Complete knowledge on Mucormycosis | Black Fungus: लक्षण और आसान उपाय

1. Mucormycosis (Black Fungus)

2. 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.

3. 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.

4. 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-supressivetreatments 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.

5. 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

6. 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.

7. Warning signs & symptoms of Mucormycosis Mucormycosis can develop within any part of your body but usually presents as a respiratory or skin infection 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

8. Signs of a skin infection may include: • Blackened skin tissue/localised facial puffiness • Blisters • Fever • Redness • Swelling • Tenderness • Ulcers

9. 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

10. Is it contagious? • No. Mucormycosis can’t spread between people or between people and animals.

11. 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

12. 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

13. 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.

14. 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

15. 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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