Delhi has reported its first-of-its-kind case of White Fungus which caused a ruptured intestine in a Covid-19 patient, doctors at Sir Ganga Ram Hospital said on Thursday.
A 49-year-old woman was admitted to the hospital on May 13. The patient reported severe abdominal pain, vomiting and constipation.
She had also received chemotherapy until four weeks ago and has a mastectomy done for breast cancer.
“White Fungus (Candida) causing multifocal perforations in the food pipe, small bowel and large bowel in COVID-19 infection has not been reported in literature to the best of our knowledge,” Dr Anil Arora, Chairman of the Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences at the hospital, told news agency Press Trust of India.
A CT scan of the abdomen revealed free air and moderate amount of free fluid in the abdominal cavity suggestive of an intestinal perforation, the Delhi hospital said in a statement.
The doctors immediately placed a tube inside the abdomen and drained about one litre of bile-stained pus, it read.
A team of surgeons led by Dr Samiran Nundy of the Department of Surgical Gastroenterology and Liver Transplantation conducted an emergency surgery on the patient the next day.
“The surgery revealed perforation in the lower end of the food pipe. A part of the small intestine had developed gangrene and sloughed off, and the patient had multiple thinned out patches in the wall of the colon with one small leak,” Dr Nundy said.
“The perforations were closed and the gangrenous segment was resected in a difficult surgery lasting four hours after which a piece of intestine was sent for biopsy”, he said to the news agency.
The woman’s COVID-19 antibody levels were markedly elevated. Her blood and peritoneal fluid culture showed exuberant growth of the fungus. She was immediately started on anti-fungals and showed remarkable improvement, he said.
However, five days later, she had to undergo a second surgery for a small leak from the anastomotic site. She is currently recovering from it, said Dr. Aurobindo of the Department of Liver Transplantation and GI Surgery in the Delhi hospital.
“There have been cases of fungal infection (black fungus) secondary to COVID-19 infection with underlying diabetes, but white fungus causing severe ulceration and gangrene of the intestine with multifocal perforations in the food pipe, small bowel and large bowel in the setting of COVID-19 infection has not been reported in literature to the best of our knowledge,” Dr Arora said.
Malignancy, recent chemotherapy, and a superimposed COVID-19 infection together drought down the immune system of the patient to dismally low levels, he added.