What is Mucormycosis aka Black Fungus?
Mucormycosis, a very rare fungal infection is caused by exposure to Mucor commonly found in soil, plants, manure, and decaying vegetables and fruits. The infection progresses rapidly, attacks the blood vessels and live tissues. It kills them, and turns them black – from which the disease gets the name “the black fungus”. It also affects the brain, lungs, eyes, and sinuses. Mucormycosis is often life-threatening in diabetics or severely immunocompromised individuals, like cancer patients or people with HIV/AIDs.
What can cause Mucormycosis?
Infection with Mucormycosis may be triggered by the use of steroids, a life-saving treatment for severe and critically ill COVID-19 patients. Steroids reduce the inflammation within the lungs of COVID infected patients and helps stop some of the damage that can happen when the body’s immune system goes into overdrive to fight against the coronavirus. However, it also reduces the immunity and increases the blood sugar. Higher blood glucose levels and more acidic blood provide a fertile environment for fungal growth. Also, the decrease in immunity is believed to be triggering these cases of Mucormycosis. Hence, unchecked and unsupervised use of steroid therapies can often make matters worse even for non-risk patients.
Who is at risk?
Cases of Mucormycosis are rising in India among patients who are either suffering or have recovered from COVID-19. At risk patients are:
- Patients with uncontrolled Diabetes and Diabetic Ketoacidosis (a complication of Diabetes where the body makes harmful acids called ketones
- Who have received high doses of intravenous or oral steroids for prolonged periods
- Who have received immunomodulators (drugs used in diseases like cancer to modify the immune system’s response).
What are symptoms of Mucormycosis?
Patients have symptoms of nasal blockage, bleeding or blackish discharge from the nasal cavity, swelling and pain in the eyes, drooping of the eyelids, blurred vision or loss of vision, chest pain or worsening of respiratory symptoms. There can also be black patches around the nose. Many patients arrive late, and it becomes mandatory to remove the eye to stop the infection from reaching the brain.
What can you do to prevent Mucormycosis?
Treatment requires anti-fungal drugs like Amphotericin B injections. These drugs have the potential to induce major side effects, including kidney damage. Often, surgical intervention with removal of all infected tissues is also needed. Risk of acquiring Mucormycosis can be reduced by some Dos and Don’ts. Control of blood glucose, use of clean, sterile water as humidifier during oxygen therapy, and use of antibiotic/antifungals judiciously are some preventive measures. Also, all cases with blocked nose in the context of immunosuppression and/or COVID-19 patients on immunomodulators should be suspected as Mucormycosis. Early detection is always better.
References
- Mucormycosis: The ‘black fungus’ maiming Covid patients in India [Internet]. BBC News. 2021 [cited 16 May 2021]. Available from: https://www.bbc.com/news/world-asia-india-57027829
- D G, V M, IS S, R R, H K, A B et al. Coronavirus Disease (Covid-19) Associated Mucormycosis (CAM): Case Report and Systematic Review of Literature [Internet]. PubMed. 2021 [cited 16 May 2021]. Available from: https://pubmed.ncbi.nlm.nih.gov/33544266/
