While the medical community battles to keep the Covid-19 cases down, a fungal infection – known as black fungus has caused concern among Sri Lankans as India faced an outbreak.
Since this is a serious disease which we know very little about, the Sunday Observer sought the help of Consultant Medical Mycologist, Head of the Department of Mycology, Medical Research Institute, Colombo 8, which does all the laboratory testing of clinical specimens and confirms the diagnosis, Dr Primali Jayasekera, to explain to readers what exactly the disease is.
“The scientific term for black fungus is “Mucormycosis,” she said.
Asked who were most vulnerable to developing it, she said those particularly vulnerable to developing it are patients with prolonged or profound neutropaenia, diabetes mellitus (type I and II), metabolic acidosis, malnutrition, steroid usage, HSCT (bone-marrow transplant) recipients, solid organ transplant recipients, patients with haematological malignancies (blood cancers), patients with burn injuries, injection drug users and some patients with no apparent immunological defects.
Asked whether those with Covid-19 were at risk due to the ongoing pandemic, she said, “We have had some Covid-19 patients infected with Mucormycosis. Few deaths also had been reported. All these patients had poorly controlled Diabetes Mellitus in addition to Covid- 19. ”
Commenting on the latest reports that cases of black fungus had been reported from the Colombo National Hospital and the Kurunegala and Ratnapura Teaching Hospitals, she said, “This infection has been in Sri Lanka for years. We have been diagnosing and treating these patients.
The fungus group that causes the infection, is found ubiquitous in soil and decomposing organic matter as Sri Lanka is a country with a tropical climate. It can be found in indoors, outdoors and in rotten food items and dust too. ”
On symptoms at its onset or at its late stages, and the site of entry of the fungal spores to human body, she said, “The signs depend on the site of infection. As the site of entry of fungal spores is the nose via inhalation, the commonest form is rhinocerebral mucormycosis.”
She said, “Patients can present with fever, unilateral (one half of the face is affected) facial swelling, unilateral headache, nasal or sinus congestion or pain and a blood-tinged nasal discharge. Characteristic diagnosed signs include necrotic black ulceration on the hard palate or nasal turbinates, ptosis, proptosis (protrusion of eyes), ophthalmoplegia (muscles attached to eyes are not working properly), loss of vision and drainage of black pus from eye/s.
Asked to share some basic easy to follow Do’s and Don’t’s with the public, she listed the following guidelines:
“If you have diabetes, ensure you have adequate control of diabetes mellitus which can make you vulnerable to the disease due to your lowered immunity levels. Immunocompromised persons should avoid sources of environment exposure such as gardening. Avoid eating old and contaminated food.
Avoid contaminated surgical dressings and syringes. It is also important to avoid inhalation of spores and always use a clean face mask.
Take all doses of your Covid-19 vaccine. If you contact with Covid-19, take treatment from a qualified doctor as self-medication is dangerous due to side-effects. They can make you more prone to Mucormycosis, she said.