Hyderabad: More than 1,000 black fungus patients are undergoing treatment in government and private hospitals here while the health department has advised doctors to use posaconazole injections to treat them.
In a break-up of the patient numbers, Gandhi Hospital has 250, Government ENT Hospital 300 and Sarojini Devi Eye Hospital six persons under treatment. A 200-bed facility is to be created at Sarojini Devi Eye Hospital to shift patients who have undergone surgery in the ENT Hospital, for further medical recovery in the eye hospital.
Private hospitals in Hyderabad have more than 500 patients and the situation there is being monitored by the government-appointed nodal center. The main challenge in treatment continues to be scarcity of amphotericin B liposomal, which is the first line of medicine for treatment.
Director of health Dr Srinivas Rao had a meeting with ENT doctors from private hospitals on Friday. He told them that amphotericin B liposomal injections were scarce and they must instead administer posaconazole injections to black fungus patients. Posaconazole is available in the market.
Amphotericin is available but it is highly toxic and doctors are not keen on using it on patients.
An ENT specialist says, "There is a trinity at work in black fungus cases -- uncontrolled diabetes, Covid19, and excessive and improper use of steroids. This trio is creating havoc in the body.
If we use lower grade medicines, the liver and kidney functioning may be affected. This will have to be monitored for the next three to six months in these patients. “They have to control their sugar levels and the functioning of these two organs have to be tested to avoid complications."
Due to the toxicity of the medicines, many doctors are in a dilemma. They have to cure the patients and they also have to save the patients’ life.
Another ENT doctor said, "We can opt for treating with posaconazole in patients who have black fungus infection in nose, cheeks and the facial region. Those who have invasion in their eyes will require amphotericin. We have to use medicines judiciously."
The government supply is five vials per patient per day. The rules are not changing even as a minimum of 20 patients are reporting to different hospitals with black fungus complaints every day. A relief is that the paperwork has been simplified and private hospitals will only have to list the name of the patient and their status.
Another ENT doctor said: "We are going to see patients till June end as those suffering from Covid19 and recovering will be coming to hospitals with black fungus complaints. The good thing is that there is awareness and this is bringing patients early to hospitals. This will help patients. Till the nose region, this can be managed well."
Experts say those who have taken steroids must check their sugar levels and work towards building cell immunity to protect themselves from black fungus.
