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Everything About Black Fungus or Mucormycosis

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Of late, many people recovering from COVID-19 are experiencing a deadly fungal infection known as Black Fungus or Mucormycosis. In several hospitals across the country, COVID-19 patients are being afflicted with it, and if not treated on time, the same can turn dangerous.

So, what are Black Fungus, its symptoms, and treatment? This blog will delve deep into several aspects of this fungal infection.

What is Black Fungus?

Black Fungus, also known as Mucormycosis, is an infection that’s caused due to exposure to mucor mould known as mucormycosis. This mould is commonly found in plants, soil, manure, decaying fruits and vegetables, and rotten woods.

It affects sinuses, lungs, and brains and can be life-threatening for those who have diabetes or have pre-existing conditions such as cancer. If it enters through wounds, then it can cause a local infection. It is known as Black Fungus due to the formation of black lesions in the infected area.

Note that while Black Fungus is affecting people being diagnosed with COVID-19, it can also affect you if you have a weak immune system or suffering from any medical problems.

Characteristics of Black Fungus

Some characteristics of Black Fungus are:

  • It eats and lives on sugar and hence it’s common in people suffering from diabetes
  • Intake of steroids can increase its threat as they increase sugar in the blood
  • This is an Angio-invasive infection, which means that it infiltrates the blood vessels
  • It’s aggressive opportunistic and is heat tolerant
  • Infecting deeper tissue such as the sinus, eye and bone to the brain, it spreads pretty rapidly and could turn fatal
  • This lead to eye pain and in the worst-case permanent loss of vision
  • It can enter after someone breathes in spores or through skin cut, burn, scrape or trauma. It can also come to the body due to ingestion
  • It’s not contagious and doesn’t spread between people and its complications include blindness and organ dysfunction
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Who are at Risk of Getting Infected?

  • Those with a weak immune system due to constant use of steroids
  • Those on immunosuppression and have uncontrolled diabetes
  • Those suffering from blood disorder such as Neutropenia
  • People with prolonged ICU/hospital stay
  • Those suffering from cancer or undergoing organ transplant
  • Those with skin injury

Types and Symptoms of Black Fungus

The common types of Mucormycosis are:

  • Rhinocerebral that infects the nose and brain
  • Pulmonary that infects the lungs
  • Cutaneous that infects the skin
  • Gastrointestinal that infects the stomach
  • Disseminated
  • Uncommon presentations

The symptoms are:

Rhinocelebral

 Local pain on the cheekbone, facial pain on one side, numbness and swelling

  • Blackish discolouration over the bridge of nose/palate
  • Loosening of teeth, jaw involvement
  • Discharge of Black pus from eyes
  • Blurred or double vision with pain
  • Nasal or sinus congestion or pain or discharge
  • Fever and headaches

 

Pulmonary

  • Fever
  • Cough
  • Chest Pain
  • Dyspnea

 

Cutaneous

 Local skin trauma

  • Pus
  • Abscess
  • Swelling
  • The appearance of red skin
  • Ulcer covered black eschars

 

Gastrointestinal

  • Abdominal pain
  • Nausea
  • Vomiting

 

Black Fungus and COVID-19: The Link

Normally, our body’s immune system is well-prepared to fight such fungal infections. However, COVID-19 affects our immune system and weakens it to a great extent. Thus, the body’s ability to fight the virus goes down significantly.

Additionally, COVID patients undergoing oxygen therapy in the ICU where humidifiers are used are at risk of developing this infection because of moisture. Usage of non-sterile water in a humidifier in an oxygen concentrator and cylinder also increases the risk of developing the infection.

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What Is Black Fungus Treatment?

Black Fungus or Mucormycosis treatment :

  • Rapid diagnosis
  • Reversal of predisposition
  • Urgent surgical debridement

It can turn fatal if it’s not diagnosed early and aggressively treated. Some antifungal drugs used in its treatment are Amphotericin B, Posaconazole, or Isavuconazole. In the case of Rhinocerebral, Cutaneous and Gastrointestinal infections surgical resection of the infected tissue is required

Dos and Dont’s to Keep Black Fungus at Bay

Dos

  • Do control diabetes
  • Keep monitoring blood glucose levels
  • Judiciously use steroids, antibiotics and antifungals
  • Make sure to use clean and sterile water for humidifiers while undergoing oxygen therapy

 

Don’ts

  • Watch out and don’t miss the warning symptoms and signs
  • Avoid considering all cases with blocked noses as that of bacterial sinusitis, especially in the context of immunosuppression and/or COVID-19 patients who are on immunomodulators. It’s not advisable to ignore blocked nose/sinusitis either
  • Do seek investigations as deemed fit, such as KOH staining and microscopy, culture, for detecting fungal aetiology
  • Don’t lose out on time in seeking treatment for the infection and don’t hesitate to seek help

Additionally, don’t skip monitoring blood sugar for weeks and months after recovering from COVID-19.

Preventive Measures

  • Keep washing your hands at regular intervals
  • Wear an N95 respirator
  • Keep your room well ventilated
  • Don’t prick your nose and avoid rubbing your eyes
  • Avoid scratching your skin
  • Keep a tight control on diabetes and reduce steroids when possible
  • Avoid direct contact with the water-damaged building and flood water areas
  • Avoid activities that involve contact with soil or dust such as gardening
  • Wear gloves while handling materials such as soil and moss
  • Do clean skin injuries well with soap and water, if contaminated

Also, do make your immune system robust to fight this deadly infection and maintain a healthy diet of vitamins, minerals, proteins and fibre.

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