Invasive fungal infections threat to low immunity patients
Patients who have very low levels of immunity are not well-equipped to withstand attacks from pathogens like fungus, which makes them vulnerable to a host of diseases and infections.
Such patients are mostly those who undergo critical surgeries or in need for of high dosage of drugs as part of prescribed therapy, especially those who suffer from HIV, cancer or uncontrolled diabetes.
“Low immunity can also be caused (i) by treatments like chemotherapy which suppress the immune system to enable medicines to work; (ii) in cases of organ transplant where it becomes necessary to suppress immunity so that the new organ is accepted by the body, which would otherwise be rejected by the natural immune system and (iii) unprescribed or prolonged antibiotic abuse, consumption of steroids.
All these cause an increase in the risk of infection. Invasive fungal infections (IFIs) mostly occur in hospitals and have high risks of mortality and morbidity. Aspergillosis, candidiasis, and moulds are the most common IFIs that occur in hospitals,” said Dr Shrinath Kshirsagar, Consultant, Hematologist-Hemato-oncologist and Bone Marrow Transplant.
IFI scan also be community acquired, especially from soil or environmental pathogens. The infections are usually latent but tend to flare up and manifest when the patient undergoes treatment for major diseases like HIV or cancer, during which their immunity is low.
Patients with trauma, burns, and neonates are also at high risk of acquiring these infections. Furthermore, environmental changes, increased travel, and increased virulence/endemic migration of fungi mean that these infections will likely appear in more regions and more patient populations than in past eras.
“Invasive fungal infections are difficult to diagnose and treat. Quite often doctors identify these infections by using various diagnostic testing like surrogate markers. Fungal infections may also require prolonged treatment that may last for around six weeks. Contracting invasive fungal infections further complicates cases as the treatment needs to be balanced with antifungal therapy to boost immunity. Invasive fungal infections are associated with prolonged hospital and ICU stays, prolonged recovery, and result in increased cost and high mortality. Hospitals deploy various measures to control IFIs, like avoiding prolonged indwelling catheters, antibiotic stewardship, adhering to antibiotic guidelines, and conducting regular surveillances,” said Dr. Shrinath Kshirsagar, Consultant, Hematologist/ Hemato-oncologist and Bone Marrow Transplant, Parel, Mumbai.
Awareness plays a key role in safeguarding the patient from IFIs. Immunity compromised patients and their families must be alert for symptoms like fever, headaches and eye swelling. Sometimes these seemingly innocuous symptoms may signal IFIs and hence should be reported to the doctor immediately.
- Consumption of over-the-counter antibiotics or drugs should be avoided.
- Hospital rules should be followed which helps in warding off infections.
- Visitors should not bring flowers for patients as they often harbour fungal spores.
- Immunity compromised people should avoid activities like gardening, trekking in the forests or green belts, etc.
- Construction sites should be avoided.
- Due to increased pollution levels and air borne infections, N95-99 masks should be used by the patients while venturing out.
- At home, using HEPA-based air filtration system at homes can filter out particles as small as 0.3 microns can prevent fungal spores from entering the rooms to a greater level.
- Patients should avoid pets or bird droppings, as they are carriers of fungal infections.
- In terms of food, patients should avoid consuming soft, over-ripe fruits, vegetables with black spots like onions and greenish spots on bread which might be fungus.
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