Nasal aspergillosis: Another fungal infection haunts after black fungus

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Photo by Anna Shvets from Pexels
Photo by Anna Shvets from Pexels

New Delhi : People are still struggling to find a solution for black fungus, which has been diagnosed in more than 11,000 COVID-19 patients so far, and another funal infection - Nasal aspergillosis – has been detected to make things murkier.

Vadodara, which has 262 patients undergoing treatment for mucormycosis in two government hospitals — SSG and Gotri medical college — now has at least eight patients of aspergillosis in SSG, admitted over the past week.

SSG also has 13 patients of Candida auris, an invasive, multi-drug-resistant yeast infection that is being found in Covid-19 patients.

Dr Sheetal Mistry, advisor for Covid-19 to the city and district administration, told Indian Express, "Pulmonary aspergillosis is commonly seen in immuno-compromised patients but aspergillosis of the sinuses is rare. We are seeing it now in patients who have recovered from Covid or are undergoing treatment. Although aspergillosis is not as mutilating as mucormycosis, it is also invasive. The fungal infections seen these days are mostly invasive in the rhino-orbital-cerebral passage."

She mentions in the report that the growing case of fungal infection are related to use of steroids for the treatment of coronavirus patients.

Mistry said, "Fungal infections are opportunistic in nature and feed on glucose. Therefore, patients with a history of diabetes, who have undergone a rigorous course of steroids to treat Covid-19 as well as those who have turned diabetic following Covid-19 infection are at risk of developing the fungal infection. We are also observing low counts of lymphocytes in the blood (lymphopenia), which compromises on immunity and makes way for fungal infections."

She also says, "When the person is diabetic and is not improving on oxygen and other regular treatment protocols, we send the sample for testing for serum galactomannan level for aspergillosis. If detected, they are put on treatment for the fungal infection. It is difficult to diagnose invasive fungal infections through blood profile because the galactomannan level does not indicate the presence of fungus in Covid patients. It is possible that some chronic patients may have even succumbed to the invasive fungus without getting detected."

Some of the media reports called it Yellow fungus, while she said that it cannot be given a particular colour code as it has been detected with different colour in different patients.