Black Fungus COVID-19

Black fear

Its consequences are more frightening than Covid -19. Mucar mycosis is a new fungal infection. It is not limited to the nose and mouth. It spreads to the eyes and brain and puts them in serious danger. These symptoms are similar to those of diabetics.

Why is it booming?

Mooncar mycosis. This is what anyone hears. Called black fungus, this is a very rare problem. But it is noteworthy that many people are now affected by the outbreak of Covid-19. Mucar mycosis, which is currently emerging, is linked to Covid-19 N. Vishnuswaroop Reddy can be said to be the problem. It is true that the outbreak of Covid-19 in the EAN Surgeon, CARE Hospitals, in the early stages, but Banjara Hills, was not seen so much. At present, in the second phase of Hyderabad, more people are getting affected by it and it is becoming dangerous. Mucaramycosis is emerging more and more after covid-19 subsides. It is seen mainly in those who suffer from diabetes, and in those who have used corticosteroids as part of their treatment for Corona. Some people get affected by it when they are corona positive.

Fungus origin: Black fungus is caused by a fungus called Mucarmycetes (Zygomycetes). It can be indoors or outdoors in any environment. Air enters the nose and throat and increases. Generally healthy people do not do this. It can be problematic in immunocompromised people. Diabetics usually have a weak immune system. That is why the risk is higher for people who have not controlled diabetes for a long time. Cancer patients, leukemia patients, chemotherapy patients, organ transplant recipients, those taking oriconazole to treat other types of fungal infections, and those taking immunosuppressive drugs. Mucar mycosis mainly attacks the nose and the air spaces around the nose (paranasal sinuses). It is not limited there. Expanding to the eyes and brain. That's why it' Rhino Orbito Cerebral Mucar Mycosis' means 'no rhino infection'. It attacks the eyes. be |

With overuse of steroids: It is true that corticosteroids are used as life-saving drugs for severe cases of Covid-19. They control inflammation and help reduce the severity of the problem and side effects. If they are used in the required amount and as required, they work like Rambanam. For those on external oxygen and those on ventilators, steroids such as dexamethasone and methylprednisolone should be given intravenously. But taking too much, unnecessarily, without taking the advice of the doctor is a dangerous thing to do. Currently, lists of Covid-19 medicines are widely circulating on social media. Seeing these, buying and using medicines on their own has recently become more common. Steroids should be used sparingly like other drugs. It is not good at all to start steroids in the first 5 days after corona. If you feel tired after 5 days, you can take it. However, it should be taken under the supervision of a doctor in the correct dosage. Because with these, people with diabetes, high blood pressure, stomach ulcers, dropsy and tuberculosis will have more problems. Diabetics need more vigilance. Steroids can increase blood glucose levels. This is what is currently seeding mucormycosis. Even in non-diabetics, new onset diabetes occurs with steroids. • Elevated fetin levels in the blood are also a threat. This allows the fungus to adhere to tissue. Even in non-diabetics, new onset diabetes occurs with steroids. • Elevated fetin levels in the blood are also a threat. This allows the fungus to adhere to tissue. Even in non-diabetics, new onset diabetes occurs with steroids. • Elevated fetin levels in the blood are also a threat. This allows the fungus to adhere to tissue.

Treatment 

With a team of experts: Mucormycosis is associated with many organs. Therefore, all specialists like ENT surgeons, neurologists, neurosurgeons, ophthalmologists, dental, facio-maxillary surgeons, oculoplastic surgeons, intensivists, etc. have to be treated together.

Glucose Control: Keeping diabetes under control is of utmost importance. Among them, the acidity in the stomach is very high due to diabetes. Mucormycosis is controlled only when glucose is under control. Otherwise, it expands rapidly and darkens.

Fungal medications: Medications to reduce fungal infection should be started as soon as the disease is diagnosed. The main drug for this is liposomal amphotericin B. It is given at 5 mg per kg of body weight per day. required For severe infection, 10 mg for brain spread. It may also be necessary. This should be given for 2-4 weeks. It is mixed with saline solution and given slowly. Currently, liposomal amphotericin B is not widely available. The price is also high. Therefore deoxycholite can be used as an alternative. It is 1 mg per kg of body weight per day. required per It has more side effects like chills, so it has to be given more slowly. Fosaconazole can be used as an alternative. 300 mg twice a day on the first day. is given per It is enough to give it once a day from yesterday. Isavuconazole tablets can be used instead. These are 200 mg. The dose is given 3 times a day for two days. After that, it is given once a day. These should be taken until the disease is under control.

Caution : Liposomal amphotericin B may cause kidney damage, so blood creatinine and potassium levels should be monitored frequently. If the creatinine is increasing then the medicine is stopped. If saline is given in large amounts, creatinine will decrease. The next day the drug will be resumed. If potassium is decreasing, it is given in the form of syrup. It should be ensured that the water content of the camel does not decrease.

