Most mucormycosis patients in Tamil Nadu need surgery, say doctors

The Rajiv Gandhi Government General Hospital in Chennai has handled a high number of patients with mucormycosis in Tamil Nadu.

July 18, 2021 01:07 am | Updated 01:20 am IST - Chennai

A patient being screened for Mucormycosis at Rajiv Gandhi Government General Hospital in Chennai.

A patient being screened for Mucormycosis at Rajiv Gandhi Government General Hospital in Chennai.

The Rajiv Gandhi Government General Hospital has handled a high number of patients with mucormycosis. E. Theranirajan, RGGGH dean, said 863 patients were so far treated for the fungal disease.

“While 362 persons recovered and were discharged, we currently have 395 patients undergoing treatment. We have been receiving patients from both government and private hospitals across the State and other States such as Andhra Pradesh and West Bengal,” he said.

The special mucormycosis clinic has so far screened 944 patients, he said, adding, “The ENT department has been performing surgeries on at least 18 to 20 patients a day.”

R. Muthukumar, director, Institute of Otorhinolaryngology, RGGGH, said that so far, they have performed 600 major surgeries and 900 endoscopic suction clearance. The major surgeries included endoscopic sinus surgeries, endoscopic orbital decompressions, endoscopic maxillectomy and total maxillectomy.

“The fungus is all around. When the immunity is lowered in the post-COVID period, it starts invading the issues and blood vessels. The blood supply to the tissue is cut, and it leads to infarction and necrosis of the tissue. The fungus thrives on the decaying organic matter, and our aim is to remove the necrotic tissue,” he said.

R. Malarvizhi, professor of Ophthalmology, Regional Institute of Ophthalmology and Government Eye Hospital, said they have so far screened 581 patients of whom 353 had eye involvement. “We stage patients, and those in stages 3 and 4 have eye involvement. We administer intraorbital antifungal injection for patients. So far, we have administered these intraorbital amphotericin injections for 262 patients,” she said.

So far, 32 eyes were removed, the process called as exenteration done.

Stanley hospital

At Government Stanley Medical College Hospital, around 256 patients with mucormycosis were treated so far. Of them, 216 patients underwent endoscopic surgical intervention and debridement under the Chief Minister’s Comprehensive Health Insurance Scheme, Gowrishankar, professor and head, Department of ENT, said.

“Almost two-thirds of the patients require surgery. We do endoscopic exploration for almost every patient and debridement,” he said. He added that most of them came in early stages.

Most of the patients present with nasal stuffiness, nasal crusting, headache, eye pain in the earlier stages. In late stages, they present with headache, vomiting, visual disturbances and orbital swelling, he said.

Suresh Kumar, consultant-Infectious Diseases, Apollo Hospitals, said that so far, they have seen approximately 100 patients with mucormycosis. “With the fall in COVID-19 cases, there has been a fall in mucormycosis cases in the last two to three weeks. Right now, we are seeing one to two patients with mucormycosis a week. In the majority of the patients, the sino-orbital region is involved. We have also seen a few patients with pulmonary and gastro-intestinal involvement. If we take 10 patients, the sino-orbital area is involved in 8 to 9 of them,” he said.

During peak COVID-19, we saw patients developing symptoms on day 8 to 10. But usually, there is a time gap of three to four weeks, he said, adding: “Almost 90 to 95 per cent of patients needed surgery. The remaining were unfit or unwilling for surgery.”

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