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Mucormycosis – The Black Fungus

What is Mucor mycosis?
Mucormycosis, or black fungus, has been heard, so much of late during the Covid 19 pandemic, Many of them have heard it first time. This is a fungus that normally resides in our nasal passageways and causes infection when the immunity goes down. It is a rare but severe fungal infection. By and large it may manifest and affect the eyes, nose, sinuses, lungs, and brain. Without prompt treatment and in rare cases, it can lead to loss of the upper jaw or eye.

Is Mucor mycosis, a Serious Infection?
Mucor mycosis simply known as — Black Fungus – first develops in the nasal tract, travels towards the eye and then onwards to the brain. It typically destroys/ eats away the tissue it infects, first it blackens the nose and palate and then spreads to the eye causing loss of vision very swiftly and permanently. If not stopped, it enters the brain and then it’s a matter of time before the person becomes unconscious and dies

What is the Mortality Rate of Mucormycosis?
Amid the pandemic, post covid recovered patients are coming back with a devastating fungal (mucor) infection of the nose, face, eyes, and brain. The mortality rate for rhino-orbital-cerebral (sinuses-eyes-brain) Mucor mycosis ranges from 35%-65%.

What are leading causes of Mucormycosis infection?
Who are at risk of developing this infection?

  1. It can affect Patients with uncontrolled diabetes. In these patient’s blood sugar levels are usually high. As a result, it tends to be a fertile medium for the fungus to grow uninhibited.
  2. Higher dosage or prolonged usage of Steroids (it acts as a lifesaving drug) in several stages of the Covid infection leads to Mucor mycosis. Unsupervised or self-medication can also cause high sugars and reduced immunity leading to severe mucor infection.
  3. Covid seems to reduce the immunity and make the patient more prone to mucor
    The water used in the oxygen humidifier if unsterile or not changed for a long time can also be a source of the infection.

What are the symptoms / early warning signs?
As per the guidelines of Indian Council of Medical Research (ICMR), Mucor mycosis infection should be suspected in hospitalized and recovering COVID-19 patients when there is

  1. Pain on one side of the face
  2. Pain/swelling in the eye
  3. Stuffiness in the nose
  4. Nosebleed
  5. Thrombosis (formation of clots in veins or arteries)
  6. Loose teeth
  7. Black or greyish colour change on the roof of mouth
  8. Decrease in or loss of vision.

Which Doctor, should a patient consult in the event of Mucormycosis?

This disease requires multi-disciplinary approach. Hence it is advised to visit a center that has availability of experts from ENT, Neurosciences, Ophthalmology, Maxillofacial and Reconstructive specialists.


How to prevent mucormycosis?

As per the Experts, the risk of this infection can be minimized by adhering to certain precautionary measures both during and after hospitalization (for COVID-19 treatment).

Precautions to be taken during hospitalization:

  • Appropriate measures to be taken to regulate diabetes and diabetic ketoacidosis
  • Discontinue / or reduce the use of antifungal medications
  • Minimize use of steroids, with an objective to discontinue quickly
  • Use sterile water for humidification while administering oxygen
  • Maintain good oral hygiene by saline gargle or povidone-iodine gargles

Precautions to be taken post-hospitalization:

  • Daily monitoring and Control blood sugar levels
  • Avoid going outdoors and stay indoors as much as possible
  • Maintain oral and nasal hygiene
  • Wear an N-95 mask when going outdoors
  • Maintain physical distancing and hand hygiene
  • Avoid polluted areas
  • Avoid close contact with moist surfaces / soil

What are the long-term scenarios for mucormycosis survivors?

In some cases, Early intervention with antifungal medications and aggressive surgical removal of the fungal infected tissues is the only hope to overcome this deadly infection of mucormycosis. However, during surgical intervention, it may lead to the loss of the upper jaw and sometimes even the eye. But modern medical science has evolved vastly, that it can be fixed with Prosthetic reconstruction. Post-surgery rehabilitation plays a vital role. Replacement of the missing facial structures with prosthetics will also ensure the cure is not more frightful than the disease.

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