After several cases of the ‘black fungus’ or mucormycosis being reported among COVID-19 patients, doctors have now flagged another fungal infection called aspergillosis or a ‘white fungus’ infection in layman’s terms. TNM spoke to doctors who confirmed that so far, there is no evidence to prove that aspergillosis is more dangerous than mucormycosis, negating several alarmist newspaper reports stating that the ‘white fungus’ was more fatal than the ‘black fungus’.
“As per medical literature, aspergillosis is not as dangerous as mucormycosis. However, if left untreated, it can, just like mucor, spread to the eyes and the brain and can be fatal,” says Dr Anchlia, Professor and Head of the Department of Maxillofacial Surgery at the Govt Dental College and Hospital, Ahmedabad. The Ahmedabad hospital set up a 100-bed-ward recently to treat patients with mucormycosis, during the second wave of COVID-19. According to Dr Sonal who works at the same hospital, mucormycosis can spread dangerously in a span of a day, depending on the patient’s overall health condition.
“Last year, we treated a few cases of aspergillosis in our hospital. They were non-serious cases, compared to the mucormycosis cases and were found to have originated in the upper jaw and mouth (maxillofacial region). In the second wave, we have not had any cases of aspergillosis. So we cannot present conclusive evidence on how it spreads in COVID-19 patients,” she adds.
Aspergillosis was recently detected in four patients at the Patna Medical College in Bihar, where COVID-19 cases are on the rise. “There are mainly three kinds of fungi mold that are present in our oral and nasal cavity - mucormycetes, aspergillus which cause aspergillosis, and candida which causes candidiasis. All of these are opportunistic fungi which grow when the patient’s immunity weakens,” Dr Sonal adds.
How to check for post-COVID fungal infections
Doctors insist on a COVID-19 profile of patients which includes a Random Blood Sugar (RBS) test. Most patients with mucormycosis have been found to have high blood sugar levels, probably due to a combination of reasons.
“Steroid use is common for COVID-19 treatment now and this can spike blood sugar in patients. COVID itself weakens patient immunity and can lead to a spike in blood sugar. Poor hygienic conditions including poor mask hygiene, poor oral hygiene, pre-existing diabetic conditions and a compromised immune system can also make patients more vulnerable to the fungal infection,” Dr Sonal adds. This stands true for aspergillosis too, she adds.