The decline in cases of mucormycosis, commonly known as black fungus, is no reason for complacency, say doctors.
“Neglect of initial symptoms can result in loss of vision and brain damage. I was anguished when the eyeball of a young patient had to be removed,” says Dr. S.K.E. Appa Rao, a noted ENT surgeon in the city.
The 27-year-old male patient was on steroids when he took treatment in home isolation for COVID-19. He was cured of COVID and did not bother to see a doctor for follow-up treatment. “I was pained at being unable to save his sight, despite the advances in modern medical care. It would not have happened had he got his nose examined during the initial phase.” Dr. Appa Rao says.
Fungal spores enter through the nose and go through the sinus to spread to the eyes and brain, causing obstruction in one side of the nose, facial pain, swelling, numbness and tenderness, dental pain, blurring of vision, double vision and watering of eyes.
The standard investigations include: endoscopic examination of nose, an OP procedure to take nasal scrapings, biopsy to confirm the type of fungus, followed by contrast gadolinium enhanced MRI.
“A routine check-up by an ENT specialist, after undergoing COVID treatment, is necessary to rule out the prospect of black fungus. This is all the more important for diabetics and patients, who have been on ventilator support or on steroids,” says Dr. Appa Rao, who is also past president of the Indian Society of Otology.
“While 99 out of 100 post-COVID patients may develop only mild complications or may not get murcormycosis at all, the unlucky ones may have to forego their vision, suffer brain damage or even lose their life, if not treated early. This makes it imperative for all post-COVID patients to undergo a mandatory check up,” he says.
“The incidence of mucormycosis has, no doubt, declined. But, patients coming with other complications like involvement of the brain and eye are increasing. On the positive side, now there is no shortage of drugs and injections for treatment of black fungus cases. Early identification of symptoms and treatment will ensure complete cure, while delays can cause serious complications,” says Dr. B. Ramachandra Rao, Associate Professor, Government ENT Hospital.
The ENT Hospital, notified as a ‘Mucormycosis hospital’ in addition to the special ward functioning at the King George Hospital (KGH), reported around 240 cases and 100 surgeries were performed, and 30 patients have died, till last week.