Last updated on April 8th, 2022
Overview of Black Fungus or Mucormycosis
India was still grappling with the second wave of COVID-19 and anticipating a third wave, when the entire healthcare machinery was taken aback with the emergence of “mucormycosis”, more popularly known as “black fungus”.
The fungus has already infected at least 7,250 people in India, while 219 have lost their lives to it. Basically, it is a complication caused by COVID-19 disease, but has way worse implications.
As per the official numbers, the infection has reached to 13 states and Union Territories already, and the central government has ordered the states to notify black fungus under the Epidemic Diseases Act, 1897.
What is Mucormycosis (Black Fungus)?
Black fungus is a very rare infection, which occurs when a person is exposed to mucor mould, which is generally found in decaying fruits and vegetables, soil, manure and plants.
The more dangerous thing is that it is ubiquitous and may be found in air and soil. It can also be found in the nose and mucus of a healthy person. It attacks the sinuses, lungs and the brain.
What are the Symptoms of Mucormycosis?
Chairman of Medanta Hospital, Gurugram, Dr Naresh Trehan, who is one of the leading doctors across India, has pointed out some symptoms which can help you trace mucormycosis infection. Have a look –
- Pain/stiffness in the nose
- Inflammation on cheeks
- A fungus patch inside the mouth
- Swelling in the eyelid
He emphasised that to get rid of symptoms of black fungus, the patients require very aggressive medical treatment. So far, the mortality rate of this infection has been recorded at 50 percent.
According to Indian Council of Medical Research (ICMR), the symptoms of mucormycosis may include –
- Sinus pain & nasal blockage on side
- Headache on one side
- Loss Loosening of teeth
The hospitals handling the cases of black fungus in India have also reported some common symptoms of black fungus among the patients. Have a look –
- Blurry vision
- Discoloration or blackening of tissue on nose and cheeks
- Black lesions inside the mouth
- Black lesion discharge from nose
In most of the cases, the infection has been traced in patients 12-15 days after they recovered from COVID-19 disease. It, however, is also common among the people who are already infected with COVID-19.
The earliest symptoms of black fungus infection arise inside the nose and sinus. If you feel any sort of unusual discomfort in your nose or mouth, you must immediately see a doctor to trace the problem before it gets to the brain.
Easy Targets For Mucormycosis
As per the experts, diabetes patients are the most vulnerable among all to the black fungus. Others who are most at risk include immunosuppressed people, who have recently recovered from COVID-19 or suffer from cancer or HIV/AIDS.
Diabetics who are COVID-positive must be kept under proper observation, as controlling the sugar levels is the best preventive measure you can take against this disease, says ICMR.
It can cause lethal bloodstream infection if not treated cautiously.
Causes of Mucormycosis or Black Fungus
Generally, this infection enters into the body of a person through fungal spores floating in the environment. It, however, can get into the body through any kid of skin trauma, cut or burn.
After getting in contact with any body part, this fungus can stick to it and make its way inside the body via nose, lungs or sinus. It becomes fatal when it affects the eyes and reaches through to the brain.
As per the experts, the black fungus started prevailing when the COVID-19 patients were taking medicines at home without keeping their blood sugar levels in check. Some of them also believe that it started affecting immunosuppressed patients due to their unsanitary post-COVID living conditions.
Mucormycosis cases are also increasing rapidly because people have been overusing cheap steroids to bring the ill effects of COVID-19 under control. These steroids diminish the immune response of the body against other infections like black fungus.
Experts have also claimed that use of normal tap water in flow meters of oxygen cylinders is also responsible for the spread of black fungus. These cases may also be the result of mold-tainted oxygen pipes and humidifiers.
Noted pulmonologist and Director of AIIMS Delhi, Dr Randeep Guleria, believes that doctors being under immense pressure and people panicking are also worsening the situation. He said, “Doctors sometimes opt for a knee-jerk reaction, using aggressive medical treatments instead of following the conservative approach.”
