Shortage of Amphotericin B injections, which are used for the treatment of mucormycosis and in few cases even shortage of specialist doctors, is forcing patients from inter-city and inter-state to travel for seeking mucormycosis treatment. In the whole process, the treatment cost is mounting to lakhs.

Mohd Manzoor Hussain, aged 68 years, who is a Srinagar resident had faced a difficult last month, as he was coping with COVID-19, then his wife’s death and later got infected with mucormycosis. 

The retired forest officer had to travel to Mumbai for treatment as he was unable to get surgical intervention to remove the fungus in Srinagar. Sitting in the doctor’s cabin after his discharge, he smiled and said that he just wants to go home as it is pleasant in Kashmir and Mumbai is very hot.

Mohd Hussain’s entire family was infected with coronavirus infection in Srinagar. He lost his wife just two days after being discharged and within afew days, he developed a gnawing tooth ache. He made multiple visits to private hospitals and dentists for almost 7 days.

The fungus had grown in his sinus, mouth and also around the eyebrows as an endoscopy hinted at mucormycosis. He was readmitted in a private hospital and scheduled for a surgery but the surgery kept on getting delayed. Someone in the hospital advised him to get treatment in Delhi or Pune. On 6th May, Hussain then flew to Mumbai as one of his friends arranged for a bed at Bombay hospital. The next morning, a surgery was undertaken to remove the black fungus.

Dr Gautam Bhansali, Consultant physician said that the fungus had spread to most part of his face but luckily had not reached eyes or brain. Bhansali said that during his covid treatment, Hussain was administered an unusually high dose of 500 mg steroids in Srinagar. The usual dosage of steroidsis 40-50 mg per day.

Bhansali said that the root cause of mucormycosis is still unknown. It could be diabetes, steroids, or contamination, but a sudden rise in India is perplexing. Bombay hospital has treated nearly 27 mucomycorsis cases. Out of them, 10 cases were from outside Mumbai.

Assistant Medical Officer, Dr Pravin Bangar said that in KEM hospital, a special 60-bed ward is created for mucormycosis patients and is already full. Many patients are from outside the city.

Chetan Kumar Dholakia, aged 52 years had to travel from Rajkot to Mumbai due to the shortage of anti-fungal medication Amphotericin B. Dholakia’s son Sumit said that every morning, he used to stand in a government centre’s queue to buy Amphoterecin. By the time his turn came, the medicines stock used to get over. He further said that there is a crisis of these injections in Gujarat. The family booked train tickets 3 days ago and travelled to Mumbai for his father’s treatment. At least 5 members of his family have accompanied, in case they have to search around for Amphoterecin vials in Mumbai.

Mucormycosis requires a multi-speciality team, that includes ENT specialist, ophthalmologist, neurosurgeon, general surgeon, physician along with the anaesthetist, if the infection spreads to brain and face.

Subhash Pacharia (62) district Jhunjhunu made a quick decision within a day of being diagnosed with mucormycosis and travelled to Mumbai last week. Pacharia’s son Abhishek said that there is no MRI or CT scan facility and doctors could not collect samples to culture the fungus. They had asked them to go to Jaipur, but they thought Mumbai was a better option. Pacharia required five Amphoterecin vials each day. His son had to go to Thane civil hospital to buy these vials. 

Dr Avinash Supe, who is a chairman of the death audit committee, Maharashtra, said that Mumbai has reported 28 mucormycosis deaths. 

In the past few days, out of 100 cases, 30 to 40 patients of Covid-associated mucormycosis have died. According to the data, which is released by the Ministry of Chemicals and Fertilizers, India has recorded 8,848 mucormycosis cases till 22nd May.

Source: The Indian Express