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Black, White and Yellow Fungi not new to Panic: Dr Anirudha R. Podder

While those in power are in jittery and all those in the health sector are literally facing unheard challenges of their lifetime in the form of Covid-19 mutated virus, of late both of them appeared to be a bit relieved. But with the emergence of Black fungus cases and their gradual surge has again raised alarms! 
image source: New Indian Express

Dr SR Narahari, Director of Institute of Applied Dermatology, Kasargod district in Kerala opines: Thanks to the fall in numbers of positive cases and dip in admissions to the ICU, in general, it looks the curve has begun to flatten. The deaths may be more due to other comorbidities rather than Covid-19 mutated virus only, he feels.

Dr Deepak V. Haldipur, a renowned ENT surgeon having the unique distinction of performing the maximum number of Black fungus surgeries in the state is right in a way. He feels the surge in the number of Black fungus cases is not all that alarming in comparison to the state population for the local "terrorist broadcast media" to make scary pronouncements.

In a way, such a scenario may not be the worst like the way it is being projected in the media. But at the same time, one cannot undermine the grave situation of lack of proper infrastructure, paucity of surgeons to treat and scarcity of suitable medicines in a big way. And unless these issues are attended on a top priority basis, there are much more tragic circumstances we may ultimately land up into.

Dr Anirudha R. Podder, Consultant and Head, Gynec-Oncology, Mahavir Cancer Sansthan and Research Centre(MCSRC), Patna allays some fears now let loose on public platforms: Several cases of fatal fungal infections being detected in patients who have recovered from COVID 19 are being reported for quite some time now. Unfortunately, some of these reports are alarmist in nature. It is being projected as though, many new dangerous pathogens are being discovered every day. But the occurrence of fungal infections is not new to mankind, and the existence of black, white, and yellow fungi has always been known for several decades...

...Superficial fungal infections, i.e., fungal infection of the skin hair and nails are very common and occur in people who sweat a lot, and in persons with poorly controlled diabetes. The combination of moisture, poor hygiene, and increased blood sugar levels favours the growth of fungi. Superficial fungal infections can be easily treated by antifungal creams, shampoos, dusting powders, and oral medications. Daily Bath, frequent change of clothes, wearing loose cotton garments, and keeping the sweat bearing regions of the body dry are also essential in the treatment of superficial fungal infections, he points out.

Fatal if not treated in time: Deep-seated fungal infections, on the other hand, are fatal if not detected and treated in time. And they almost always occur in people who are immunocompromised, like HIV positive patients in full-blown AIDS, transplant recipients, diabetics with very poorly controlled blood sugars, the elderly etc...

...In fact, the diagnosis of deep-seated fungal infections, like aspergillosis, mucormycosis (black fungus), cryptococcal meningitis, oesophagal Candidiasis (white fungus), mucor septicus (yellow fungus), etc., should immediately trigger a search for an underlying condition that is responsible for the immunocompromised state, feels Dr Anirudha R. Podder.

Who'll are Susceptible? : So what could be the cause of black, white, and now recently reported yellow fungus in patients who have recently suffered from covid? Steroids are used in patients who have severe covid lung ailments, and it is true that prolonged use of steroids causes immunosuppression like how it does in organ transplant recipients. But that does not entirely explain the occurrence of deep-seated fungal infections in covid patients, because many people with arthritis, lupus, severe asthma remain on steroids for extended periods of time. But then it is known that people with badly damaged lungs which does happen following severe covid are easily susceptible to severe infections...

...Any person who has just recovered from a bout of severe illness has undergone major surgery, or any life-threatening condition like extensive burns or trauma is vulnerable to infections and covid patients are no exception. Therefore it is essential that those who have suffered covid remain indoors, to avoid dusty and damp places, to give up smoking, and to consume only warm freshly prepared nutritious meals and purified water, he advises.

Significance and Danger of Masks: The most important thing is to discard masks after 6 to 8 hours of use. Masks of good quality do offer protection but need to be washed or discarded after 6 to 8 hours of use. Masks themselves might be harbouring fungal spores and other dangerous pathogens after a few hours of use. Obviously, oxygen masks should never be shared and must also be discarded/sterilized after a few hours of use...

...There are several misleading reports of fungal infections transmitting through refrigerators and through certain foods. Washing utensils and all food items before cooking will kill all bacteria, viruses, and fungal spores. Anybody who has a headache, facial pain, visual symptoms, hearing loss- (suggestive of black fungus or mucormycosis), difficulty in eating or swallowing, diarrhoea, abdominal pain (suggestive of white fungus or oesophagal candidiasis), non-healing wounds with or without thick yellow pus (suggestive of yellow fungus or mucor septicus), extreme fatigue, fever, weight loss, loss of appetite, or any other distressing symptoms should report to the nearest doctor or Hospital, concluded Dr Anirudha R. Podder.

-Manohar Yadavatti

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