New Delhi | Jagran News Desk: Amid the increasing cases of COVID-19-triggered Black Fungus (Mucormycosis) across the country, the Ministry of Health on Thursday issued the guidelines for the management of the fungal infection in children below 18 years of age.

Mucormycosis is a serious fungal disease seen in patients with underlying/predisposing factors such as immunosuppression, poorly controlled diabetes mellitus, misuse/overuse of steroids, cancer, organ/stem cell transplantation, and those under prolonged ICU treatment, as per the Ministry of Health.

"Do not wait for culture results to initiate therapy as mucormycosis is an emergency. Early complete surgical debridement is the cornerstone of treatment, and may be repeated as required," the DGHC said in its guideline.

As per the guidelines issued by the government, "Conventional Amphotericin B as a prolonged IV infusion through a central venous catheter or PICC; closely monitor kidney function and electrolytes during treatment".

"Reconstitute in water for injection, and dilute in 5 per cent dextrose (do not use normal saline/Ringer's lactate, start with test dose: 1 mg IV infusion over 20-30 minute. Loading dose: 0.25-0.5 mg/kg IV infused over 2-6 hours; gradually increase by 0.25 mg-increments/day to reach maintenance dose: 1-1.5 mg/kg/day," the guidelines further stated.

"Liposomal Amphotericin B or Amphotericin lipid complex, if available; prolonged infusion over 2-3hours through a central venous catheter or PICC and closely monitoring KFT and electrolytes. Reconstitute in water for injection, and dilute in 5 per cent dextrose (do not use normal saline/Ringer's lactate); start full dose from first day; 5 mg/kg/day (10 mg/kg/day in case of CNS involvement)," it added.

"Posaconazole should be given as salvage therapy in cases who cannot be given Amphotericin B. Children less than 11 years in age dose - 7-12 mg/kg/dose IV twice on the first day and maintenance dose - 7-12 mg/kg IV once a day, starting on the second day," the guidelines said.

Mucormycosis can be life-threatening in diabetic or severely immuno-compromised individuals such as cancer patients or people with HIV/AIDS. The doctors in India are documenting an alarming number of cases of Mucormycosis among patients with COVID-19 and those who have recently recovered. They believe that Mucormycosis may be triggered by the use of steroids, a life-saving treatment for severe and critically ill COVID-19 patients.

Posted By: Talibuddin Khan