The Black Fungus and its relation with Covid

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Mucormycosis, also called Black Fungus, is a serious but rare fungal infection caused by a group of molds called mucormycetes. It most commonly affects the sinuses or the lungs after inhaling fungal spores from the air. Misuse of steroids is a major cause behind the infection (Mucormycosis). Chances of fungal infection increase in the patients who are diabetic, COVID positive and are taking steroids. The disease (Mucormycosis) can affect the face, infecting nose, orbit of eye, or brain, which can even cause vision loss.

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Mucormycosis,The Black Fungus and its relation with Covid  Articles also called Black Fungus,  is a serious but rare fungal infection caused by a group of molds called mucormycetes. They are naturally found in the environment which affect the people who have health problems or take such medicines that lower the body’s ability to fight germs and sickness. 

 

Where does it affect? It most commonly affects the sinuses or the lungs after inhaling fungal spores from the air. It can also occur on the skin after a cut, burn, or other type of skin injury.

 

Why has the incidence of Black fungus increased because of Covid infection?

Misuse of steroids is a major cause behind the infection (Mucormycosis). Chances of fungal infection increase in the patients who are diabetic, COVID positive and are taking steroids. The disease (Mucormycosis) can affect the face, infecting nose, orbit of eye, or brain, which can even cause vision loss. It can also spread to the lung.

 

Recently, several states in India have flagged cases of COVID-triggered mucormycosis, especially among patients who are diabetic. Overuse, misuse & rampant use of steroids in COVID patients was seen as the major cause behind it. Steroid use must be reduced. If given to patients with O2 level over 90, black fungus is a possible side-effect. 

 

Symptoms of the illness include pain and redness around eyes or nose, fever, headache, coughing, shortness of breath, blood while vomiting and altered mental status. Patients with uncontrolled diabetes, immunosuppression by steroids and prolonged stays in the ICU, with co-morbidities or treated with antifungal medication like Voriconazole are more likely to contract the infection.

 

The disease is likely to kill about half the patients it infects, according to available medical data, but medical experts have said that chances of survival can be increased by early detection and proper care. Early diagnosis is critical. CT scan of face would detect this infection.

 

The Indian Council of Medical Research (ICMR) has said treatment includes weeks of intravenous antifungal therapy and involves surgically removing all dead and infected tissue, which could lead to the removal of the upper jaw or sometimes even the eye.The ICMR has also advised capping the use of Tocilizumab, a drug that suppresses the immune system.

 

Indian Council of Medical Research has given some guidelines for the DO’s and Don’t to tackle Black Fungus-

 

DO’s 

  1. Judicious use of steroids by the medical fraternity
  2. Use of antibiotics/antifungals at proper time and completing the course
  3. Control hyperglycemia or high blood sugar levels 
  4. Keep an eye on blood glucose level post Covid-19 discharge and also in diabetics
  5. Use clean, sterile water for humidifiers during oxygen therapy

 

Don’ts

  1. Do not miss or ignore warning signs and symptoms 
  2. 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 drugs that weaken the immune system
  3. Do not lose crucial time to initiate treatment for mucormycosis which may be fatal
  4.   Do not hesitate to seek “aggressive” investigations, as directed by medical experts (KOH staining & microscopy, culture, MALDI- TOF), key for detecting the infection