270 black fungus cases reported in Pune; therapy SOPs framed

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Around 270 cases of Mucormycosis, a rare but dangerous fungal infection, have been reported so far in Pune district, prompting a government task force to come up with a set of standard operating procedures (SOPs) for patient management in hospitals, officials said on Friday.

Symptoms of Mucormycosis, also known as black fungus, include headache, fever, pain under the eyes, nasal or sinus congestion and partial loss of vision. It affects the sinuses, the brain and the lungs and can be life-threatening in people who are diabetic or have suppressed immunity.

Mucormycosis, whose treatment requires a multidisciplinary approach, has come in focus during the pandemic as it has been detected in some recovering and recovered coronavirus patients. Saurabh Rao, Divisional Commissioner, Pune division, said so far around 270 cases have been reported in various hospitals in the district.

"Our divisional task force member Dr Bharat Purandare has come up with a detailed SOPs for management of Mucormycosis. The SOPs have been vetted by the task force," he said.

"The SOPs have been issued to all hospitals in the state. We have asked hospitals to follow the guidelines mentioned in the SOPs," the IAS officer said. The SOPs contain details about clinical management, treatment protocols, patient management, surgical intervention and medication, Rao said.

Also Read: Explained: Why Covid-19 patients are vulnerable to mucormycosis, or black fungus; causes, symptoms, prevention

Asked about fatality rate among Mucormycosis patients in Pune district, the senior bureaucrat said they are collating data in this regard. It is a rare fungal infection. Before Covid-19 also, we used to see such cases, but their number was very low. During the first wave of Covid-19, we came across hardly four to five cases.

"But during the second wave of Covid-19, we are seeing quite a number of cases, said Dr Abhishek Ghosh, a microvascular reconstructive surgeon at Noble Hospital. He said so far around 40 cases of Mucormycosis have been reported in his hospital.

"For a rare disease like Mucormycosis, the number is very big," said Dr Ghosh. It is more common in patients who are diabetic and whose sugar levels are not under control, said Dr Ghosh, adding Covid-19 patients are more susceptible to Mucormycosis due to prolonged steroid use during their treatment.

"If the patient reports early, then his/her vision is not lost. Recovery without an orbital exenteration surgery (removal of the eyeball and surrounding tissues) is possible by using anti-fungal drugs," said Dr Ghosh.

However, if the infection is severe and the patient reports late, there is no option but to remove the eye completely to get rid of the fungus, he said. He said they performed an orbital exenteration surgery on a 28-year-old man, who had a severe infection.

"We performed the surgery on the same day he was admitted to the hospital and removed his one eye and treated the infection. Post-surgery, he was put on anti-fungal drugs for the next 3 to 4 weeks," Dr Ghosh said. "Yes, there is trauma as he has lost one eye but at the same time, the person is happy that his life was saved," he said.

A 48-year-old resident of Baramati tehsil, who was infected with Mucormycosis after recovering from a bout of Covid-19, has lost one eye, but considers himself lucky to have survived the deadly infection caused by black fungus.

He underwent a surgery in which his left eye was removed. "Though I have lost my left eye, I consider myself lucky as my life is saved after the surgery," he said.

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