The biggest reason behind the spread of black fungus is improper sanitation during or after recovering from COVID-19. The second biggest cause is consumption of immunosuppressant drugs or steroids, which have been overly used by patients to control and avoid COVID-19 complications.
Risks Related to Mucormycosis For Diabetic Patients
As we have already discussed, diabetes patients are more vulnerable to black fungus because of their suppressed immune response to all kinds of infections. Hence, it is very important for them to maintain proper sanitation and hygiene to stay safe from this infection.
This infection attacks the nasal area, sinus, teeth, eyes and finally brain. Being a diabetic or having uncontrolled blood sugar levels can make it easier for the infection to spread through these body parts quickly and even cause fatality.
Prevention of Mucormycosis For Diabetic Patients
Every diabeties patient must ensure to keep his/her blood sugar level in check at all the times. If you are suffering from COVID-19, and even if you do not have any major symptoms, you must maintain your hygiene and keep your living area completely clean and sanitised. The other preventive measures include –
- Only the patients with hypoxemia should use systemic steroids
- People with normal oxygen saturation in room air should not use oral steroids
- If your doctor has prescribed you systemic steroids, you must keep checking your blood sugar levels as often as possible
Dosage and duration of steroid therapy has to be limited to dexamethasone (0.1mg/kg/day) for 5-10 days
- Using a mask all the time helps lessen the chances of inhaling Mucorales
- The patient must avoid being near any construction site
- Once discharged from hospital after COVID-19 treatment, the patient must closely look for early symptoms black fungus
- These early signs include chest pain, nasal blockage, respiratory insufficiency, excessive nose discharge and facial pain
Diabetes patients have to be extra cautious to prevent this infection. They must keep a close watch on their blood sugar levels and consult with their doctor to discontinue all types of steroids gradually if they are taking any.
Treatment For Mucormycosis or Black Fungus
Mucormyosis used to be a rare disease, but with the second wave of COVID-19, it has turned into an epidemic. It is a fatal disease with a mortality rate of 50 percent. Hence, it is categorised as a medical emergency, which requires a team approach to treat.
It may require collaboration of an infectious disease specialist, intensivist, ophthalmologist, microbiologist, neurologist, surgeon, ENT specialist, radiologist, histopathologist, etc. It is really important to keep diabetes and diabetes ketoacidosis under control, reduce steroid dependency, and gradually discontinue them, if the patient is taking any.
The doctors also have to reduce and gradually discontinue any type of immunosuppressant drugs if the patient is taking any.
Mucormycosis requires emergency treatment and it may require a team of doctors to treat the patient. Hence, any sort of discomfort in the nose or mouth must be reported to a doctor immediately.
Black fungus or mucormycosis has turned into an epidemic, and it requires even more caution than COVID-19. It has a 50 percent mortality rate, and many doctors have reported that they had to remove an eye of the patients in a bid to save their life. Hence, it becomes extremely important to follow all the protocols and preventive measures to keep yourself and your family safe.
Where is black fungus found?
Mucormycosis is triggered by a group of mould known as mucormycetes. As per the Center for Disease Control and Prevention, these fungi are found in the environment. People used to catch it through soil or decaying plant leaves, rotten wood or compost piles.
Is black fungus contagious?
No, it is not contagious, but it may spread through the fungal spores floating around in the environment.
How does black fungus start?
Generally, it happens because of environmental fungal spores. It can also spread or enter inside a person’s body through any skin trauma, cut or burn injury.
What is black fungus in humans?
Mucormycosis generally affects those who have a weak immune system. It can be traced in a person through blackening or discoloration over the nose, coughing blood, chest pain, blurred or double vision and insufficient respiratory functioning.
Last Updated on by Dr. Damanjit Duggal
The information included at this site is for educational purposes only and is not intended to be a substitute for medical treatment by a healthcare professional. Because of unique individual needs, the reader should consult their physician to determine the appropriateness of the information for the reader’s situation.