Mucormycosis/Black Fungus

Mucormycosis, also known as "Black fungus" by the media and the general public, is a disease caused by mould that is prevalent in decaying vegetation and soil. It causes necrotic black tissue to form in infected areas, hence the name. It was more common in uncontrolled diabetics or persons on significant immunosuppression in the Indian environment. During the COVID epidemic, we have witnessed an increase in Mucormycosis cases. Several theories have been advanced to explain the abrupt increase of the deadly fungus which affect,

• Diabetes that is uncontrolled
• Long-term usage of steroids and other immunosuppressive medications
• Immunosuppressed individuals

COVID19 may have an effect on the pancreas, which can disrupt the glycemic balance, resulting in prolonged periods of elevated sugar levels in these patients. Thus, Mucormycosis can be found in COVID patients who have not been treated with steroids or other immunosuppressive medicines.

Mucormycosis is caused by Rhizopus oryzae, the most common fungus responsible for the disease, accounting for around 70% of cases. Despite improved treatment and vigorous treatments, the black fungus sickness has a mortality rate of more than 50%. Furthermore, the death rate is increased in cases with disseminated illness or persistent neutropenia. The illness necessitates immediate and aggressive medical attention; otherwise, it may have severe or lethal implications.

Who is affected?

People who have the following conditions/procedures are more likely to get black fungus disease:

• Immunity has been compromised.
• Corticosteroid administration
• Burns and trauma
• Neutropenia
• Diabetes mellitus uncontrolled in ketoacidosis
• Transplantation of organs or bone marrow
• Hematologic cancers 
• Metabolic acidosis 
• HIV/AIDS
• Surgery
• Deferoxamine treatment in hemodialysis patients

How are they going to get it?

Exposure to the mucormycetes mould is the cause of black fungus. The fungus can be found in the soil, decomposing wood, a compost pile, and leaves.

You can get a black fungus infection through your skin. You can get black fungus disease if you have a cut or abrasion on your skin and come into contact with the fungus.

Another way to get this condition is to inhale mould spores, which causes pulmonary exposure. Inhalation can cause an infection in the lungs and sinuses, which can spread to the brain, eyes, and face.

However, not everyone who is exposed to these moulds develops this condition. People with a weakened immune system are at a higher risk of contracting black fungus sickness.

Is it able to spread through the air?

The black fungus is not an infectious disease that spreads from animals to humans. Fungal spores can be found in the environment, including the air. When a person inhales these spores, the immune system usually attacks and destroys them. Molds, on the other hand, live and cause infection in immunocompromised persons.

What Are the Symptoms of a Black Fungus Infection?

Some of the black fungal signs are as follows:

The most prevalent type of presentation is sinus, oral cavity, and nasal involvement with extension to the eye.

• Skin Infections: The interior tissue is exposed to the black fungus as a result of a cut, scratch, or burnt skin. Symptoms may include ulcers, redness, swelling, discomfort, blisters, and darkened skin tissue.
• Brain Infection: A coma or impaired mental status may develop from a disseminated black fungus infection in the brain.
• Ocular infection: A black fungal infection in the eyes can cause pain, redness, swelling, poor vision, and blindness. In some situations, the eyes must be removed to prevent infection from spreading.
• Infection of the gastrointestinal tract with a black fungus can cause nausea and vomiting, abdominal pain, and gastrointestinal bleeding.

How Does a Doctor Determine the Presence of Black Fungus Disease?

There are several ways to identify black fungus illness. Among them are:

Headache is the most prevalent presenting characteristic in clinical practise. Tissue necrosis is the obvious clinical sign, and looking for eschar (black scab) in the mouth or nasal cavity aids in the diagnosis. The presence of redness and protrusion of the eye with swelling, as well as loss of vision, severe facial discomfort, and focused numbness, should increase the possibility of the condition.

Imaging Techniques: A CT scan of the paranasal sinuses and brain aids in the diagnosis of rhino-orbital illness. CT lungs can aid in the search for pulmonary nodules, and effusion can aid in the diagnosis of pulmonary illness.

Histopathological and microbiological investigation: The most crucial stage in diagnosing is identifying the fungus on microscopic inspection of the tissue and checking for uptake of particular attains to identify the fungus.

Molecular testing: Molecular assays such as restriction fragment length polymorphism analyses (RFLP), conventional polymerase chain reaction (PCR), melt curve analysis of PCR products, and DNA sequencing of specific gene areas aid in determining Mucorales existence (pathogen responsible for black fungus disease). These tests are rarely routinely performed because a microscopic examination is generally sufficient.

What Treatment Options Are There?

The treatment of black fungus illness necessitates a multifaceted strategy. It include addressing the underlying risk factors, removing necrotic tissues, commencing antifungal treatment, and providing adjuvant therapy. The following are some strategies for dealing with black fungus disease:

Surgical debridement: According to certain infection specialists, surgical debridement of the infected portion is necessary to save the patient's life. It aids in the prevention of disease progression. Following the successful completion of treatment, the patient may elect to have plastic surgery.

Overview of black fungus

Black fungus is a severe invasive fungal illness caused by RHIZOPUS that is more common in immunocompromised people.

There has been an increase in the occurrence of this fungal infection in patients with COVID 19 illness.

Several causes, including underlying diabetes, immunosuppressives, host factors, and COVID 19-induced pancreatic endocrine dysfunction, have been hypothesised as potential causal processes for Mucormycosis.

However, in patients with severe COVID 19, the prudent use of steroids and/or other immunosuppressants should not be withheld, as they can be life-saving.

The treatment is long-term and consists of a combination of medicines and surgical procedures. Contact BEWELL hospital for any of the above symptoms and book your appointment today for your treatment.