much more lethal than the Wuhan Virus and it is difficult to treat them. Their effects are horrible, and even if the patients survive, they usually end up with a disability or disfigurement.
Even though Black Fungus had sparked concerns towards the end of last year, the cases are now mounting. White Fungus is relatively new and Yellow Fungus came to be in the second wave. Black Fungus was announced as an epidemic last week by all states. Rajasthan, Telangana and Tamil Nadu have already declared it as a notifiable disease under the Epidemic Diseases Act, 1897.
White Fungus, more dangerous than Black Fungus, recently came up, with 4 cases in Patna, Bihar. However, there is now a third type of fungal infection posing risk to people- Yellow Fungus. Said to be more dangerous than the other two, a case has been reported in Ghaziabad, Uttar Pradesh. The patient is currently being treated in Ghaziabad.
Black Fungus, or Mucormycosis, had always been around but was rare. However, in December 2020, doctors noticed that the cases had risen exponentially. The common factor was that patients infected with this illness were mostly those who had recently recovered from COVID-19.
Even though it did not worry people much back then, it has now become a problem, with more than 5,400 cases in the country.
Although it can spread through the air, it will not cause any problem if a person is healthy, said AIIMS Professor and Head of Department of Endocrinology and Metabolism, Dr Nikhil Tandon.
The illness primarily affects those who are severely immunocompromised and have comorbidities. Uncontrolled diabetes, immunosuppression by steroids, long ICU stay, malignancy, and voriconazole therapy may lead to the infection.
Symptoms of Black Fungus are pain and redness around the eyes and/or nose, fever, headache, coughing, shortness of breath, bloody vomits, and altered mental status. Sinusitis, one-side facial pain or numbness or swelling, blackish discoloration over the bridge of the nose or palate, toothache, loosening of teeth, blurred or double vision with pain, skin lesion, thrombosis and necrosis, chest pain, and worsening respiratory symptoms are also present in more severe cases.
More dangerous than Black Fungus, White Fungus, or Apergillosis, can prove to be lethal by causing damage to the lungs, brain, and digestive tract.
Effects can be seen on the kidney, mouth, skin, and brain. According to Dr. Kaushal Verma of All India Institute of Medical Sciences (AIIMS), the white fungus begins from the tongue or private parts; it makes the tongue white, and then it spreads to other parts like the lungs, brain, and oesophageal tract.
Aspergillosis, just as Mucormycosis, is more common in people with compromised immunity and comorbidities such as diabetes, cancer, etc. It may also be detected in patients who have been on steroids for a long or have been in ICU for an extended period.
The symptoms of this rare fungal disease are similar to COVID-19 infection. The primary target of White Fungus is also the lungs and can be detected by performing a CT scan test or an X-ray.
The most telling symptoms of White Fungus infection are cough, fever, diarrhoea, dark spots on the lungs, reduced oxygen level.
The infection starts internally, which causes pus leakage, slow healing of wounds, and in severe cases, organ failure and acute necrosis. Symptoms, in the beginning, include lethargy and loss of appetite. In some cases, it affects the patients’ eyes; thus, one needs to be alert for redness or sunken eyes.
Even though it is yet to be clarified as to who is more at risk, patients with low immunity are advised to be more careful. Those with comorbidities should be careful as well.
The only treatment for all three fungal infections is Amphotericin B injection, which is a broad-spectrum antifungal medicine.
Black fungus is not contagious and can’t spread from one person to another. AIIMS Director Dr. Randeep Guleria has stated that it is not contagious, adding that low immunity leads to black fungus. “About 90-95 percent of cases have diabetes and have been given steroids,” Guleria added.
Fungal infections usually spread when one inhales moulds in the environment. While yellow fungus infections could also spread via high levels of humidity or the presence of stale and contaminated food, poor hygiene and unclean conditions remain the main reasons for the infection.
Hence, it is important to stay indoors, maintain sanitary conditions. Patients with low immunity should remain more careful. At the first sign, one should contact their doctor.
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