Aspergillosis or Green Fungus: A Threat To Post-COVID Patients.

Black fungus or mucormycosis has given a life-threatening scare to people who were diagnosed with COVID infection, and now a different fungal infection is appearing in Post COVID patients. The COVID pandemic, which apparently weakened the immunity in many patients has exposed them to several opportunistic infections like Black fungus, Yellow fungus, and Green fungus. Green fungus is known as Aspergillosis.

Dr. Samiran Panda, the Head of Epidemiology and Communicable Diseases at the Indian Council of Medical Research (ICMR) has said that "terms like a black, green or yellow fungus" are confusing and causing panic, saying the "underlying phenomenon is immunity or the ability to fight the fungal infection."

An ICMR study revealed that at least 3.6% of hospitalized COVID-19 patients were affected with secondary bacterial and fungal infections during the first wave of the pandemic. However, the hospitals did not report cases of the fungal infection mucormycosis.

Fungi is a unique category of plant-like species that depend on other organisms for nutrition. There are more than 60,000 different species in this group. Aspergillus is one of the microfungi that is found everywhere. Its spores may enter the respiratory system of humans and cause diseases. Though there are more than 180 varieties of aspergillus, only 40 are thought to be disease-causing. It is a common mold and everybody inhales the spores. Usually, our immune system counters them.

In view of the recent reports of fungal infections after recovering from Covid, people are afraid of colored microfungi. People with weakened immune systems and those with lung diseases may suffer from it. Patients suffering from Asthma, Tuberculosis, COPD (Chronic Obstructive Pulmonary Disease), Cystic fibrosis, Sarcoidosis are more prone to Aspergillosis. Mucormycosis (Black fungus), candida, and Aspergillosis are common infections in immune-compromised patients.

Symptoms of Aspergillosis:

• Wheezing, shortness of breath, cough, and fever are seen in allergic bronchopulmonary Aspergillosis.
• Running nose, headache, stuffiness, and reduced ability to smell are seen in allergic aspergillus sinusitis.
• Cough, shortness of breath, and coughing up blood are seen in the Aspergilloma (fungus ball).
• Weight loss, cough, coughing up blood, fatigue, shortness of breath is seen in chronic pulmonary Aspergillosis.

If the patient observes the above symptoms they can approach an ENT specialist or a Pulmonologist. In severe cases, a General Surgeon and Radiologist should be consulted for the treatment

Aspergillosis is neither a contagious disease nor is a new disease. For all the fungal diseases medical and surgical treatment is available. The signs and symptoms are similar to tuberculosis.

How is Aspergillosis Diagnosed:

The green fungus is diagnosed through a chest x-ray or a CT scan of the lungs or other parts of your body depending on the location of the suspected infection. Diagnosing Aspergilloma and invasive Aspergillosis is difficult. So an expert has to diagnose the disease.

Treatment for Aspergillosis:

Simple fungal infections don’t need treatment. Oral corticosteroids, antifungal medications like Amphotericin, and surgery are prescribed in serious conditions. To remove the fungal mass surgery has to be applied. A special technique called Embolization, injecting material through a catheter into an artery where bleeding is happening, is applied in bleeding caused by a fungal infection. All these conditions need hospitalization and proper care. As per the Center For Disease Control And Prevention(CDC), People with severe cases of aspergillosis may need surgery.

What Precautions One Should Take:

1. To avoid Aspergillosis one should live in hygienic areas, use masks, keep indoors clean, and try to enhance immunity with physical exercise and good nutrition.

2.This being the rainy season, the moisture content is high in the air, which gives favorable conditions for green fungus to grow and spread. It is advised to check for green fungus Before consumption of stored or preserved food items like bread, sauces, Canned juices to name a few.