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  • Some of the common symptoms of mucormycosis are one-sided facial swelling, headaches, nasal or sinus congestion, black lesions on nasal bridge or upper inside of mouth that quickly become more severe, and fever.

New Delhi: With the 'black fungus' identified in Covid patients, followed by a 'white' variant and now 'yellow', AIIMS Director Dr Randeep Guleria on Monday advised that mucormycosis should be identified by its name, rather than by its colour.

He said that it is better not to use the term 'black fungus' while talking of mucormycosis, as it leads to a lot of avoidable confusion.

"Black fungus is another family; this term got associated with mucormycosis due to the presence of black dots among the culture of white fungal colonies. In general, there are various types of fungal infections such as candida, aspergillosis, cryptococcus, histoplasmosis and coccidioidomycosis. Mucormycosis, candida and aspergillosis are the ones observed more in those with low immunity," he told the media here.

"Fungal infection observed in Covid-19 patients is mostly mucormycosis. While the number of cases are increasing, it is not contagious or infectious like Covid," he said.

Guleria also clarified that there is "no definite link between oxygen therapy and catching the infection as 90 to 95 per cent of mucormycosis patients are either diabetic and/or taking steroids".

"This infection is seen very rarely in those who are neither diabetic nor taking steroids," he said.

He said that some of the common symptoms of mucormycosis are one-sided facial swelling, headaches, nasal or sinus congestion, black lesions on nasal bridge or upper inside of mouth that quickly become more severe, and fever.

The AIIMS director said anti-fungal treatment goes on for many weeks, so it is proving to be challenging for hospitals, since Covid-positive patients and Covid-negative patients who catch mucormycosis need to be housed in separate hospital wards. Surgery also needs to be done judiciously since aggressive surgery for mucormycosis can have adverse outcomes for Covid patients.

Maintaining proper hygiene is very important for diabetic patients since chances of opportunistic infection is very high in such patients, he said, adding that those using oxygen concentrators should ensure cleaning of humidifiers regularly.

Mucormycosis Can Spread To Brain: AIIMS Director


Randeep Guleria further said that Mucormycosis, a fungal infection also known as ‘black fungus, can infect the lungs, eyes and the gastrointestinal tract, and can even spread to the brain.

Mucormycosis is a rare fungal infection which is being detected quite frequently in Covid patients across the country for the past few weeks.

Guleria said that three type of fungal infections are found in patients with high diabetes and steroid doses -- Candida, Aspergillosis and Mucormycosis.

Mucormycosis can be categorised depending on which organ is attacked by it, he said, adding that signs and symptoms of the infection also vary depending on the affected body part.

"The Rhino orbital cerebral Mucormycosis infects the nose, orbit of eye/eye socket, oral cavity and can even spread to the brain. The symptoms include headache, nasal congestion, nasal discharge (green colour), pain in sinus, bleeding nose, swelling on face, lack of sensation on face and skin discolouration.

"The Pulmonary Mucormycosis affects the lungs. It causes fever, chest pain, cough and coughing of blood. The fungus can also infect the gastrointestinal tract," Guleria said

"The Candida fungal infection can manifest with symptoms such as white patches in the mouth, tongue and oral cavities; it can infect the private parts and can also be found in the blood (in which case it can become serious).

"Aspergillosis, which is relatively uncommon, affects and invades the lungs by creating cavities in the lungs. What is observed during the pandemic is mostly Mucormycosis; Aspergillosis is observed occasionally, while Candida in found in some people," the AIIMS Director noted.

Speaking about the high-risk category of people who are being infected by Mucormycosis, Gularia said: "90-95 per cent of patients getting infected by Mucormycosis are found to have been either diabetic and/or taking steroids. This infection is seen very rarely in those who are neither diabetic, nor taking steroids."

Guleria also said that Covid positive patients, who have uncontrolled diabetes and use steroids, should immediately report to the doctors.

"If the warning signs for Mucormycosis -- such as headache, rusting or bleeding from nose, swelling below the eye, lowering of facial sensation -- are observed in high-risk patients or those taking steroids, they need to inform to doctors so that early diagnosis and treatment can be given," Guleria said.
 

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