The number of mucormycosis (black fungus) cases in Visakhapatnam are growing steadily even as the COVID-19 curve is on the downward trend.
There are bright chances of recovery from the fungal infection if the symptoms are diagnosed and treated early. On an average, five new cares are being reported in the city every day.
Symptoms like facial pain, blurring of vision, cheek pain, changes in skin colour and loosening of teeth in patients who have recovered from COVID-19 could be an early warning sign of mucormycosis. The special ward, opened at KGH nearly a month ago and the one at ENT Hospital, opened two weeks ago. A few notified private hospitals are also treating black fungus cases.
“The second variant of COVID-19 has targeted the nasal defence system besides lowering immunity in patients. In addition to this, prolonged use of steroids, uncontrolled diabetes and other pre-existing conditions lead to an abnormal rise in mucormycosis cases,” says Dr. B. Ramachandra Rao, an Associate Professor at the Government ENT Hospital.
“Though other medical specialties like ophthalmology and neurosurgery are also involved, ENT surgeons play a major role in the treatment. The fungus finds easy prey in those with low immunity levels, due to long-term steroid use for treatment of COVID-19, and those with uncontrolled diabetes. When there is eye intervention, the patients are referred to the special ward in KGH, where a full-fledged team is available,” says Dr. Ramachandra Rao.
The very first mucormycosis surgery at the special ward in KGH was done on May 29. The fungus entered the maxillary sinus, from there to the eye and emerged out through the skin on to the cheek. Dr. P.V. Sudhakar, plastic surgeon and principal of Andhra Medical College, led the team, which successfully performed the surgery.
Dr. Bharathi (plastic surgeon), Dr. M.V. Vijayshekar (neurosurgeon), Dr. M. Veer Kumar and Dr. Sudha (ENT) and Dr. Allu Padmaja (anaesthetist) were the other team members.
“So far, over 70 mucormycosis surgeries have been performed at KGH and a majority of the patients responded well to the treatment. Some patients were brought to the Casualty ward with gasping and in such acute cases, fatalities are higher. Some patients are referred to KGH, after surgery at private hospitals, as those hospitals are not having adequate supply of antifungal drugs. Amphotericin-B costs ₹7,000 a vial and a patient has to be given six injections a day. Posaconazole costs ₹600 for each tablet and a patient has to be given three tablets a day. All these are being given free of cost at KGH,” says Dr. Vijayshekar.
