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Updated May 21st, 2021 at 15:07 IST

COVID-19: Assam government issues new SOPs to treat Black Fungus infections

Amid the sudden increase in Black Fungus cases across India, the Assam Health Department released a new Standard Operating Procedure (SOP) for the disease. 

Reported by: Srishti Goel
Assam
​​​​​​​Picture Credit: PTI | Image:self
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After the sudden increase in the cases of Black Fungus or Mucormycosis across the country and a recent incident at Apollo Hospital in Guwahati, the Assam Health Department released a new Standard Operating Procedure (SOP) for the disease. The SOP was issued after a suspected case of mucormycosis (Black Fungus) was found in a hospital at Guwahati, according to an order issued by the principal secretary to the Assam government's health department on Thursday, May 20.

Assam govt issues SOPs

The order read, A large number of similar cases have been reported from other parts of the country” and “there is the likelihood of an increase in the number of such cases in the near future. Therefore in order to screen, diagnose and manage such cases of mucormycosis (black fungus) in COVID patients, the Standard Operating Procedure” is notified with immediate effect “in order to contain the further spread of the disease and in order to provide treatment as per protocol to the patients affected by such disease." 

The SOPs issued by the Assam Health Ministry also list Pre-disposing factors, When to suspect? How to diagnose? How to prevent?, COVID patients in Home isolation, Community in general, Treatment for Black Fungus and other related information. While explaining, What is mucormycosis (black fungus), the official order explained, "Mucormycosis is a rare serious fungal infection caused by fungus Mucor. People get mucormycosis by coming in contact with its spores in the environment. It can also develop in the skin after the fungus enters the skin through a cut, abrasion, burn or other types of skin trauma."

Guidelines for Black Fungus

It informed, "Patients who have comorbid conditions like Diabetes Mellitus, on immune suppressant drugs, renal transplant patients or those or steroids for medical cause need to observe the following warning symptoms":

  • Facial Pain/ Cheek pain
  • Bloody & foul-smelling nasal discharge
  • Nasal stuffiness
  • Eye Symptoms like — Eyelid oedema, redness in the eye, any visual disturbance.

Treatment for Black Fungus: 

  • Medical management Antifungal Therapy:
  • Hydrate the patient with 500 ml of NS before Amphotericin-B
  • Inj. Liposomal Amphotericin-B — 5-10 mg/kg/day to be diluted in 500 ml of 5% Dextrose over 4-5 hours for 14-21 days in the hospital. OR Inj. Amphotericin-B — 1-1.5mg/kg/day mixed with 500 ml 5% Dextrose over 4-5 hours for 14-21 days in the hospital.
  • Special precaution to be taken during Amphotericin-B infusion as this drug is photosensitive.
  • Monitor S. Creatinine and S. Potassium every 72 hours
  • Patients who are intolerant to Amphotericin-B can be given alternative agents like Posoconazole Tab. 300mg twice daily on day one followed by 300 mg once a day for 3-6 months.
  • Monitor patient clinically microbiologically and with radio imaging for assessing & disease progression.
  • After 3-6 weeks of Amphotericin-B therapy, consolidation therapy with Posaconazole for 3-6 months to be instituted. Duration of therapy depends on clinical response and radiological resolution and has to be individualized.

Picture Credit: PTI

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Published May 21st, 2021 at 15:07 IST

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