What is Mucormycosis or Black Fungus ?

Mucormycosis or Black Fungus is a deadly but rare fungal infection caused by a group of moulds called mucormycetes. Such kinds of fungi live throughout the environment, mainly in soil and in decaying organic matter, such as leaves, compost piles, or decomposed wood. 

A person can be affected by Black Fungus by coming in contact with the fungal spores in the Surrounding. Which means the lung or sinus infection can occur after someone breathes in spores. Mucormycosis usually affects the people who have several health problems like diabetes, high blood pressure or take medicines that lower the body’s immunity. 

In recent times many people recovering from COVID-19 have been afflicted by black fungus or mucormycosis disease. Many cases can be Seen throughout India. These fungus invades the sinus and makes its way into the eye / intraorbital and brain / intracranial  regions. If it’s not treated or identified early, 50-80% of patients could die. 

Indian Council of Medical Research (ICMR) issued an advisory related to Black Fungus, the following conditions in COVID-19 patients increase the risk of Mucormycosis infection:

1) Uncontrolled diabetes

2) Consumption of steroids during Covid treatment weaken the immune system

3) Prolonged ICU/hospital stay

4) Co-morbidities / post organ transplant / cancer

5) Voriconazole therapy (used to treat serious fungal infections)’

Symptoms of Black Fungus/Mucormycosis?

When Mucor attacks the sinuses, it can spread to the lungs, the brain and the central nervous system. Common symptoms of  mucormycosis include:

• Fever
• Headache
• Redness or swollen skin near the nose or eyes
• Facial pain
• Cough producing bloody or dark fluids
• Shortness of breath

It can also  lead  to blackening or discoloration of skin over the eyes, nose, blurred or double vision, chest pain, breathing difficulties and cough.

Prevention of Mucormycosis:

Black Fungus can be cure by adapting the following habits:

1) Use a clean mask  regularly when in a public place.

2) If walking near the soil or doing gardening wear shoes, trousers, full sleeve shirts and gloves 

3) Maintain personal hygiene , good oral hygiene  including thorough scrub bath.

4) The disease can be managed by controlling diabetes, discontinuing immunomodulating drugs, judicious use of  steroids and extensive surgical debridement- to remove all necrotic materials.

Do’s

• Control hyperglycemia
• Closely monitor blood glucose level post-COVID-19 discharge and also in diabetics
• Use steroid judiciously
• Use sterile, clean water for humidifiers during oxygen therapy
• Use antibiotics /antifungals judiciously

Don’ts

• Do not miss warning signs and symptoms
• Do not consider all the cases with blocked nose as cases of bacterial sinusitis, particularly in the context of immunosuppression and/or COVID-19 patients on immunomodulators
• Do not hesitate to seek aggressive investigations, as appropriate (KOH staining & microscopy, culture, MRI ), for detecting fungal etiology
• Do not lose critical time to initiate treatment for mucormycosis 

After recovering from Covid-19, people should closely monitor and should not miss any warning signs and symptoms of Mucormycosis as mentioned above , as the fungal infection is found to emerge even weeks or months after recovery.