Mucormycosis-The Black Fungus

May 16, 2021Articles

Mucormycosis -The black fungus is an opportunistic infection.It’s sad to think that people who have gone through the immense distress of COVID now have to deal with this severe disability as well.

Here are some Important facts about this deadly Mucormycosis-The Black fungus-
• ‘Black fungus’ is caused by a fungus named mucormycetes, which is found on wet surfaces.It spreads as rhino cerebral mucormycosis, which starts in the sinuses and can spread to the brain.
• Mucormycosis is normally not spread person to person, but is found in the environment. However, due to the level of spread, it is too early to say how this is spreading.
• Mucormycosis, to a large extent, is happening to people who have diabetes. It is very uncommon in those who are not diabetic.
• This disease is not new but is on the rise among COVID patients because the use of steroids elevates sugar level and some medicines suppress the patients immunity.
• The ‘Black fungus’ is present in the environment and those with suppressed immunity or co-morbidities are more vulnerable to infection.Conditions like HIV/AIDS, uncontrolled diabetes mellitus, cancers, organ transplant, long term corticosteroid and immunosuppressive therapy increase the risk of this disease and the predisposing factor for most of the cases prior to the COVID-19 pandemic.
• Main symptoms of mucormycosis- The black fungus include headache, fever, pain under the eyes, one-sided sided facial swelling nasal or sinus congestion with bleeding nose, partial loss of vision and toothache.
• Symptoms have typically appeared two to three weeks after COVID-19 infection.
• The diagnosis of black fungus need to be as earliest possible so that we can stop it to reach the level of life threat.
• The treatment involves anti-fungal therapy of injections for 21 days with surgical removal of all dead and infected tissue. The basic cost of the injections is around ₹9000 per day.
• Even though it’s an invasive disease, it can be treated, so there’s no need to panic but to aware and attentive more towards warning sign and symptoms
  Don’ts in Mucormycosis –
• Do not consider all blocked nose cases as bacterial sinusitis, mainly in the context of COVID-19 patients on immunomodulators or individuals on immunosuppression.
• Do not miss warning sign and symptoms.
• Do not hesitate to seek out aggressive investigations, as suitable (KOH staining & microscopy, culture, MALDI-TOF ), to detect the fungal aetiology.
• Do not lose or wait crucial time to initiate treatment for mucormycosis as delay could be fatal for your patient.
Do’s to prevent Mucormycosis –
• Control hyperglycemia
• Monitor blood glucose level post COVID-19 hospitals discharge and similarly in diabetics
• Use clean, sterile water for humidifiers during the oxygen therapy
• Use steroid cautiously – correct timing, correct dose and correct duration
• Use antifungals/antibiotics cautiously only under medical advice
Some other precautions are-
• Wash your hands often
• Wear a mask so that you do not end up inhaling the fungal spores

• Don’t use same masks for many days ,as humidity creates more possibility for fungus to grow

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