Updated: May 27, 2021 9:56:06 pm
A case in Delhi’s Sir Ganga Ram Hospital suggests that the immunosuppressed state brought about by Covid, along with other factors, may have contributed to aggravation of normally occurring Candida — what is popularly being called White Fungus — in the intestine to an invasive form, say doctors in the hospital.
This was seen in the case of a 49-year-old woman who had received chemotherapy for breast cancer four weeks ago. The patient was taken to the hospital with severe abdominal pain, vomiting and constipation, and was in a state of shock and respiratory distress at the time of admission.
According to doctors, the CT scan and surgery revealed perforation in the lower part of the oesophagus, gangrene in a part of the small intestine and thinning of multiple patches of the wall of the colon. Biopsy revealed ulceration of the intestinal wall caused by invasive Candida pseuodhyphae. They also stated that her Covid antibody levels were “markedly elevated”.
“The Covid 19 virus has been known to affect the lungs and upper respiratory tract. Infection of the intestine by Mucormycosis secondary to steroid use has been recently reported but Candida causing severe ulceration and gangrene of the intestine presenting with multifocal perforations in esophagus, small bowel and large bowel in the setting of Covid-19 infection has not been reported in literature to the best of our knowledge,” Dr Anil Arora, Chairman of the Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences at the hospital, said.
He added, “As the exact mechanism is unknown, the probable explanation involves an unholy combination of three states causing immunosuppression: a malignancy (carcinoma breast), recent chemotherapy, and a superimposed Covid-19 infection. All three factors, conspired together in her case, brought down her immunity resulting in transformation of a normal inhabitant of intestine called Candida into a monstrous invasive form resulting in multifocal intestinal perforations with resultant shock and septicemia.”
He added that the intestine normally “remains in perfect harmony” with the Candida fungus.
“The affliction of White Fungus is milder than that of mucormycosis but in this Covid era, one must definitely be aware of this possibility,” Dr Samiran Nundy, advisor at the Department of Surgical Gastroenterology & Liver Transplantation of the hospital, said.
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