Doctors involved in the treatment of mucormycosis or black fungus patients at the North Bengal Medical College and Hospital (NBMCH) had termed the disease and the treatment as ‘scientific dilemma.’ According to them, if excessive use of steroids could be one of the key reasons for the rise in the cases among Covid19 patients or those who have recovered from the virus, there were also other diseases where high doses of steroids are used, but no significant trend of mucormycosis had been observed in them.
The health department has cautioned that “steroid abuse” and uncontrolled diabetes are likely contributing to the mucormycosis outbreak. Mucormycosis cases have also been found among Covid patients who did not use steroids, the doctors underlined during an inter-departmental orientation programme on ‘Diagnosis, Management and Preparedness’ of ‘Opportunistic Infections,’ including Mucormycosis, organised by the Medical Education Unit of the NBMCH today.
“According to our observations, mucormycosis cases in bigger volume are now found in India. It is not easy to say what is leading to the sudden surge of the cases in the past few weeks. Rational use of steroids is advised to check mucormycosis, but the disease is also being detected among Covid patients who did not use steroids at all. The steroids are also used for the treatment of patients suffering from diseases like rheumatoid arthritis and nephrotic syndrome. However, the trend of mucormycosis is not found there. On the other hand, there are patients suffering from the disease here who have not been infected with Covid-19. Therefore, I would like to call the situation a scientific dilemma,” said Dr Smarajit Banik of the department of medicine.
Mucormycosis is a fungal infection mostly found in patients with compromised immune systems. While there has been an outbreak of the infection among Covid-19 patients, it was prevalent even before the pandemic, experts have said. NBMCH principal Prof Indrajit Saha said mucormycosis had been detected also among persons who had received Covid treatment under home isolation, and were not admitted in hospitals.
“It has been observed that contamination of oxygen humidifiers in hospitals may also be reasons for the mucormycosis, but the disease is also showing in patients who were never admitted in hospitals and remained in home isolation without oxygen support,” Prof Saha said. One the other hand, being one of the ‘regional hubs’ for the management of recalcitrant mucormycosis cases, the NBMCH needs to create the infrastructure for plastic surgery, as the surgical debridement is the key to controlling and eliminating mucormycosis, the doctors said.
According to Prof Saha, the facility will be available once the proposed super-specialty block is functional. Associate professor of pathology Dr Kalyan Khan said the number of mucormycosis cases was much higher in India than in other countries. Faculties and PGTs of the department of ophthalmology, ENT, anesthesia, medicine, pediatrics, pathology, microbiology and radiology participated in the programme.
“The oriention programme discussed the implantation of the treatment protocol issued by the state government. It stressed on how to deal with the disease, as experienced by the doctors during the treatment based on the protocol,” Prof Saha said. Fifteen mucormycosis patients are presently admitted in the NBMCH. According to official figures, four patients have died there of the disease so far.
Dr Khan said they had discussed preparedness of the hospital for treatment of mucormycosis patients, even if it is found among children in the near future.