Mucormycosis effect: Four children of varying ages lose an eye

There is a new paediatric post-Covid nightmare doctors are grappling with. Four children of varying ages have each lost an eye to the dreaded black fungus horror. According to doctors, in all four cases, the children had recovered from coronavirus, only to contract mucormycosis later.

Dr Jesal Sheth, Senior Consultant Paediatrician, Fortis Hospital, said three children, 4, 6 and 14 years old, were operated on at two hospitals in Mumbai. While the first two children are not diabetic, the 14-year-old is. In the fourth case, the 16-year-old turned diabetic after recovering from Covid and a part of her stomach was infected with black fungus. The hospital has already treated two teens with mucormycosis, earlier this year.

“The first girl, with a history of diabetes, was admitted to the hospital in a severe condition, and had severe complications - diabetic ketoacidosis with seizure. However, we stabilised her. But the following day, she developed blackening of eyes with black nasal crusts. We promptly diagnosed mucormycosis. The child was treated with removal (debridement) of the infected part of sinuses, enucleation of one eye along with six weeks of medicines, like amphotericin B with posaconazole,” said Dr Sheth.

The 16-year-old who did not have any history of diabetes, directly presented with diabetic ketoacidosis and a perforated appendix. “We stabilised her sugar and performed an appendectomy. While she improved, just before discharge, she developed low BP with intestinal bleeding. We diagnosed her as having two myopic aneurysms of the right external iliac artery, which is the branch of the aorta,” Dr Sheth added.

Moreover, both children were found positive for Covid antibodies and had a history of exposure to the virus. The RT-PCR tests for both children were negative.

The younger children, who were not diabetic, had been admitted to Mumbai’s KBH Bachooali Ophthalmic and ENT Hospital. Both had Covid.

Last week, Maharashtra had reported its first known case of paediatric mucormycosis, with a Class 8 student, losing vision in one eye.

The 14-year-old resident of Ratnagiri had been referred to Brihanmumbai Municipal Corporation’s RN Cooper Hospital in Andheri last week, with complaints of loss of vision in her right eye and swelling in the cheek region, said the ophthalmology department in-charge Dr Charuta Mandke.

“Since she came down with vision loss in the right eye last week, we had a biopsy done. We first suspected it was a tumour and pursued that line of treatment, since there was no history of Covid-19,” she said.

“When we saw her, we knew we had to remove the right eye to save her life, but further medical investigation was also necessary. We sought an opinion from the ENT (ear, nose and throat) team,” Dr Mandke said. The ENT team asked for an MRI, which confirmed what the earlier biopsy report had said about the presence of the fungus.

The patient is currently recuperating in the hospital’s dedicated mucormycosis ward for females. However, the hospital will continue to monitor her condition with CT scans and nasal swabs to ensure that all the fungal growth has been eliminated. Once this is established, there are plans to help fix the disfigurement of the minor’s face. Dr Mandke told this reporter, “We will consider plastic surgery to aesthetically fix the disfigurement of the child's face due to the removal of her right eye.”

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