Mucormycosis is a rare fungal infection which usually affects the sinus, throat, mouth, eye, brain and finally may spread to the whole body.
This fungus has been there for many years but has suddenly found new fame-all thanks to Covid -19.
This fungus starts growing in your body and gradually affecting all organs spreading to the vital organs and gradually causing a shutdown of the entire metabolism and once it causes multi organ failure, it is definitely fatal to the patient.
What are the symptoms we need to look for?
The symptoms are quite similar to sinusitis. The patient has throbbing headache, pain in the face area,peri orbital (around the eyes) pain and swelling, swollen eyes with black spots, vision disturbances, difficulty in breathing ,nasal discharge which can be bloody or mucuous,swelling in the nose or sinus area etc.
Diagnosis
It is possible to diagnose mucor by CT scan, MRI, or by nasal endoscopy. Nasal endoscopy is very useful in sinonasal mucormycosis to diagnose as well as to debride and remove the fungus.
A biopsy is taken during the endoscopy and is sent for KOH examination and culture sensitivity to the pathology laboratory. Aseptate branches broad hyphae are visible under the microscope which are diagnostic of mucormycosis.
Who should worry
This is not a usual fungus. It usually affects immunocompromised people i.e. those having low immunity due to uncontrolled diabetes, chronic liver or kidney diseases, multiple oral surgeries, those taking immunosuppressant medicines, post-transplant or the elderly. But a special mention to those recovered from Covid 19.Due to the excessive inflammation that covid causes to the body, doctors may have to use high dose steroids to prevent lungs from having permanent damage and to tide over the crisis of the inflammation. This causes metabolic changes in the body, increasing blood sugar and inviting the fungal infection in the body. So though the patient has been lucky to be saved from Covid 19, the body is left battling with a nasty and notorious fungal infection. This is specially after a long battle with covid, requiring mechanical ventilation, long duration of hospital stay, secondary bacterial infection, poor nursing care, long standing sepsis and higher antibiotics which leave the body vulnerable to this fungus.
Let us hear from one of the best ENT surgeons of India and the directors of Aashwi ENT Hospital, Ahmedabad, and Dr Mihir Mehta and Dr Manish Goyal.
“We have operated more than 200 cases of sinonasal mucormycosis in the past one year post covid pandemic. Previously we used to get 15 – 20 cases a year which has suddenly jumped to 7-10 cases per week. Though this number may be slightly higher than that found with other centres and that is because we are a tertiary referral centre for all ENT cases and complicated cases from all over India are referred to us for treatment. In this second wave of the pandemic, we have been sometimes operating 3-4 patients a day also.Initally the mortality rate was very high because patients and the general practioners were not aware of the symptoms and often the patient turned up late for treatment but with now the mortality rate has reduced to about 0.5 to 10 percent varying from case to case. The reason why we can save so many patients today is because we have very good early diagnosis, good antifungal medications and the scope of early debridement. This is very important because if we remove the fungus early then we can prevent it from spreading in the body and causing multiorgan failure.”
So to summarize,
Don’t ignore symptoms like headache, periorbital pain, vision disturbance, nasal discharge especially if it is bloody, breathing difficulty, persistent cough especially after recovery from covid 19.It may be a part of post covid residual symptoms but may be pointing towards a bigger problem in the bofy.
Immunocompromised people specially need to take care.
Keep a check on your blood sugar specially if you have been on steroids.
Consult a specialist as early as possible to diagnose the condition so that appropriate treatment can be done.
Here at Aashwi ENT Hospital, the consultant and staff is committed to provide the best comprehensive care for sinonasal mucormycosis.
