Black Fungus: All you need to know about mucormycosis

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Black Fungus (Image: Pixabay)
Black Fungus (Image: Pixabay)

New Delhi : The second wave of coronavirus has struck hard in India and the doctors have found a new issue in coronavirus patients – black fungus – mostly detected in patients from Delhi, Maharashtra and Gujarat. 

A rare but serious fungal infection, known as mucormycosis or black fungus, often manifests in the skin and also affects the lungs and the brain. With increasing number of patients with black fungus, the experts at national Covid-19 task force issued an evidence-based advisory.

What is black fungus?

Although rare, it is a serious infection. It is caused by a group of moulds known as mucormycetes present naturally in the environment. It is easily contracted in people who are on medication and have low ability to naturally fight pathogens present in the environment.

Sinuses or lungs of such individuals get affected after they inhale fungal spores from the air. Doctors in some states have noted a rise in cases of mucormycosis among people hospitalized or recovering from Covid 19, with some requiring urgent surgery. Usually, mucormycetes does not pose a major threat to those with a healthy immune system.

Sign and symptoms of Black Fungus infection:

Warning signs include pain and redness around the eyes or nose, with fever, headache, coughing, shortness of breath, bloody vomits, and altered mental status. According to the advisory, infection with mucormycetes should be suspected when there is:

* Sinusitis — nasal blockade or congestion, nasal discharge (blackish/bloody);

* Local pain on the cheek bone, one-sided facial pain, numbness or swelling;

* Blackish discoloration over bridge of nose/palate;

* Loosening of teeth, jaw involvement;

* Blurred or double vision with pain;

* Thrombosis, necrosis, skin lesion;

* Chest pain, pleural effusion, worsening of respiratory symptoms.

Treatment for Black Fungus

While it is treated with antifungals, mucormycosis may eventually require surgery. Doctors have said that it is of utmost importance to control diabetes, reduce steroid use, and discontinue immunomodulating drugs. To maintain adequate systemic hydration, the treatment includes infusion of normal saline (IV) before infusion of amphotericin B and antifungal therapy, for at least 4-6 weeks.

How can one prevent it?

One should remember that it is a rare disease. However, some groups of people are more vulnerable than others. What predisposes patients is uncontrolled diabetes mellitus, immunosuppression by steroids, prolonged ICU stay, and comorbidities — post transplant/malignancy, voriconazole therapy.

Experts advise that you use masks if you are visiting dusty construction sites. Wear shoes, long trousers, long-sleeved shirts and gloves while handling soil (gardening), moss or manure. Maintain personal hygiene including a thorough scrub bath.

Who is vulnerable?

Vulnerable groups include people who have health problems or take medicines that lower the body’s ability to fight germs and sickness. These include those with diabetes, cancer, or those who have had an organ transplant.