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Ask The Doctor: How To Differentiate Between A Seasonal Viral Infection and Black Fungus

Prof (Dr) Nitin M Nagarkar, Director and CEO at AIIMS Raipur.

Prof (Dr) Nitin M Nagarkar, Director and CEO at AIIMS Raipur.

In this week’s column, Prof (Dr) Nitin M Nagarkar, Director and CEO at AIIMS Raipur and Head of Department of ENT, Head and Neck surgery has replied to queries related to COVID-19 and ear, nasal as well as throat infections.

A year after the Coronavirus pandemic wreaked havoc on our collective lives, our society has been grappling with fear and insecurity. As a result, we have seen misinformation spread like wildfire, and many resorting to bizarre and incorrect methods of dealing with the virus. With this column, which will be published every Sunday, we aim to address any health or vaccine-related question our readers might have about the coronavirus pandemic.

In this week’s column, Prof (Dr) Nitin M Nagarkar, Director and CEO at AIIMS Raipur and Head of Department of ENT, Head and Neck surgery has replied to queries related to COVID-19 and ear, nasal as well as throat infections.

What kind of precautions should people with Ear, Nose, Throat infections take to prevent COVID-19?

Always wear a mask to prevent the entry of pathogens into the upper respiratory tract. People with pre-existing infections, or a tendency towards contracting infections, should also avoid crowded places. They should maintain personal hygiene with regular hand washing and seek early medical advice if any symptoms arise.

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Since ENT is a high-risk specialty during Covid, what challenges have you encountered while treating patients?

As ENT specialists, we have to examine the nose and throat which are entry points for a pathogen. Therefore, it is important to take adequate care and precautions while performing procedures that generate aerosols. Emergency surgeries like tracheostomy should be conducted using proper protective gear.

What are the government guidelines to reduce the risk of Covid-19 among ENT doctors?

An ENT surgeon should wear an N95 mask, use a facial shield while examining patients, and wear PPE kits while performing procedures. Besides, all healthcare workers should take vaccines according to the government rules.

Does a rise in blood sugar level gives an indication of any ENT-related problems in COVID patients?

Yes, uncontrolled blood sugar levels can lead to various ENT problems like invasive fungal sinusitis like Mucormycosis.

Due to season change and monsoon setting in, many are experiencing stuffy noses and blocked sinuses. How can one differentiate between just a seasonal viral and a black fungus? Can those who have no history of covid or diabetes also have black fungus?

In black fungus (Mucormycosis) infections, bleeding from the nose, facial numbness, dental pain, and diplopia are common symptoms, which are usually not a common feature of viral infections or allergies. Yes, patients can have black fungus (Mucormycosis) infection even in the absence of COVID or diabetes. Any immunosuppressed state like cancer, organ transplantation can lead to these opportunistic fungal infections.

How long does it take black fungus to aggravate and show visible signs? What are some of the markers that help us identify the black fungus in the very initial stages before it damages the body parts?

Usually, within 1-2 weeks, symptoms noticed are headache, nasal congestion/ crusting, facial numbness and pain, diminished vision/ double vision, loosening of teeth, palatal ulceration. Any post-Covid patients with uncontrolled blood sugar with increased ferritin levels are prone to black fungus infection. A high index of suspicion, Diagnostic Nasal Endoscopy along with KOH smears or biopsy from nasal cavities is also essential. Imaging like MRI/CT scan also helps in early diagnosis.

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