Mucormycosis or Black Fungus: Doctors explain causes, symptoms, treatment and precautionary measures

Cases of black fungus infection, called mucormycosis, are rapidly increasing in the country, especially among patients who have been infected with COVID-19.

The situation is worsening across the country, which is why the Union Ministry of Health and Family Welfare has made this infection notifiable, meaning that every confirmed or suspected case of black fungus would have to be reported by the states.

But what exactly is this infection and what are its symptoms and treatments?

Black fungus: What it is and why does the infection occur?
Explaining in detail what mucormycosis is, Dr Laxman Jessani, Consultant, Infectious Diseases, Apollo Hospitals Navi Mumbai, said, “Mucormycosis, also known as “black fungus” is an infection caused by the Mucorales mould or fungus, which is often seen in immune-compromised patients (in this case, COVID patients). COVID patients are particularly susceptible because not only does the virus affect the immune system but the drugs used for treatment also suppress their immune responses. The black colour is actually the dead tissue resulting from the fungal infection that invades the blood vessels and destroys them causing tissue death.”

Explaining a little more, Fortis Hospital Bannerghatta Road, Bengaluru’s Consultant ENT Specialist Dr Susheen Dutt said, “It is a fungal infection, which is opportunistic and rarely seen in the general population. If you have any form of immunocompromise, then you are at risk. When you are immunocompromised, your immune system’s defenses are low, affecting its ability to fight off infections and diseases. It includes diabetes mellitus, or some forms of cancer, or people who are on steroid therapy for any other problem.”

Jiva Ayurveda Director Dr Partap Chauhan listed the causes that are leading to rising cases of black fungus in the country, saying, “Excessive use of steroids, uncontrolled blood sugar levels, unhygienic tubes through which oxygen is supplied to the patients and poor nasal and oral care could be the reasons that lead to fungal infection. The use of unclean masks is also considered one of the causes of this fungal infection.”

Dr Ashvin Agarwal, Executive Director, Dr Agarwal Group of Eye Hospital added, “Black Fungus affects the skin, lungs, eyes, mouth, and brain. When they infect, they grow in sinuses. In certain cases they can spread from sinuses around the eye or in some cases in the eye.”

Mucormycosis: How to identify black fungus

Dr Agarwal listed some symptoms that can be used to identify the infection. “Symptoms of mucormycosis include pain and redness around the eyes and nose, a fever, headache, coughing, vomit with blood in it, black and bloody nasal discharge, pain on one side of the face and in the sinuses, blackish discoloration over the nose, tooth pain, and painful and blurred vision, double vision, protrusion of the eyeball majority of mucormycosis infections have been seen in Covid patients with diabetes or those with underlying and undetected high blood sugar,” the doctor said.

Dr Chauhan said, “It is important to identify the fungal infection in the early stage. The infection generally starts from the nose and then spreads to cheekbones, palate, eyes and can go into the brain. Immediate consultation with the doctor is necessary to avoid complications”

Precautions that must be taken

“Patients, especially those with diabetes, those on immunosuppresants and steroids, or any condition that affects the immune system need to take precautions like controlling high blood sugar levels, monitoring blood sugar level regularly and using steroids and antifungal medicines only when prescribed by the doctor,” Dr Jessani said.

Dr Agarwal also gave some more precautionary measures that people must follow, saying, “Considering the strong and growing Covid-eye connection, people should begin using goggles and facial protection, while following other standard Covid appropriate behaviour and guidelines such as wearing masks, maintaining physical distancing, and frequent washing hands with soap. Along with this, immunity is also of vital importance. It also plays a key role in speeding up recovery even if there is an infection. Hence, make no compromise on good food, stay hydrated, exercise regularly, have enough sleep, and cultivate a stress-free mind. Those with diabetic conditions need to keep an eye on their blood glucose level.”

Treatment for black fungus
“Early diagnosis and aggressive treatment is required. Black fungus is treated with specific antifungal medicines that need to be administered intravenously. The most common medicine includes Amphotericin B that is used to treat serious fungal infections. Patients may need up to six weeks of treatment to recover. Their recovery depends on how early the disease was diagnosed and treated. Often, surgery is required to cut away dead or infected tissue,” Dr Jessani said.

Dr Agarwal explained how vision impacted by black fungus could be treated. “In the case of vision loss, if patients can reach ophthalmologists in time – sight can be very well saved with proper treatment at the earliest to see the doctor. Even in the case of mucormycosis infection affecting eyes, it can be treated either in the form of medicines (antifungal Amphotericin B) or surgery. Again timely or a prompt diagnosis can always save the eye and thereby vision.”

Source – Financial Express

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