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Black Fungus or Mucormycosis

13 May, 2021 - By Bhanu

Mucormycosis, commonly called black fungus, is a serious and rare fungal infection affecting those suffering from coronavirus in India.

The black fungus that invades the brain is being increasingly seen in vulnerable patients in India as the health system continues to struggle amid the pandemic

This infection caused by a group of fungi called mucormycetes. These are ubiquitous in the environment and can often be seen on rotting food. Despite being common in the environment, it doesn’t cause infection in humans as our immune cells can easily fight such pathogens.

What is Black Fungus or Mucormycosis?

Mucormycosis is considered to be a big, serious threat right now. While documented cases of fungal infection are still rare, the ICMR has now issued guidelines that not only could it affect a lot of COVID patients in recovery, it could also become extremely fatal if left unchecked.

According to experts, the black fungal infection is caused by a group of molds called 'mucormycetes', which is present in the air and causes complications when an ill patient inhales these, which then spreads into the sinus cavities, lungs, and chest cavities.

Again, how exactly is the black fungus infection linked to COVID is yet undisclosed. However, some experts believe that a high dependency on steroids (used to treat inflammation in COVID cases), pre-existing comorbidities, such as diabetes may make a person suffering from COVID at a higher risk for catching mucormycosis as well.

How does the infection start and progress?

The Central government in an advisory said the fungal infection mainly affects people who are on medication that reduces their ability to fight environmental pathogens.

The evidence-based advisory for screening, diagnosis, and management of the disease was released by the Indian Council of Medical Research (ICMR) and the Union health ministry.

“Mucormycosis, if uncared for, may turn fatal. Sinuses or lungs of such individuals get affected after fungal spores are inhaled from the air,” it said.

How is it prevented and treated?

To prevent the disease, blood glucose level should be monitored post-COVID discharge and also in diabetic patients; steroids should be used judiciously incorrect timing, dose, and duration; clean sterile water should be used in humidifiers during oxygen therapy, and antibiotics and antifungal medicines should be used correctly, it said. 

The disease can be managed by controlling diabetes, discontinuing immunomodulating drugs, reducing steroids, and extensive surgical debridement- to remove all necrotic materials, according to the advisory. 

Medical treatment includes installing peripherally inserted central catheter, maintaining adequate systemic hydration, infusion of normal saline intravenously before Amphotericin B infusion, and anti-fungal therapy for at least six weeks besides monitoring the patient clinically with radio imaging for response and to detect disease progression, it said.