Even as concern grows over the increasing number of mucormycosis cases in the city, doctors have reported cases of another invasive fungal infection — aspergillosis — among Covid-positive patients as well as those who have recovered from the virus.
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 this newspaper, “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.”
Mistry attributes the growing cases of fungal infections to the usage of steroids for treating Covid patients as well as the use of non-sterile water used for hydrating the oxygen supply.
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.”
Pointing out that early diagnosis is important, Mistry adds, “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.”
Mistry added aspergillosis cannot be classified by colour codes as it is being done at the moment. “It is being called while or yellow fungus but it presents itself in different colours. In some cases, it shows brown, bluish-green, yellowish-green, green, and even gray. The treatment is the same, using Amphotericin-B,” Mistry said.