Mucormycosis

Mucormycosis

(Black Fungus)

What is Mucormycosis?

Mucor is a fungus which is naturally present in the environment and soil. It causes infection only when immunity is very low.

Mucormycosis is a type of fungal infection. Its not a new disease.

Previously it was called as zygomycosis.

Mucormycosis can cause loss of vision and maybe life threatening.

Mucormycosis and COVID-19

Many people recovering from COVID-19 have been found getting infected by the black fungus.

The fungus invades the sinus and makes its way into the intraorbital and intracranial regions.

When Mucor attacks the sinuses, it spreads to the lungs, the brain, and the central nervous system.

If its progression is not checked early, it may cause death in 50-80% of the cases.

Why the sudden rise in Mucormycosis infections?

Immunosupressive treatments are widely been used to treat COVID-19 infection.

The severity of Mucor infection is largely dependant upon the patient’s immunity and general health.

Co-existence of COVID-19 and high blood sugar levels along with use ofimmuno-supressive treatments would expectedly increase the incidence and severity of Mucormycosis.

Mucormycosis infection may occur during COVID-19 infection or after a few weeks of recovering from it.

What causes Mucormycosis?

Mucormycosis is caused by exposure to mucormyete molds. These organisms occur in:

- Leaves- Piles of compost

- Soil- Rotting wood

One can get Mucormycosis by breathing in the mold spores in the air. This is referred to as a sinus (pulmonary) exposure and through this one may develop the infection in:

- Central nervous system (rarer)- Eyes

- Face- Lungs

- Sinuses

The fungus can also infect the skin via a cut or burn (cutaneous exposure). In such cases, the wound or burn ends up becoming the area of infection.

Although these types of molds can naturally occur in the environment, not everyone exposed to it will get the fungal infection.

Warning signs & symptoms of Mucormycosis

Signs of a sinus or respiratory related infection may include:

Cough

Fever

Headache – If persistent or severe and not responding to pain medicines

Nasal congestion or blockage

Sinus pain

Nasal discharge (blackish/bloody)

Local pain on the cheek bone

One sided facial pain

Numbness or swelling Blackish discoloration over bridge of nose/palate Toothache

Loosening of teeth

Blurred or double vision with pain

Worsening of respiratory symptoms

Mucormycosis can develop within any part of your body but usually presents as a respiratory or skin infection

Blackened skin tissue/localised facial puffiness

Blisters

Fever

Redness

Swelling

Tenderness

Ulcers

Signs of a skin infection may include:

Who gets Mucormycosis

Anyone with a weakened immune system is at an increased risk of contracting this type of infection. Conditions that may increase the risk includes:

People suffering from COVID-19

Burns

Cuts and scrapes

Cancer

Recent organ transplant

HIV or AIDS

Untreated or irregularly treated Diabetes

Surgery

Long-term corticosteroid use (COVID-19 patients treated with steroids)

Too much Iron in the body

Is it contagious?

No. Mucormycosis can’t spread between people or between people and animals.

Other Health Issues due to Mucormycosis

Mucormycosis is particularly dangerous because it spreads quickly throughout the body.

If left untreated, the infection can spread to the lungs or the brain. This can cause:

A brain infection

Paralysis

Pneumonia

Seizures

Death

DO’s

Control hyperglycemia if you are a diabetic

Monitor blood glucose level post COVID-19 discharge

Use steroids with caution – correct timing, correct dose and duration

Use clean, sterile water for humidifiers during oxygen therapy

Use antibiotics/antifungals wisely

Maintain adequate systemic hydration Infuse

Don’ts

Do not miss warning signs and symptoms.

Do not consider all the cases with blocked nose as cases of bacterial sinusitis, particularly in the context of immunosuppression and/or COVID-19 patients on immunomodulators.

Do not hesitate to seek aggressive investigations, as appropriate (KOH staining & microscopy, culture, MALDITOF) for detecting fungal etiology.

Do not lose crucial time to initiate treatment for mucormycosis.

How to prevent?

Use masks if you are visiting dusty construction sites

Wear shoes, long trousers, long sleeve shirts and gloves while handling soil (gardening), moss or manure

Maintain personal hygiene including thorough scrub bath

REFERENCES

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

https://www.cdc.gov/fungal/pdf/mucormycosis-basics.pdf

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

https://covid.aiims.edu/mucormycosis-in-covid-19/

https://www.icmr.gov.in/pdf/covid/techdoc/Mucormycosis_ADVISORY_FROM_ICMR_In_COVID19_time.pdf

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