As mucormycosis is fast spreading like an epidemic, it is essential for doctors to identify the patients at high risk for early detection and prevention of this deadly fungal disease. Read the article to know more.
The second wave of COVID infection has led to an increasing number or spike in black fungus or mucormycosis cases that can prove fatal, especially in immunosuppressed patients and diabetics. AIIMS (All India Institute of Medical Sciences) has released a new set of guidelines for the early detection and prevention of black fungus.
Identification of high-risk patients in the COVID ward:
1) Examination of high-risk patients in the COVID ward.
2) Examination should be performed by an ophthalmologist:
- Weekly thereafter till the time of discharge.
- Follow-up after discharge to be explained.
Depending on the patient's condition, follow-up must be advised as follows:
1. Every two weeks for six weeks.
2. Monthly thereafter by teleconsultation for a period of three months from the time of discharge.
History of nasal congestion or blockage, vision loss, double vision, pain, swelling, drooping of the lid, inability to close eyes, numbness or tingling around eyes or cheeks, difficulty in chewing, prominence of the eye, or any other ocular symptoms.
1) Vision assessment (preferably aided) – subjective as reported by the patient, objectively with finger counting till a distance of 6 m.
2) Torchlight examination for facial asymmetry.
3) Full face examination, including the periorbital area for swelling, bluish or blackish discoloration/crust, induration, or tenderness.
4) Presence of proptosis by Worm's eye view.
5) Retropulsion test to assess the infiltration of the orbit (both eyes simultaneously will help to compare), Ptosis/ lagophthalmos, conjunctival chemosis or congestion ocular movements/ squint cornea, and anterior segment. Pupillary reactions V1 and V2 sensations Fundus examination if recent-onset visual complaints or RAPD - if possible educate the patient and caregiver about the signs and symptoms of rhino-orbital disease
6) Immediate consultation with ENT specialist.
7) Imaging with contrast to other relevant consultations on an urgent basis.
Danger signs of Black Fungus (mucormycosis):
The national COVID-19 task force in India has issued an evidence-based advisory on the main measures to be taken for controlling the spread and precautionary measures on an everyday basis for both the patients who have recovered from the COVID infection and the patients in the ICU wards and COVID wards. The following measures need to be implemented by any individual affected by the COVID virus hence:
Hence timely detection and diagnosis in high-risk cases and patients affected by COVID is the need of the hour to prevent the spread and the secondary infections that follow because of mucormycosis.
Last reviewed at:
07 Jun 2021 - 4 min read
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