Our Covid-19 patients are facing the epidemic of Mucormycosis affecting Mouth, Palate, Maxilla, Mandible, Nose, Sinuses, Eyes, Brain and Lungs. This fungus is usually diagnosed after 3-4 weeks of Covid infection. Those who are diabetics or have received high dose of steroid, often, have contracted this Healthcare Acquired Infection during the treatment of Covid.
How the Fungus enters in body?
The black fungus enters the body tissue because of injury – a cut/break in skin of face, lips, nose or eye lids and cuts or damage in mucus membrane of mouth, palate, sinuses, conjunctiva, and can directly spread then to brain and to lungs too. Prevention of fungus infection is by preventing its entry in the body and this can be done by preventing injury to skin or mucus membrane of above mentioned areas. Injury can occur to these parts, while the patient is given oxygen. Oxygen therapy equipment, if not fungus free, can cause fungus infection.
How can Covid patients be saved?
Instruments which are used for supplying extra oxygen, must be sterile. Plastic tubes and masks are disposable and must be changed every day and disposed of suitably. This is a costly affair, but in the interest of the patient, this must be practiced. Those tubes which can not be changed daily, needs to be cleaned and disinfected daily by appropriate disinfectant as advised by supplier.
Nasal canula, Simple breathing mask, Bipap breathing mask Humidifier having water, Endo tracheal tube used for this purpose must be fungus and bacteria free and no injury should occur by them while introduction. Ventilator and Oxygen Concentrator also must be made fungus and bacteria free by chemical antiseptics as advised by the manufacturer. The patients in ICU and on extra oxygen support must be looked after by properly trained Nurses. The nurse must be sincere and must know all aseptic precautions to be taken. He or She must know how to don the sterile glows and PPE kit; she must know everything about proper nursing.
Oral Hygiene is Important
Most important for prevention of fungus is – oral hygiene in bed ridden patient with oxygen tubes and mask. Nursing staff must have received special practical training for this work. For preventing the fungal infection, Nurses must clean lips and inside of mouth with antiseptic like Chlorhexidine or Betadine and use fresh sterile nasal canula, oxygen ordinary and Bipap mask every day. Use sterile endotracheal tube and clean the tube by antiseptic daily.
Humidifier bottle should be sterilized by putting it in boiling water for 5 minutes and fill the bottle with bacteria and fungus free boiled water. For prevention of fungus, use minimum of steroid, keep blood sugar level below 200 and stop self-medication by patient.
-Writer is a well-know figure in Medical fraternity and have been working for the welfare of humanity on and off road.
Very useful information and guidance