In what could be a double whammy for Rajasthan, the emergence of mucormycosis cases in the state amid the second wave of COVID-19 pandemic has resulted in a panic among the state’s health administration.
Mucormycosis, commonly known as black fungus, is a rare fungal infection that if left untreated can result in blindness and even death. COVID-19 patients availing treatment at hospitals with lower immunity are at greater risk of mucormycosis.
Rajasthan govt issues instructions
The state government has issued instructions to chief medical and health officers (CMHO) of all districts to safeguard people against mucormycosis that can seriously affect their eyesight. It suggested that the excess use of steroid in patients, particularly the elderly, could result in them getting infected with the fungal disease.
Dr Sudhir Bhandari, Principal of the Sawai Man Singh Medical College & Hospital, who has led the state government’s fight against COVID-19, has issued an instruction to the CMHOs against the excessive use of steroids.
Over 50 cases of mucormycosis
There are over 50 cases of mucormycosis registered in various districts of the state and each day around three to four new cases are being reported.
Jodhpur is the worst-affected and recently an elderly woman lost her both eyes because of black fungus.
Excessive use of steroids
Dr Bhandari said steroids should not be given in the first week of COVID-19 as it is the time when the deadly virus replicates. He said the steroid should be given only in the second week of treatment, which is a period of inflammation. Only such patients who require oxygen support to improve breathing should be given steroids.
The treating doctors in Jodhpur and other places were forced to remove the eyes or jaws of the black fungus patients. The doctors found during the treatment that the black fungus aggravated because of the use of steroids when the blood sugar dipped. During the early stage, patients suffer from swelling over the eyes and experience numbness.
Medicines to treat fungal infection available
Liposomal Amphotericin 50 mg injections and Posaconazole are the effective medicines for treating such patients. Due to the spurt in demand for the injections, the black marketing of these jabs has started. It can be procured from the state government-run medical stores only.
The state-run Rajasthan Medical Services Corporation Ltd has ordered the purchase of 2,500 Liposomal Amphotericin 50 mg injections from Bharat Serums and Vaccines Ltd. There is a nationwide shortage of the injections as a large number of cases have been reported from several states, including Gujarat.
The state government has also placed orders for Isoconazole, a substitute of Liposomal Amphotericin 50 mg.
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