Tirupati: Amphotericin B injections scarcity irks black fungus patients

Tirupati: The cases of mucormycosis or popularly known as black fungus have been increasing in Chittoor district with at least 17 cases were reported in the last three days itself. Out of them 10 is getting treatment at Ruia hospital. Some patients are even going to places like Chennai for treatment. Though officials were denying any deaths due to black fungus, a 40-year-old patient from Vedurukuppam mandal has reportedly died due to it.

Dr V Chandrasekhar, Professor and HoD of ENT at Ruia hospital, which is one among the 14 notified hospitals for black fungus disease treatment, told The Hans India that due to multiple factors like prolonged treatment for Covid, excessive usage of steroids, high sugar levels, increased oxygen dependency and low-immunity in patients, black fungus cases are on the rise.

It makes people severely sick and involves huge risk in the recovery process as the fungus may spread to other organs through vessels. As black fungus develops in the body, Covid recovery will be delayed and unless it is cured, the patient's infection will not be controlled and so too the sugar levels. All these coexisting factors become vulnerable for the patients.

The treatment consists of medical and surgery parts which require teamwork involving doctors from different branches. The patients require Amphotericin B injections 300 mg dose daily for 2-4 weeks. It has two forms out of which one is a very cheap drug and is toxic and leads to many side effects.

Another one is a refined form known as Liposomal Amphotericin B which has good penetration and needs to be used. Dr Chandrasekhar said that currently these injections are not available and are expected by next week as they have already placed an indent. Meanwhile, patients are being treated with antibiotics and pain relievers.

"Covid leads to low-immunity due to which fungus will penetrate and spread through vessels. Due to increasing use of steroids in Covid treatment, the sugar levels are rising along. So too the dependency on oxygen which creates the whole problem," he maintained.

Along with the injection course, surgery will also be done to the patients after they become stable and assess their fitness. On the whole, 2-3 weeks hospital stay is needed. A separate ward with 25 beds was set up at Ruia hospital for patients with black fungus disease and the number of beds will soon be increased to 50 or more as it involves long hospital stay.

To another question on the symptoms of black fungus, Dr Chandrasekhar said that patients will have severe facial pain, nose crusting, some blackish discharge from nose, headache, severe sickness, pain around eyes.

It even displaces the eyeball which may lead to loss of vision or double vision. In the next stage it may extend to the brain also. He advised that there must be judicious usage of steroids. Extreme care is required in oxygen intake. The masks, water, surroundings etc., should all be clean from fungus.