Black fungus of the intestine: A new and dangerous complication found in COVID-19 patients in Delhi

Two patients in Delhi's Sir Ganga Ram Hospital detected with rare black fungus infection of the intestine. Read on to know all about it.

According to doctors, the cases treated at Sir Ganga Ram Hospital were unique as both patients had covid and the small intestine (instead of stomach or colon) was involved in both.

In just a few days, the black fungus infection has assumed epidemic proportion in India with many states reporting an alarming increase in the number of patients complaining of this serious complication of COVID-19 infection. According to Ministry reports, there are now approximately 8,848 cases of mucormycosis or black fungus in India and the numbers are rising. To add to the woes of the already beleaguered healthcare system of the country, a novel complication of black fungus has been detected in a Delhi hospital where the fungal infection infected the lower intestine of two patients. This included a 56-year-old who lost three family members, including his wife, to COVID-19. Both the patients, one aged 68 years, are currently undergoing treatment at Sir Ganga Ram Hospital in Delhi for more than a week. Hospital authorities have said that this is the first time that the black fungus infected the lower intestine and even made a hole in it.

Case study 1: Pain in abdomen alerted patient

One of the patients had barely completed the last rites of his wife when he experienced pain in his abdomen. He was tested positive for Covid along with his wife and had mild COVID symptoms. His abdominal pain was taken for gastritis or stress and the patient self-medicated for acidity. This delayed proper and timely treatment by three days. He came to the Covid emergency of Ganga Ram Hospital where a CT scan revealed that his small intestine (jejunum) had been perforated. His COVID disease had also worsened and he required ventilator support. The patient was admitted and taken for emergency surgery.

Ulceration in small intestine roused suspicion

The doctor treating the patient, on seeing the ulceration of the Jejunam (first part of small intestine), suspected fungal disease and started the patient immediately n anti-fungal treatment. A portion of the removed intestine was also sent for biopsy, which confirmed the presence of black fungus.

Case study 2: A diabetic who received steroids for COVID treatment

Another patient, Ijaz, had recovered from COVID-19. After recovery, he developed mild abdominal pain. This patient was a diabetic and had received steroids for treatment of Covid. He did not exhibit any fever and pain was also very mild. A clinical examination did not reveal any signs of intestinal perforation. But, acting on suspicion, the doctor treating him asked for an urgent CT scan to be conducted for the patient. The scan revealed small intestinal perforation similar to the first patient and the biopsy confirmed mucormycosis. Both patients had Covid and diabetes but only one of them had received steroids.

Who are at risk of gastro-intestinal mucormycosis?

GI mucormycosis is rare and the patient presents with vague abdominal symptoms. It involves the Rhino-orbital-cerebral system or the lungs. This fungus commonly involves the stomach or the large intestine.

• Immune-compromised patients.
• This kind of mucormycosis is also seen in organ transplant recipients.

According to doctors, the cases treated at Sir Ganga Ram Hospital were unique as both patients had covid and the small intestine (instead of stomach or colon) was involved in both. In recent times history of Covid exposure along with treatment with steroids should warrant an early CT scan of abdomen, say doctors.

(With inputs from IANS)