Surge in black fungus cases baffles Hyderabad doctors

Hyderabad: Specialist doctors at the ENT and eye hospitals – both private and government – in the city are baffled by the growing number of black fungus cases by each passing day. Two to five cases of

black fungus or mucormycosis per day are reported in these hospitals for the last one week.

ENT centres have witnessed a surge in the cases as the nose is affected after the infection. There have been 50 to 150 cases in the last two months.

Severe cases where the fungus has invaded from nose to eyes and brain are being reported in multi-speciality hospitals. Specialists of ENT, eye and neurosurgeons are perplexed as they have not seen such high incidence of mucormycosis in their medical practice.

In normal situations, ENT surgeons see five to 10 cases in a year. But from March 2021, they have been witnessing an unexpected surge of cases. ENT surgeons are the first point of contact for the patient as there is pain and bleeding from the nose. Sinusitis is the first indication in Covid-19 recovered patients that there is an invasive fungal infection stemming in their body.

From the nose, the fungus spreads behind the eyeball and if not treated, will affect the brain. Mucormycosis disease presentation and treatment is divided into five stages where stage 1 is nose, stage 2 is jawbone, stage 3 is eyes, stage 4 is brain and stage 5 is lungs.

Dr Manish Gupta of the Government ENT Hospital told Deccan Chronicle: "Those who are coming early with infection in nose and eyes can be salvaged but those in the brain require high end intervention to survive."

Private ENT clinics where patients are first approaching say that they had to send more than 100 patients to multi-speciality hospitals as the fungus had invaded their brains. These stage 4 patients require a team of neurosurgeons, eye and ENT specialists to attend to them.

Dr K.R. Meghanadh, chief ENT surgeon and director at MAA ENT Hospitals, explained, "Patients who have recovered from Covid-19 must be alert for pain in the nose, bleeding from the nose or sinusitis as that is the first sign of the disease. This disease is affecting those who were given steroids and also those who were not given steroids.”

“It is a myth that only those who were given steroids are infected with black fungus. We have 30 patients who were not given steroids but are suffering from black fungus. The youngest patient with us is a three-year-old child whose one eye is infected," Dr Meghanadh said.

The reason for this category suffering from black fungus is that the cell immunity is compromised by Covid-19. Due to this reason, during invasion of fungus from air to nose, the immune system is not able to identify it, say experts.

“The biggest problem now is shortage of medicines. We want the state government to procure medicines and supply them directly to us. In stage 4 and stage 5 of mucormycosis invading the brain and lungs, patients are not surviving as the invasion is complete,” said doctors at a private hospital.