The number of mucormycosis (black fungus) cases in Visakhapatnam is steadily increasing even as the COVID-19 curve is on the downward trend.
If symptoms are diagnosed and treated early, there are good chances of recovery from the fungal infection. On average, five new nursing cases are reported in the city every day.
Symptoms such as facial pain, blurred vision, cheek pain, changes in skin color, and loosening of teeth in patients who have recovered from COVID-19 could be an early warning sign of mucormycosis. The special ward that opened at KGH just under a month ago and the one at the ENT hospital opened two weeks ago. A few reported private hospitals also treat cases of black fungus.
“The second variant of COVID-19 targets the nasal defense system and not only lowers the patients’ immunity. In addition, prolonged use of steroids, uncontrolled diabetes and other pre-existing conditions lead to an abnormal increase in mucormycosis cases, ”says Dr. B. Ramachandra Rao, Associate Professor at the State ENT Hospital.
“Although other medical specialties such as ophthalmology and neurosurgery are also involved, ENT surgeons play an important role in the treatment. The fungus finds easy prey in people with low immunity due to long-term use of steroids to treat COVID-19 and in people with uncontrolled diabetes. For eye interventions, the patients are referred to the special ward in the KGH, where a full team is available, ”says Dr. Ramachandra Rao.
The very first mucormycosis operation on the special ward in the KGH took place on May 29th. The fungus penetrated the maxillary sinus, from there to the eye and through the skin on the cheek. Dr. PV Sudhakar, plastic surgeon and director of Andhra Medical College, led the team that successfully performed the operation.
Dr. Bharathi (plastic surgeon), Dr. MV Vijayshekar (neurosurgeon), Dr. M. Veer Kumar and Dr. Sudha (ENT) and Dr. Allu Padmaja (anesthetist) were the other team members.
“So far, over 70 mucormycosis operations have been performed at the KGH and the majority of patients responded well to the treatment. Some patients have been rushed to the emergency room wheezing and deaths are higher in such acute cases. Some patients are referred to KGH after operations in private hospitals because these hospitals do not have adequate supplies of antifungal drugs. Amphotericin-B costs ₹ 7,000 per vial and a patient must receive six injections per day. Posaconazole costs ₹ 600 for each tablet and a patient must be given three tablets a day. All of this is offered free of charge at KGH, ”says Dr. Vijayshekar.