Indore: Kala Bai, 50, tested negative for Covid-19 mid-May, after several weeks of battling the infection. But soon after she recovered, the right side of her body began feeling weak and tired. Her family got a CT scan done of her brain on a doctor’s suggestion, where a peanut-size lesion was found. She decided to isolate for a few weeks and rest at home in Madhya Pradesh’s Dhar district. But she soon found that the weakness on her right side had only gotten worse.
She then visited Indore’s Medicare Hospital for a check up with celebrated neurosurgeon Deepak Kulkarni. “We got an MRI of her brain done. The peanut-size lesion that was visible in her earlier CT scan had grown by over 20 times in a matter of two weeks,” Kulkarni told ThePrint.
In July, Kulkarni will complete 25 years as a neurosurgeon, having operated on innumerable brains, removed umpteen tumours, bullets and even an axe from his patient’s skull.
Looking at Kala Bai’s brain MRI, he decided to operate upon it immediately to remove what he thought was a classic case of a malignant tumour.
He along with his team of doctors operated on her brain on 8 June, removed the tumour and sent it to histopathology (biopsy) to study it further. Except the biopsy revealed something else. The tumour wasn’t a tumour at all — it was white fungus.
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‘Never seen anything like this in my 25-year-long career’
White fungus or Aspergillosis is an infection caused by Aspergillus, a common fungus that people breathe in every day without getting sick.
When the immune system is weakened, however, or when a person is suffering from lung diseases, as in case of Covid, there is a risk of developing health problems and infections in lungs and other organs due to Aspergillus.
In Kala Bai’s case, the white fungus was found to be the size of 8.4 X 4 X 4.6 cm by volume. Kulkarni claimed this is the “largest white fungus to be found in a patient’s body in the world”.
“It was starting from the frontal region then going to the parietal, then the post-parietal region and up to the occipital region,” he said.
“When we went inside her brain, we operated upon it like we were operating upon a tumour. In the MRI, it looked exactly like a tumour and the feel of the abnormal tissue in the brain was also like that of a tumour,” Kulkarni said. “It was only when the biopsy results came that we learnt it was white fungus.”
In Kulkarni’s 25-year career, he has found his name in the Guinness Book of World Records twice — first in 2001 for removing a tumour weighing 570 gram from the brain of a four-year-old child, and then in 2011 for removing a tumour weighing 1.4 kg (the heaviest until then) from the brain of a 65-year-old patient. For the latter, he found a mention in the Limca Book of Records as well.
But he said he has never seen anything like this.
“I have removed a total of 16 bullets from the brains of different patients in the span of my career. I have also removed an axe that was fixed in a patient’s head,” Kulkarni said. “But I have never seen a white fungus of this size in a patient’s brain. This is definitely a unique thing.”
While several black fungus cases have been reported across various parts of the country, white fungus cases have been relatively fewer.
On 27 May, Delhi reported its first white fungus case, found in the abdomen of a patient and one that had caused intestinal perforations.
Covid and Aspergillus infection
Several studies in the past have shown the link between Covid and Aspergillus infection. A study from Taiwan, for example, estimates that as much as 33 per cent of patients with severe Covid may become infected with white fungus.
Studies from US, Argentina and Spain have earlier noted that Aspergillus infection can occur in severe Covid patients.
Experts caution that the fungus needs to be treated in its early stage before it either grows in size or reaches the brain via blood.
“Patients who have had Covid and have a compromised immunity are likely to be attacked by these funguses,” said Dr Arvind Kinger, ENT specialist at Indore’s Apollo Hospital. “For white fungus, its symptoms largely depend on which part of the body it has attacked. If it attacks the brain, it can be very lethal.”
Kulkarni said the white fungus presented itself in the patient’s brain the same way a tumour would, with similar symptoms. “She had difficulty in speech, and a dense hemiplegia or paralysis on the right side, with difficulty to move her limbs,” he said.
Ramesh Pawar, Kala Bai’s son, said she is now on anti-fungal medicines and physiotherapy. “She will take some time to recover, but we are grateful she could be treated,” he said.
(Edited by Arun Prashanth)
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