What Is Mucormycosis Or Black Fungus In COVID Recovered Patients

One can never forget what happened in 2021, thousands of people succumbed to black fungus. The prevalence of mucormycosis in India is 80 times higher than in other countries. Following the rise in the cases of COVID-associated black fungus, the Government of India declared mucormycosis as a notifiable disease. Read further to learn what mucormycosis is, the early warning signs, risks, burden and treatment.

What Is Mucormycosis?

Mucormycosis is an uncommon but deadly fungal infection with poor and fatal health outcomes. Previously known as zygomycosis, it is caused by a group of molds called mucormycetes. These organisms are present in the soil, dried leaves and rotten wood. 

Black fungus primarily affects people suffering from other health issues or those taking medications to suppress the immune system (immunosuppressants). Mucormycosis attacks the sinuses or lungs after one inhales fungal spores present in the air. The black fungus also impacts the mouth, brain, skin and gastrointestinal tract. This fungus is usually present in the environment and does not transfer from person to person.

Different Types Of Mucormycosis:

There are five types of mucormycosis that affect the human body differently. They include:

• Rhino-orbito-cerebral mucormycosis: This occurs more commonly among people who have diabetes and have undergone kidney transplant surgery. This type of black fungus attacks the sinuses and affects the brain.
• Pulmonary mucormycosis: This is the most commonly occurring mucormycosis that attacks people with cancer and those who have gotten organ transplants.
• Gastrointestinal mucormycosis: This is more common among children and infants with low birth weight. It attacks one-month-old infants who have received antibiotics or other medications that suppress the immune system.
• Cutaneous mucormycosis: This type of infection occurs after skin injury due to burns, cuts, scrapes, etc. The fungus enters through the injured part and spreads in the body. This is the most common kind of mucormycosis that affects people who do not have weak immune systems.
• Disseminated mucormycosis: Disseminated mucormycosis is when the infectious fungi enter the body and spread through the bloodstream to affect other organs. They mostly affect the brain, spleen, heart and skin.

What Is Black Fungus Burden?

The burden of black fungus is enormous in India, as we saw many cases during this pandemic. Since India is referred to as the diabetes capital of the world, where more than six crore people have diabetes, our population is incredibly vulnerable to mucormycosis. 

Diabetic people infected with COVID 19 suffered from black fungus as a post COVID complication. Out of the thousands affected, approximately 80% had a history of diabetes. People with diabetes and others who experienced severe symptoms received steroid treatment. Steroid medications, unfortunately, increase the risk of mucormycosis and is one of the main reasons for fatal outcomes.

Transmission Of Black Fungus: Does It Spread From One Person To Another?

Black fungus is not contagious, and it does not spread from person to person. They are found in the surroundings and spread through inhalation and ingestion of spores. Water leaks, poor air filtration, medical devices, building construction, adhesive bandages, etc., are some of the examples of how mucormycosis spreads in a hospital setting.

Who Is At The Risk Of Getting Infected With Black Fungus?

Everyone with a weak immune system is at a considerable risk of getting a black fungus infection. People who belong to the following categories have weaker immune systems than others:

• People who have recently recovered from COVID
• Elderly males
• Uncontrolled diabetes
• Cancer
• Recipients of organ transplant
• Tuberculosis infection
• HIV
• Long-term alcohol consumption
• Liver and kidney disease
• Prolonged stay in the ICU
• Chemotherapy and immunosuppression treatment

Watch Out For The Early Warning Signs:

Here are the general early warning signs and symptoms for mucormycosis that you need to be careful about: 

• Pain and redness in the eyes and nose (PNS)
• Fever, headache
• Cough, breathlessness
• Bleeding
• Nasal congestion and discharge
• Facial swelling and numbness
• Nausea, vomiting, stomach pain

Things You Should Understand About Black Fungus Treatment:

If your physician suspects black fungus infection, let them know if you have come in contact with spoiled foods or been to areas where fungal infections are common. Your doctor will recommend some tests such as tissue sampling, CT, and MRI scans to check the severity of your infection.

It is challenging to treat mucormycosis. It may require both intravenous antifungal treatments and a surgical approach. Hence, it requires a multidisciplinary approach in a hospital rather than a clinic.

Your physician will prescribe Liposomal Amphotericin B, posaconazole or isavuconazole. These are antifungal medicines that your physician will put you on immediately after confirming your diagnosis. The antifungal therapy will start with injecting the medication through the veins for a few weeks. 

Once your symptoms improve, your doctor will plan for your discharge and convert the IV medicines to oral dosage. Let them know if you feel stomach discomfort, breathing trouble or heartburn before switching from IV to oral. Your physician will suggest surgery to remove the affected parts in severe cases, to prevent the infection from spreading.

Know About The Epidemic And Stay Safe:

Mucormycosis is a very rare disease that affects an individual very badly. Hence, if you suspect a mucormycosis infection, consult your doctor immediately. After recovering from COVID-19, closely monitor for the signs and symptoms of mucormycosis.

Prompt treatment with accurate diagnosis can cure mucormycosis. Practise good personal hygiene to prevent mucormycosis.