Dark fungus versus white fungus versus yellow fungus: Which is more hazardous and who is in danger?

In the midst of the rising instances of Black Fungus disease in a few territories of India, an instance of destructive Yellow Fungus contamination has been accounted for from Ghaziabad in Uttar Pradesh. As per specialists, Yellow Fungus is more perilous than both Black Fungus and White Fungus. The tainted patient is as of now going through treatment at a medical clinic in Ghaziabad. 

Hardly any days prior, four instances of white fungus were accounted for in Patna, Bihar. White fungus is additionally more hazardous than dark fungus and cause significant issues whenever left untreated. 

Dark fungus was as of late declared as a pandemic by 29 states in India.

On Saturday morning, Dr. Akshay Nair, a Mumbai-based eye surgeon, was waiting to operate on a 25-year-old woman who had recovered from a Covid-19 battle three weeks ago.

During the operation, the ear, nose, and throat surgeon was already working on the patient, who was diabetic.

She had inserted a tube through her nose and removed mucormycosis, a rare but dangerous disease. This aggressive disease affects the nose, eyes and sometimes even the brain.

After the colleague is finished, Dr. Nair will perform a three-hour procedure to remove the patient's eye.

"I will remove his eye to save his life. That is how the disease works," said Dr. Nair.

Although the second deadly Covid-19 wave destroys India, doctors are now reporting an outbreak of cases involving a rare infection - also known as "black mold" - between recovery and finding Covid-19 patients.

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What is mucormycosis?

Mucormycosis is a very rare disease. It is caused by exposure to mucus fungus which is commonly found in soil, plants, manure and fruit and rotting vegetables. “It is ubiquitous and is found in soil and air and even in the noses and mucous membranes of healthy people,” says Dr. Nair.

It affects sinuses, brain and lungs and can be life-threatening for people with diabetes or severe disabilities, such as cancer patients or people with HIV / AIDS.

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Doctors believe that mucormycosis, with a total mortality rate of 50%, may be caused by the use of steroids, a life-saving treatment for acute and severe Covid-19 patients.

Steroids reduce inflammation in the lungs of Covid-19 and appear to help prevent further damage when the immune system goes into overdrive to fight coronavirus. But they also lower the immune system and raise blood sugar levels in both diabetic and non-diabetic patients Covid-19.

It is thought that this decline in the immune system could cause these cases of mucormycosis "Diabetes weakens the immune system, coronavirus triggers it, and steroids that help fight Covid-19 act as fuel in a fire," said Dr. Nair.

Dr Nair - who works at three hospitals in Mumbai, one of the cities most affected by the second wave - said he had already seen about 40 patients suffering from the fungus in April. Most of them were diabetic people who had recovered from Covid-19 at home. Eleven of them had to have their eye removed surgically.

Between December and February, only six of his colleagues in five cities - Mumbai, Bangalore, Hyderabad, Delhi and Pune - reported 58 cases of the virus. Most patients received it within 12 to 15 days after recovering from Covid-19.

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Mion's busy Zion Hospital reported that there had been 24 cases of fungal infections in the past two months, from six million a year, according to Dr Renuka Bradoo, head of the ear, nose and throat hospital.

Eleven of them had to lose their eyesight, and six of them died. Most of his patients are middle-aged diabetics who contracted fungus two weeks after recovering from Covid-19. "We've already seen two to three cases a week here. It's a nightmare inside the epidemic," he told me.

In the southern city of Bangalore, Dr. Raghuraj Hegde, an optometrist, tells a similar story. He has seen 19 cases of mucormycosis in the past two weeks, most of them young patients. "Some were so sick that we couldn't even have surgery."

Doctors say they are amazed at the severity and prevalence of the fungus during the second wave, compared to other cases during the first wave last year.

Dr Nair said he had encountered no more than 10 cases in Mumbai in the past two years. "This year is different," he said.

In Bangalore, Dr. Hegde had not seen more than one or two cases a year in more than a decade. Patients with fungal infections often have nasal congestion and bleeding; swelling and pain in the eye; decreased eyelids; and fades and finally, loss of vision. There may be dark spots on the nose.

Doctors say that most of their patients arrive late, when they have already lost their sight, and doctors have to remove the eye with surgery to prevent the infection from reaching the brain.

In some cases, Indian doctors say that patients have lost their eyesight. And in rare cases, doctors should surgically remove a jaw bone to prevent the disease from spreading.

An intravenous anti-fungal injection costs 3,500 rupees ($ 48) dose and should be administered daily for up to eight weeks with the end of the course of treatment against the disease.

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Another way to prevent the possibility of a fungal infection was to ensure that Covid-19 patients - both on treatment and after recovery - were given the right dosage and duration of steroids, said Dr Rahul Baxi, a diabetes doctor in Mumbai.

He said he treated about 800 patients with diabetes Covid-19 last year, and none of them contracted the disease. "Doctors should monitor blood sugar levels once the patients are out," said Dr. Baxi.

A senior government official says there is no "serious disease". However it is difficult to say why an increasing number of cases of mucormycosis are reported across the country. "The type of virus appears to be potent, sending blood sugar up to very high levels. And surprisingly, fungal infections affect many young people," said Dr. Hegde.

Her youngest patient last month was a 27-year-old man, who was not even diabetic. "We had to operate on him for his second Covid-19 operation and have his eye removed. It hurts."