India detects first case of white fungus

India's capital Delhi reported its first case of white fungus, which causes multiple perforations in the intestine of a Covid-19 patient, doctors in a leading private hospital said today.

"White fungus (Candida) causing multifocal perforations in the food pipe, small bowel and large bowel in a Covid-19 patient has not been reported in literature to the best of our knowledge," Anil Arora, Chairman of the Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences at Ganga Ram Hospital in central Delhi, told the media according to our New Delhi correspondent.

A 49-year-old woman was admitted to the hospital on May 13 with complaints of severe abdominal pain, vomiting, and constipation. She had undergone a mastectomy for breast cancer in December last year and had received chemotherapy till four weeks ago, he said.

A CT scan of the abdomen revealed free air and a moderate amount of free fluid in the abdominal cavity, suggestive of intestinal perforation, the hospital said in a statement.

The doctors immediately placed a tube inside the abdomen and drained about one liter of bile-stained pus.

A team of surgeons, led by Dr Samiran Nundy of the hospital's Department of Surgical Gastroenterology and Liver Transplantation, conducted emergency surgery on the patient the next day.

The surgery revealed a 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. Afterward, a piece of the intestine was sent for biopsy, he said.

The biopsy revealed severe ulceration of the intestinal wall, with resulting perforation and necrosis caused by an invasive white fungus, Arora said.

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 antifungals 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 Aurobindo of the Department of Liver Transplantation and GI Surgery.