Black Fungus: How to identify high-risk COVID patients to prevent mucormycosis, Zee explains

New Delhi: Amid an alarming rise in the number of black fungus cases across the country, the All India Institute of Medical Sciences (AIIMS) has issued a new set of guidelines for the identification of high-risk patients in the COVID-19 ward and to protect them from deadly mucormycosis.

The AIIMS guidelines list out signs for which patients and their caretakers must keep a lookout for early detection of black fungus or mucormycosis so that medical staff is alerted on time and timely treatments save lives.

The new guidelines were released by AIIMS’ Dr Rajendra Prasad Centre for Ophthalmic Studies for early detection and prevention of mucormycosis in AIIMS’s Covid Ward. 

The AIIMS COVID Portal has a complete brochure on Mucormycosis, recognition of onset and treatment by doctors. 

Who are the “high-risk” patients in the COVID ward?


The AIIMS pamphlet online says many patients with Mucor are noted to be RTpcr +ve at >10 days from onset. This may represent the immunocompromise-related persistence of COVID infection.

According to doctors, cases of mucormycosis, also known as black fungus, are being seen among Covid patients who were administered steroids to treat symptoms, and particularly among those who are suffering from diabetes and cancer. Medical experts have pointed to strong links between diabetes and infection.

Also, Covid-19 has a tendency to worsen diabetes and also precipitate diabetes in previously normal individuals.

The “high risk” COVID patients to be monitored are:

-Patients with uncontrolled diabetes, diabetic ketoacidosis, and diabetics on steroids or tocilizumab

-Patients on immunosuppressants or anticancer treatment, and patients with a chronic debilitating illness

-Patients on high dose steroids and/or long duration of steroids or tocilizumab
Severe Covid cases

-Patients on oxygen support—nasal prongs, by mask, or on a ventilator

-Ophthalmologists have been asked to conduct a baseline examination of these high-risk patients, followed by weekly examinations till the time of discharge. 

The guidelines also stress on follow-up examination, depending on the patient’s condition either every two weeks for six weeks, or once every month for three months.

What are the symptoms for early detection of black fungus


-Nose bleeding, abnormal black discharge

-Nasal congestion

-Head and eye pain

-Swelling near the eyes, blurred vision, red eyes, less visibility, difficulty in opening and closing the eye

-Numbness or tingling feeling on the face

-Difficulty in opening the mouth or chewing something

-Toothache, swelling inside or around the mouth

What to do if you have symptoms of black fungus?


AIIMS has also laid out guidelines on what to do if a patient shows symptoms of black fungus

-Contact an ENT doctor immediately, contact an eye expert or contact a doctor who is treating a similar patient

-Follow the treatment every day. If you have diabetes, then monitor blood sugar

-If there is any other disease, keep taking medicines and monitor it

-Do not take steroids or any other medicines on your own. Take medication only after consulting the doctor

-Get MRI and CT scan done on the advice of the doctor. The nasal-eye examination is also important


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