'First-ever' white fungus case
Delhi's Sir Ganga Ram Hospital (SGRH) has come across a first-of-its-kind case of white fungus which causes multiple perforations “throughout the intestine" in a COVID-19 patient, doctors said on 27 May 2021. 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, said.
- 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.
- Normally the intestine remains in perfect harmony with the fungus called candida.
- In immunosuppressed states such as diabetes, injudicious use of steroids, overzealous broad-spectrum antibiotics and chemotherapy for an underlying malignancy.
- There is inward migration of this candida - the white fungus - from the intestinal lumen into the body tissues by disrupting the normal gut barriers.
- This is followed by intestinal complications like ulcers, bleeding, gangrene and perforation, followed by transmigration of the candida across the beleaguered gut barrier into blood, culminating in sepsis and multiorgan failure.