How to determine ?

Nasal endoscopy : This shows how the inside of the nose is. If the turbinates in the nose look black, tarry, or sooty, it indicates a fungal infection. There may also be black and brown checks in the nose. It should be collected and examined under a microscope (KV H mounting). It determines the presence or absence of zygomycetes or mucomycetes.

CT Scan : A CT scan of the nose and air chambers reveals how far the infection has spread. MR: This can tell if the infection spreads to the brain, cavernous sinus, or eye.

Surgery along with medication Mucar mycosis is not treated with medication alone. After starting the medication, the surgery will have to be done. Medication should be continued after surgery. Otherwise, there is a risk of re-emergence of the fungus.

Removal of Fungus Tissue : Endoscopic sinus surgery removes blackened tissue in the nose and sinuses, as well as pus in the nasal chambers. If the palate is also affected, the cheekbone and part of the palate may need to be removed. Clean again after 2-3 weeks if necessary. A cleft palate patient may need to be fed through a tube through the nose until the cleft palate heals. After healing, a thin plate-like device (the turator) is placed on the top of the palate.

Eye removal : Not for everyone, but if the infection spreads to the eye, some may even need to have their eye removed. Otherwise, there is a risk of the infection spreading to the brain through the optic nerve. If the tube is removed, it may need to be removed again.

Early detection is better if the treatment is delayed. As the infection spreads to both side air chambers. If it spreads to the brain it can cause paralysis. Some may go unconscious and die within days. So | It is important to detect the infection as soon as possible. This can save eyesight and life. If you notice severe headache, cheek pain, eye pain, do not ignore it and consult a doctor immediately.  

Covid -19- Mucaramycosis

Black fungus symptoms are various, as nose, palate, eyes and brain are all affected, various symptoms are seen. The most important thing is that there is a severe headache on one side. Along with this, the symptoms are increasing depending on the respective organs.

Black inside the nose : In the initial stage, there are symptoms like stuffy nose, runny nose, brown and black mucus. There are three turbinates in our nose. These are what add moisture to the air we breathe. In Mucarma c they turn black along with the nose beam.

Eye injury : Ocular symptoms occur in about 50% of people. Pain behind the eyes, swelling of the eyelids, protrusion of the eyeball, blurred vision, double vision, reddening of the skin around the eyes, and then darkening of the skin. This is because the infection spreads from the nose and mouth to the air chambers near the brain. There are 8 air chambers around our nose. There are two air chambers at the forehead (frontal), between the eyes (ethmoid), behind the cheeks (maxillary), and near the brain (sphenoid). The infection can spread from the nose and mouth to the air chambers of the brain. Adjacent to the walls of these chambers is the cavernous sinus. It has 3, 4, 6 pu nadus. These are the ones that control eye muscle movements. These are damaged due to infection. The result is drooping of the eyelid, cessation of movement of the eyeball, dilated iris, Loss of sight occurs. Also, there is a possibility of the infection spreading to the brain through the optic nerve. While the eye symptoms start slowly for some, others get worse very quickly. It is noteworthy that some people lose their sight in one eye within two or three days.

Palate as coal : The upper part of our mouth (palate) acts as the foundation for the nasal air chambers. It turns black and charcoal due to infection of the air chambers. It is seen in about 20% of people.

Cheek pain : Due to infection of the air chambers around the nose, the cheeks may become numb and the cheeks may feel sore.

Tooth movement : If the fungus infection starts in the cavities near the cheeks, the jaw may be affected and the teeth may move. This can lead to toothache.

Can it be avoided ?Mucaremycosis occurs mainly in diabetics. So it can be avoided if it can be strictly controlled. If the glucose levels increase while giving steroids, they should be controlled by giving insulin. Steroids should also be added. Along with this, some other precautions should be taken.

• Steroids, when needed, can be used in appropriate doses to prevent infection. If there are no symptoms like fatigue then it is not suitable to use them in the first stage.
• Precautions such as using clean water in the humidifier while providing oxygen, changing the humidifier and hoses daily are mandatory.
• Personal and surroundings should be kept clean
• Rinse your mouth twice a day with a mouth wash containing betta.
• Wearing a mask can prevent the fungus from entering the nose and throat.
• Those who have been on ventilator for more than two weeks, those who have taken oxygen and steroids, those who have uncontrolled diabetes, those who are immunocompromised can use posaconazole tablets as a precaution to prevent infection.
• It is important to suspect mucormycosis in patients with bacterial sinusitis who develop covid-19.
• For those on oxygen, frequent nasal rinses with saline solution are recommended.

Early detection is better as treatment is delayed as the infection spreads to both sides of the air chambers. If it spreads to the brain it can cause paralysis. Some may go unconscious and die within days. So it is important to detect the infection as soon as possible. This can save eyesight and life. If you notice severe headache, cheek pain, eye pain, do not ignore it and consult a doctor immediately.