Misuse of steroids major cause behind mucormycosis infection: AIIMS chief

AIIMS director Dr. Randeep Guleria on Saturday warned that cases of mucormycosis infection, commonly known as the ‘Black Fungus’, are on the rise in the wake of the coronavirus disease (Covid-19) among particularly susceptible patients. Misuse of steroids is a major cause behind this infection, he said, adding that patients who are diabetic or Covid-19 positive and are taking steroids have an increased chance of contracting the fungal infection.

To prevent the mucormycosis infection, misuse of steroids must be stopped, said the director of the All India Institute of Medical Sciences (AIIMS) in New Delhi. Dr. Guleria added that such secondary infections, which include fungal and bacterial, are causing more mortality in recent days, even as Covid-19 cases keep on increasing. It is thus all the more important to properly follow protocols of infection control practices at hospitals, he said.Mucormycosis spores are found in soil, air, and even in food, said the AIIMS chief.

In a new advisory over black fungus infection, the central government asked people to be extra careful regarding infection protocols since the mucormycosis fungus enters the body through a cut, scrape, burn, or other types of skin trauma when the skin comes in contact with fungal spores in the environment.

As such, a few of the conditions in which a Covid-19 patient might find themselves to be at an increased risk of the mucormycosis infection are:

1. If they are visiting dusty construction sites without masks.

2. If they are not wearing shoes, long trousers, long sleeve shirts, and gloves while handling soil (gardening), moss, or manure.

3. If they have experienced prolonged hospital or ICU stay.

4. If they are co-morbid, have undergone organ transplant, or are suffering from cancer.

5. If they are not maintaining personal hygiene properly in general.Dr. Randeep Guleria, AIIMS chief, said that the mucormycosis fungal spores are of low virulence and usually do not cause infection. There were very few cases before Covid-19, but a large number of cases are only being reported in recent times due to the coronavirus disease infection, which affects immunity. Since steroids like dexamethasone also repress the immune system, it is necessary to be extra careful regarding its use, now more so than ever.

Overuse, misuse, and rampant use of steroids in Covid-19 patients cause black fungus, also known as mucormycosis,” said Dr. Suresh Kumar, medical director of LNJP hospital in New Delhi.

He said that steroid use must be reduced. “If given to patients with oxygen levels over 90, black fungus is a possible side-effect. Early diagnosis is critical. A CT scan of the face would detect this infection, after which antifungal drug amphotericin will be used for treatment,” he said.

“Quite often a patient dies due to black fungus (mucormycosis) instead of Covid-19,” Dr. Suresh Kumar added. Misuse of steroids major cause behind mucormycosis infection: AIIMS chief