Pune Medical Experts Sound Alarm on Steroid Overuse During Viral Season
Medical professionals in Pune have issued a serious warning about the growing trend of using steroids to treat routine viral fevers and mild respiratory infections. This concerning practice, they report, is significantly increasing the risk of dangerous post-viral fungal lung infections, particularly pulmonary aspergillosis.
Rising Cases of Viral-Associated Pulmonary Aspergillosis
Infectious disease specialists across the city have observed a noticeable increase in cases of viral-associated pulmonary aspergillosis (VAPA) during December 2025. This condition involves a fungal infection developing in the lungs days after an initial viral illness appears to have resolved. The trend coincides with widespread viral infections ranging from common colds to flu-like illnesses that have been circulating in the community.
Dr. Sujata Rege, consultant in infectious diseases at Symbiosis University Hospital and Jupiter Hospital, expressed particular concern about this development. "We have certainly been seeing these cases more often in our clinical practice," she stated. "The matter to worry about is the common thread of using early and unnecessary steroids for otherwise mild viral infections in many patients."
Dangers of Inappropriate Steroid Prescription
According to medical experts, steroids are frequently prescribed – or even self-administered – to quickly reduce fever or cough symptoms, despite there being no legitimate medical indication for their use in most viral respiratory illnesses. This inappropriate application creates ideal conditions for fungal infections to take hold.
Dr. Ameet Dravid, infectious disease specialist at Noble Hospital, highlighted the systemic pressures contributing to this problem. "Steroids are being rampantly misused," he explained. "There is tremendous pressure on frontline doctors because of the high number of patients coming in with cold and fever, and patients themselves demand quick relief. To provide fast symptomatic relief, steroids are often prescribed within the first week of illness, which results in a disaster."
Dr. Dravid elaborated on the biological mechanism behind this danger: "When steroids are given early in a viral infection, the virus can run rampant, and at the same time, fungi like Aspergillus, which are often present in the respiratory tract, get an opportunity to cause pneumonia. This becomes even more dangerous in patients with diabetes or hypertension."
Changing Patient Profile and Diagnostic Improvements
Traditionally, pulmonary aspergillosis was thought to occur primarily in diabetic patients or those with severely compromised immune systems. However, Pune doctors report they are now diagnosing the condition in patients with borderline blood sugar levels, asthma, chronic liver or lung disease, and occasionally even in individuals who were otherwise healthy.
Dr. Rege revealed that during the recent winter season, she has treated approximately ten patients with post-viral pulmonary aspergillosis – a number she considers quite high for this specific condition.
Dr. Piyush Chaudhary, infectious disease specialist at Jehangir Hospital, provided additional context about detection rates. "I have seen nearly three to four pulmonary aspergillosis patients in less than a month, and in almost all of them, there was a clear history of steroid use," he reported. "Diabetes was also a factor in some cases, but the main trigger was steroid exposure. Post-Covid, diagnostic capacity for fungal infections has improved, so we are detecting these cases readily, which could be one contributing factor. However, steroid misuse remains the primary concern."
Specific Guidelines and Risk Factors
Medical professionals emphasize that steroids should not be used for simple viral fevers or routine respiratory infections. Their appropriate use is limited to very specific situations, such as patients requiring oxygen support or intensive care unit treatment.
Dr. Dravid stressed the need for clearer guidelines: "There needs to be a very clear guideline that in viral infections, steroids should not be used at all and should be strictly reserved only for patients who develop serious respiratory complications. For symptoms like runny nose, body ache, or fever, which are self-limiting, steroids are simply not required."
Dr. Chaudhary identified additional risk factors that compound the danger: "This season, many patients with routine viral infections have had prolonged cough and upper respiratory tract symptoms lasting two to three weeks. It has become common practice to prescribe short courses of steroids in such cases. If such a patient also has diabetes or is exposed to construction activity, where Aspergillus spores are more prevalent, it creates favourable conditions for developing fungal lung infections."
Key Recommendations from Medical Experts
Infectious disease specialists across Pune have outlined several crucial recommendations:
- Avoid steroid use for common viral illnesses including colds, flu, and mild respiratory infections
- Reserve steroid treatment only for specific situations such as patients requiring oxygen support or ICU care
- Recognize that symptoms like fever and cough in viral infections are typically self-limiting and do not require steroid intervention
- Exercise particular caution with patients who have diabetes, hypertension, asthma, or other underlying health conditions
- Improve patient education about the risks associated with inappropriate steroid use
The medical community's warning comes as a response to what they describe as a dangerous trend that could have serious public health implications if not addressed promptly and effectively.
