Rampant use of life-saving steroids in Covid patients trigger black fungus, says experts | Jaipur News
Indiscriminate use of steroids in Covid treatment has given rise to a new challenge for the health authorities, Sawai Man Singh Medical College has claimed.
While deciding to set up a separate ward and an out-patient department for treatment of Mucormycosis, which is also known as ‘black fungus’, Sawai Man Singh Medical College on Saturday told all the chief medical health officers and principal medical officers across the state that Mucormycosis was emerging as a major concern due to indiscriminate use of steroids in Covid treatment.
Former chief minister Vasundhara Raje also expressed concern on it. “#BlackFungus is a new disease happening in#Rajasthan. Liposomal Amphotericin B 50mg Injections & Posaconazole 300mgtablets are needed to treat this. Request Govt. to procure these at theearliest so that people don’t have to buy it for exorbitant prices on the blackmarket,” Raje tweeted.
A video conference of officials of health department was held on Saturday on the issue. “Irrational use of steroids and Remdesivir elevate sugar levels in patients and reduces immunity, which give rise to mucormycosis cases. Steroids should not be given in first week of Covid infection as it is the time when virus replicate. Steroids should be given in second week of infection, which is a period of inflammation. Patients requiring oxygen support should be given steroids,” said Dr Sudhir Bhandari, principal and controller, SMS Medical College and head of panel for Covid treatment in the state.
Bhandari informed the health department officials in districts on the importance of judicious use of steroids to prevent Mucormycosis.
Since cases of Mucormycosis are getting reported, Bhandari said they would set up a separate ward and OPD for such patients where doctors of different specialties such as ENT, ophthalmology,neurology surgery will check the patients and decide the line of treatment of the patients.
“In some Mucormycosis patients, we haveto take tough decisions such as removal of eye or jaws or any other part of organ, which is affected due to fungus. But no treatment works until we remove the dead, necrosed tissue or involved part by conducting endoscopic debridement/orbital clearance. In severe cases, removal of cheek bone (maxillectomy), removal of eye (orbital exenteration) has to be done,” said Dr Pawan Singhal,professor (ENT), SMS Medical College.
Besides, some ENT private hospitals wrote to health department to ensure availability of Liposomal Amphotericin B50mg Injections & Posaconazole, which are not easily available in the market, which is why, the treatment of the patients has become difficult and they have no other option left except conducting surgery for removal of eye, jaw or other affected organ.
“The most important reason for this sudden spurt has been the poor blood sugar control further aggravated by the use of steroids during treatment for Covid. Mucormycosis is difficult to diagnose early, as patients often present with nonspecific symptoms such as nasal stuffiness in early stages and postnasal drip followed by dark blood-tinged or purulent rhinorrhea, sinus tenderness, headache, fever and malaise. As the infection involves the eyes, patients develop swelling over the eyes and face associated with numbness, blurring of vision or doubling of vision, protrusion of eyeballs, and loss of vision in the end stages,” said Siddharth Bharadwaj, a private vitreoretinal surgeon who is dealing with such cases.
