JOIN USSome Bengaluru 'black fungus' patients await extensive facial reconstruction post recovery
Alongside 49 heartening cases of cure and recovery from the dreaded 'black fungus' infection among 959 patients in Bengaluru (out of whom 72 died), there are nearly 30 patients awaiting extensive reconstruction and rehabilitation post vision loss, in government hospitals alone, say treating doctors.
State-run Victoria Hospital where 190 Covid positive mucormycosis ('black fungus') patients have been treated so far, 17 have undergone 'exenteration' where not just the complete surgical removal of the eyeball and contents of the eye socket was done, the tip of the nose and jaw(s) also had to be removed.
With half of their face surgically removed, the patients will need plastic surgery where some areas of their face can be reconstructed with skin tissue and the patients can get a semblance of their previous look. But that is one of the last stages of recovery, three to six months after recovering from the fungal infection, said Dr Manoj Kumar, Dean, Bowring and Lady Curzon Hospital, told DH.
"We have done exenteration in 11 patients where some had nasal sinuses and jaw(s) removed. One of our first challenges is feeding them without a jaw. They have been put on a feeding tube, which is inserted with the help of major surgeries. This tube cannot be put in for long so we opt for Jejunostomy. We have done 108 surgeries as of now in which major surgeries were done in 15-20 patients," he said.
Jejunostomy is the surgical creation of an opening through the skin at the front of the abdomen to help with feeding. "Jaw reconstructions are also being planned. We use prostheses for them so that they can consume food and talk again. Their speech will be 80% to 95% like it was previously based on tongue involvement," he added.
Dr Sujatha Rathod, Director, Minto Eye Hospital, said, "Among 37 cases of vision loss that we have seen due to mucormycosis, 11 died, seven had intracranial spread of the infection, two were discharged against medical advice and 17 underwent exenteration." Five of them are women and 12 of them are men. Three of them are aged just 27, 29 and 31 years old.
"The fungus is so fulminant (severe and sudden in onset) that it rapidly spreads. If patients don't notice the early signs when it reaches their nasal cavity, then the infection spreads to the eye. Exenteration is one of the most destructive procedures which we do not opt for unless it is the last resort. In some of these 11 patients, the entire one half of the face was shaved off right to the bone," Rathod said.
Mucormycosis: Number of cases
Bangalore Urban district cases
Victoria Hospital: 195
Bowring Hospital: 212
Total cases: 407
Total Bengaluru cases: 959
Total Bengaluru deaths: 72
Total Karnataka cases: 2,856
Total Karnataka deaths: 225