On June 22, Excelcare Hospitals in Guwahati successfully treated and discharged a patient suffering from Black Fungus (Mucormycosis). A 26-year-old male from Darrang was admitted to Guwahati’s Excelcare Hospital and Dr Karan Saraf, Nephrologist & Transplant Physicianat was taking care of him. The patient underwent kidney transplant in December 2020 and was recovering well with a normal kidney function. The patient developed COVID-19 in May this year, which was managed by changing his transplant medication and steroids. Immediately after recovery, the patient presented with greyish nasal discharge, right sided headache, blurring of vision and mild swelling of right cheek. On evaluation, he was diagnosed to have a fungal infection of the sinuses with extension to the brain.
Subsequently endoscopic debridement was done on 5th June by the ENT Team comprising of Dr Bubul Chandra Roy, Dr Akriba Ahmed and Dr Bikash Choudhury. Multiple tissue cultures were examined in Microbiology Lab of Gauhati Medical College and Excelcare Hospitals which eventually confirmed it to be a case of Black Fungus (Mucormycosis). MRI done on the seventh day showed clearance of the disease from the sinuses.
Dr Saraf said, “The patient made good recovery and was discharged on Tuesday. However, he will require long term antifungals and close monitoring. This case posed a unique challenge as the team had to balance the transplant medications and risks of antibiotics-related damage to the transplanted kidney.” He also informed that timely intervention, early surgery (if needed) and antifungals can help in reducing the mortality.
“There has been a two-fold rise in Black Fungus cases during this pandemic with a death rate of more than 50%,” said Dr Frincy Khandelwal Baruah, Chief Microbiologist at Excelcare Hospitals. Dr Manash P Baruah, Director & HOD – Endocrinology, said, “Steroid use in treatment of COVID, uncontrolled sugars and immune dysregulation has contributed substantially to the rise in such cases. Strict monitoring and control of sugars post COVID, if necessary by intravenous insulin, can help reduce the risk of black fungus infection.”