Mucormycosis or Black Fungus in COVID-19

Why it is in news?

Black fungus or Mucormycosis infection has detected in a few COVID-19 Positive patients in various states, Delhi, Maharashtra, and Gujarat in INDIA.

One of the known case COVID-19 positive and get infected with Black Fungus is as below :

Dr. Akshay Nair, a Mumbai-based eye surgeon, was waiting to operate on a 25-year-old woman who had recovered from a bout of Covid-19.

Inside the surgery, an ear, nose, and throat specialist was already at work on the patient, a diabetic.

He had inserted a tube in her nose and was removing tissues infected with mucormycosis, a rare but dangerous fungal infection. This aggressive infection affects the nose, eye, and sometimes the brain.

After his colleague finished, Dr. Nair would carry out a three-hour procedure to remove the patient’s eye.

“I will be removing her eye to save her life. That’s how this disease works,” Dr. Nair told.

Even as a deadly second wave of Covid-19 ravages India, doctors are now reporting a rash of cases involving a rare infection – also called the “black fungus” – among recovering and recovered Covid-19 patients.

Mucormycosis Black_Fungus

What is Mucormycosis?

Mucormycosis commonly called Black Fungus (Previously Known as Zygomycosis), is a serious but rare fungal infection. It is caused by a group of molds called mucormycetes. These molds naturally present or Live in our environment.

Mucormycosis mainly affects people who have health problems or take medicines that reduce their body’s ability to fight germs or sickness or environmental pathogens.

It most commonly affects the sinuses or the lungs after inhaling fungal spores from the air. It can also occur on the skin after a cut, burn, or other types of skin injury.

Types of Mucormycosis  &  Symptoms of Mucormycosis or Black Fungus :

The symptoms of mucormycosis depend on where in the body the fungus is growing.

  • Rhinocerebral (sinus and brain) mucormycosis: Symptoms include:
    • One-sided facial swelling
    • Headache
    • Nasal or sinus congestion
    • Black lesions on the nasal bridge or upper inside of the mouth that quickly become more severe
    • Fever
  • Pulmonary (lung) mucormycosis: Symptoms include:
    • Fever
    • Cough
    • Chest pain
    • Shortness of breath
  • Gastrointestinal mucormycosis: Symptoms include:
    • Abdominal pain
    • Nausea and vomiting
    • Gastrointestinal bleeding
  • Cutaneous (skin) mucormycosis:

It can look like blisters or ulcers, and the infected area may turn black. Other symptoms include pain, warmth, excessive redness, or swelling around a wound.

  • Disseminated mucormycosis :

typically occurs in people who are already sick from other medical conditions, so it can be difficult to know which symptoms are related to mucormycosis. Patients with disseminated infection in the brain can developmental status changes or coma.

Where Mucormycosis Comes From?

Mucormycetes, the group of fungi that cause mucormycosis, are present throughout the environment, particularly in soil and in association with decaying organic matter, such as leaves, compost piles, and animal dung.

Most people come in contact with microscopic fungal spores every day, so it’s probably impossible to completely avoid coming in contact with mucormycetes.

Mucormycetes, the group of fungi are present naturally in our environment, so these fungi aren’t harmful to most people however you may be at risk of contracting this type of infection if you have a weakened immune system.

Types of fungi that cause mucormycosis

Several different types of fungi can cause mucormycosis. These fungi are called mucormycetes and belong to the scientific order Mucorales. The most common types that cause mucormycosis are :

  • Rhizopus species and Mucor species.
  • Rhizomucor species
  • Syncephalastrum species
  • Cunninghamella bertholletiae
  • Apophysomyces
  • Lichtheimia (formerly Absidia)
  • Saksenaea
Who has the most at risk of mucormycosis?

Mucormycosis is rare, but it’s more common among people who have health problems or take medicines that lower the body’s ability to fight germs and sickness. Certain groups of people are more likely to get mucormycosis

  • Diabetes
  • Cancer
  • Organ Transplants
  • Neutropenia (low number of white blood cells)
  • Long term use of steroids
  • Injection drug use
  • Higher amount of Iron in the body (iron overload or hemochromatosis)
  • Skin Injury due to surgery, Burns
  • Premature birth or low body weight (New Born or infants) (for neonatal gastrointestinal mucormycosis)
Prevention of Mucormycosis or Black Fungus :
  • Protect yourself from the environment: Below these actions are recommended, they haven’t been proven to prevent mucormycosis.
    • Try to avoid areas with a lot of dust like construction or excavation sites. If you can’t avoid these areas, wear an N95 respirator (a type of face mask) while you’re there.
    • Avoid direct contact with water-damaged buildings and flood water after hurricanes and natural disasters.
    • Avoid activities that involve close contact to soil or dust, such as yard work or gardening. If this isn’t possible,
      • Wear shoes, long pants, and a long-sleeved shirt when doing outdoor activities such as gardening, yard work, or visiting wooded areas.
      • Wear gloves when handling materials such as soil, moss, or manure.
      • To reduce the chances of developing a skin infection, clean skin injuries well with soap and water, especially if they have been exposed to soil or dust.
  • Antifungal medication. If you are at high risk for developing mucormycosis (for example, if you’ve had an organ transplant or a stem cell transplant), your healthcare provider may prescribe medication to prevent mucormycosis and other mold infections.
ICMR Guidelines :

ICMR guidlines

References :

https://www.cdc.gov/fungal/diseases/mucormycosis/index.html

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