12 June,2021 07:37 AM IST | Mumbai | Somita Pal
Sanika Lingayat with her mother, Vaishali, at RN Cooper Hospital
Maharashtra's first known case of paediatric mucormycosis - the black fungus which has been manifesting in Covid-19 patients - has led to a Std VIII student, Sanika Lingayat, losing her sight in one eye.
The 14-year-old Ratnagiri resident was referred to the civic-run RN Cooper Hospital in Andheri last week with a loss of vision in her right eye and swelling in the cheek region, said the Opthalmology department in-charge Dr Charuta Mandke, under whom Sanika is admitted. "Since she came with vision loss of right eye last week, we had a biopsy done. We first suspected it was a tumour and pursued that line of treatment since there was no history of Covid-19," she said, adding, "We knew we had to remove the right eye to save her life, but further medical investigation was also necessary. We sought an opinion from the ENT (Ear Nose Throat) team." The ENT team asked for an MRI which confirmed what the earlier biopsy report said about the presence of mucormycosis.
Dr Shashikant Mhashal, associate professor, ENT at Cooper, who operated on Sanika, started her on a regimen of antifungal injection Amphotericin-B. He, however, felt something was amiss and suspected a Covid-19 connection.
"My experience in treating Covid-19 patients suffering from mucormycosis made me feel this angle needs to be pursued, though neither she nor her family had shown any history of Covid-19. So we conducted an antibody test before her surgery on June 7," he said.
With the antibody test report on June 4, things fell in place. Dr Mhashal said, "Mucormycosis due to Covid-19 in children has not been seen and reported to date. In Sanika's case, the antibody test confirmed that she might have had asymptomatic Covid-19 a month ago."
On June 7, a team of eye surgeons first removed Sanika's diseased right eye. This was followed by a debridement surgery where ENT doctors removed the fungus from the nose and sinus region. Both procedures took six hours. Dr Ninad Gaikwad, head, ENT department explained why hers is a peculiar case. "Mucormycosis is normally associated with diabetes but in the case of this child, there were no such comorbidities. She was also asymptomatic for Covid-19. According to the medical history given, she first had signs of vision loss in early May. Being a child and having a comparatively better immune system, the progress of mucormycosis seems to have been slower in her case," said Dr Gaikwad.
Dean, RN Cooper Hospital, Dr Shailesh Mohite, said, "We have, so far, not heard of a single paediatric case of mucormycosis. This shows that we need to be cautious in case of children too."
While Sanika is recuperating in the ward dedicated to mucormycosis, her mother, Vaishali, worries for her future. "We are not sure if Sanika will be able to continue her studies. She suddenly had a vision loss in the first week of May and unbearable pain. She couldn't sleep because of the pain," Vaishali said.
The hospital will monitor Sanika with CT scans and nasal swabs to check if the fungal growth is completely removed. Once this is established, there are plans to help fix the disfigurement of her face. Dr Mandke said, "We will consider plastic surgery to aesthetically fix the disfigurement to Sanika's face due to the removal of the right eye."
