BENGALURU: One of the most worrying infections during the Covid-19 second wave was mucormycosis, with Karnataka having recorded at least 2,856 cases. While Covid cases have come down, doctors are still seeing “persistence” cases of mucormycosis coming in, and are using a method called hyperbaric oxygen therapy to treat them.
While many patients have been cured by anti-fungal treatment and surgical debridement, hospitals have seen cases of persistence, days after recovery. Dr Anoop Amarnath, Head, Scientific Board and Chairman, Geriatric Medicine, Manipal Hospitals, and member of the Critical Care Support Team (CCST) said, “When we re-evaluate patients with para nasal sinuses through MRI, the radiological images show persistence in fungal infection, even after anti-fungal treatment and surgical debridement.”
Dr Amarnath said the hospital has been using an add-on method called hyperbaric oxygen therapy (HBO) to cure such patients completely, and was beneficial in six patients at Manipal Hospitals. “HBO allows for saturation of oxygen within the blood and haemoglobin, and a ten-fold increase in dissolved oxygen in plasma. Oxygen delivery to the compromised tissue is increased, and growth of fungus is curtailed, which reduces recurrence. However, we have to carry out lung evaluation, and if the middle ear cavity is intact. HBO is given as an add-on with anti-fungal treatment and surgical method,” he said.
Meanwhile, Dr Girishanand, Consultant - ENT Surgery, Aster CMI Hospital, stressed the need for patients to follow up on scans. “Recurrence can happen within a week and spread to other areas if adequate treatment -- surgery and medication -- is not given. There are instances where medication -- liposomal amphotericin -- is not available, or there are cost issues, or reaction to medication. Alternative anti-fungal medication is given, which may not really be effective. In such cases, the disease recurs and resurgery is required to clear dead tissue and restart injection therapy,” he said.
Patients also need to improve immunity. “Poor immunity and high blood sugar should be strictly managed to prevent reinfection and the microscopic fungus from spreading,” said Dr Athira Ramakrishnan, Consultant ENT specialist, Fortis Hospital, Bannerghatta Road, Bengaluru.