‘Mucormycosis is still a rare occurrence’

Doctors from Apollo Hospitals say there is no need to panic

Although the number of reported cases of mucormycosis, a serious fungal infection, has noticeably risen during the pandemic, its occurrence still remained rare and there was no need for panic, said a group of doctors from Apollo Hospitals here on Friday.

Ram Gopalakrishnan, senior consultant, Infectious Diseases, Apollo Hospitals, said while no studies had been done on the increase in prevalence now, it still remained a possibility of one in 10,000 persons who recovered from COVID-19.

M. Babu Manohar, senior consultant, ENT, and head and neck surgeon, Apollo Hospitals, said there was no need for panic. “I am personally coming across instances where people recovering from COVID-19 are panicking for normal nasal blockages and going unnecessarily for CT scans,” he said.

He added that CT scans must not be taken unnecessarily.

Pointing out that nasal blockage could be experienced by many who were recovering from COVID-19, he said it need not be a cause of concern. “When the nasal discharge turns brownish or blackish, then the person has to take notice and consult a doctor,” he said.

Other symptoms of mucormycosis include severe headache, loosening of teeth, black lesions on palette, swelling and reddening of eyes. Dr. Manohar said as mucormycosis is aggressive, immediate consultation with an ENT specialist was required for treatment.

“Sometimes, the treatment will involve doctors from across specialities,” he said.

Risk factors

Dr. Gopalakrishnan said the indiscriminate use of corticosteroids in COVID-19 treatment, which leads to an increase in blood sugar levels and compromised immunity, was a key factor making people who were already diabetic vulnerable to mucormycosis.

He said the apparent shortage of medicines, such as Tocilizumab, was making many doctors to instead go for high dosage of steroids to treat COVID-19. Stressing on the need for such vulnerable people to continuously monitor sugar levels and consult a diabetologist to bring it under control, D. Shantharam, diabetologist, Apollo Hospital, said that all those with high sugar levels need not immediately panic.

“If uncontrolled diabetes mellitus alone was a predisposing factor, we could have seen far higher cases of mucormycosis. I believe it has more to do with ketoacidosis, as increased levels of free irons in the blood is used by the fungus to grow,” he said.

Black fungus

Dr. Gopalakrishnan said that while the term “black fungus” was being used to refer to mucormycosis because of the blackening of skin being a symptom, it was a misnomer.

While mucormycosis is caused by a fungus of the order mucorales , black fungi was a different category of fungi, he said.He added that mucormycosis was not contagious.