Hospitals told to report CAM cases to medical board

With reports of increasing incidence of COVID-associated Mucormycosis (CAM), an invasive fungal infection, from across the country, the State government has alerted all hospitals to report any cases of CAM to the State Medical Board on a real-time basis.

The guidelines issued by the Health Department say that details of all cases of CAM (black fungus) reported from January this year should be shared with the medical board so that the State can plan ahead for managing the situation.

The department has also suggested aeromycological studies in all ICUs at the earliest to assess fungal spore count. An aeromycological study can check for the presence and concentration of fungi in the air. Such studies are important in hospital settings, especially in ICUs, where the immunosuppressed and severely ill patients are vulnerable to catching the infection.

According to infectious diseases experts, CAM was reported in Kerala even during the first wave of COVID-19 but the number of cases reported was below the background rate (the number of cases occurring naturally in a population) of invasive mucormycosis reported in immunocompromised patients, especially those with uncontrolled diabetes in the preceding years.

The single-most risk factor for the development of mucormycosis is uncontrolled blood sugar levels and it can become one of the most devastating complications in patients with uncontrolled diabetes.

Caution on steroids

To prevent CAM, good glycaemic control amongst COVID-19 patients is essential. Also, systemic or oral steroids should be administered with caution as steroids can turn out to be a double-edged sword.

Steroids should be administered only to the right patients, in right dose and at the right time or else it can play havoc with the blood sugar levels of a COVID patient with diabetes. However, even without exposure to steroids, CAM has been reported in patients with diabetes in whom blood sugar control has not been achieved.

‘Not contagious’

The guidelines clarify that mucormycosis is not contagious. It can occur concomitantly with active COVID-19 infection or sequentially in weeks or months following recovery. It is not spread by oxygenation, humidifier, or water. The fungi remain in the indoor and outdoor environment and enter the respiratory tract via air.

The guidelines suggest universal masking and maintenance of strict aseptic precautions while administering oxygen to patients.

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Printable version | Jun 14, 2021 7:43:32 AM |

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