‘Black fungus’ scare looms among patients on oxygen support for long

If not treated promptly, it can result in loss of vision and ultimately death, say doctors

COVID-19 patients, especially people with diabetes, who are given steroids during treatment, have to be watchful of mucormycosis or black fungus symptoms. Representational photo

The mention of ‘mucormycosis’, or ‘black fungus’ as it is commonly known, is creating a scare among the people, especially among those who have battled COVID-19 with oxygen support for long.

It is akin to the fungus that develops on bread due to moisture if stored for long.

The detection of a few cases of black fungus in a couple of States in the North, and now in Hyderabad, is causing fear among the people.

The disease, if not treated promptly, can result in loss of vision in both eyes and ultimately death, say doctors.

“The indiscriminate use of steroids to treat COVID-19 patients, which results in decreased immunity, has led to an increase in the cases of black fungus. It has to be surgically removed, or treated with drugs, failing which it can cause loss of vision, or be life-threatening if it reaches the lungs or brain,” P.V. Sudhakar, Principal, Andhra Medical College (AMC), told The Hindu on Wednesday.

“The fungus develops in individuals who use steroids indiscriminately, or in those who are on immunosuppressant drugs. The spores open and develop into fungus. If the fungus goes into the nostrils, balls form and reach the sinus, where they multiply. They reach the eye, and from there the lungs and brain. They are rarely seen as black patches on the skin,” says Dr. Sudhakar.

“While only distilled water should be used for hydrating oxygen, sometimes tap water, or any other available water, is being used either due to ignorance or negligence. The containers are seldom cleaned, leading to concentration of viruses and bacteria in the piped supply system,” according to a reliable source.

“In the past, only one or two cases used to be detected in a year. Excessive use of steroids and oxygen support due to surge in COVID-19 cases has led to an increase in black fungus cases,” says M.V.R.J. Somayajulu, a general physician and former Superintendent of King George Hospital (KGH).

“In the past, when such cases were very few, doctors and nurses used to keep a watch on the nostril area for possible black patches, and paramedics used to ensure that the flow meters and nasal prongs were clean,” he says.

“The healthcare staff should watch the nostril area for black patches. A simple test by the bedside such as scraping the nostrils and dipping it in potassium permanganate solution can reveal the fungus. At this stage, the sight and life of the person can be saved. The disease does not spread from person to person,” says Dr. Somayajulu.

“The water used for manufacturing oxygen and equipment for supply of oxygen should be clean. The oxygen prongs should be monitored and cleaned with anti-septic soap solution frequently,” he adds.