The Black Fungus: Causes,Symptoms & Precautions

The Black Fungus: Causes, Symptoms & Precautions

There is a surge in cases of black fungus, also known as Mucormycosis, which is affecting India — a country which is already experiencing an acute rise in COVID-19 cases. States all over India have begun declaring a “black fungus” epidemic as cases of the fatal rare infection shoot up in patients recovering from Covid-19.

To go ahead with the article, first let’s understand what exactly Black Fungus is, what are its symptoms and all about its treatment – the Liposomal Amphotericin B injection.

What is Black Fungus? And how it spreads?

Black Fungus, scientifically known as Mucormycosis is a very rare yet dangerous infection. It is caused by exposure to mucor mould which is commonly found in soil, manure, plants, and decaying fruits and vegetables. It is ever-present and is also found in soil and air and even in the nose and mucus of healthy people. The Black Fungus affects the brain, the sinuses and the lungs.

Doctors believe that Black Fungus, which has an overall mortality rate of 50%, might be triggered by the use of steroids; which is a life-saving treatment for severe and critically ill Covid-19 patients. There are various statistical analyses which have proven that steroid drugs are most valuable and useful in reducing the mortality (death rate) in COVID patients by 50% by lowering oxygen saturation levels.  The rapid use of steroid drugs for treating covid-19 might be setting the stage for black fungus. Steroids reduce inflammation in the lungs for Covid-19 and appear to help stop some of the damage that can happen when the body's immune system goes into overdrive to fight off coronavirus. But they also reduce immunity and push up blood sugar levels in both diabetics and non-diabetic Covid-19 patients. (1)

This can prove to be a life-threatening disease in diabetic or severely immune-compromised individuals, such as cancer patients or people with HIV/AIDS and now days common in people with COVID-19. It affects the patients initially in the nose, but the fungus can then spread into other parts like the brain, and can often only be treated by major surgery removing the eye or part of skull and/or jaw.

Symptoms of Black Fungus

Patients suffering from the black fungal infection typically have symptoms like stuffy and bleeding nose; swelling of and pain in the eye; drooping of eyelids; and blurred and finally, loss of vision. Warning signs for black fungus infections also include pain and redness around the fever, headache, coughing, nausea, shortness of breath, bloody vomits, and altered mental status. According to the medical advisory of India, Black Fungus infection should be suspected when there is:

  • Sinusitis – A nasal blockage or congestion, blackish/bloody nasal discharge
  • Local pain on the cheek bone, one-sided facial pain, numbness or swelling
  • Blackish discoloration over and around bridge of nose/palate
  • Loosening of teeth, jaw involvement
  • Blurred or double vision with pain - : Infection of black fungus in the eyes may result in severe eye pain, eye redness, eye swelling, blurred eye vision, and blindness. In some cases, there is a need to remove the eyes to prevent the spread of infection.
  • Gastrointestinal Infection: Black fungus infection might affect the gastrointestinal tract and may result in Nausea and vomiting, abdominal pain, and gastrointestinal bleeding.
  • Brain Infection: Disseminated black fungus infection in the brain may result in coma or altered mental status.(2&3))

Do’s and Don’ts for Black Fungus –

Amidst the rising concern over the increasing number of cases of black fungus, the government has advised people to look out for signs and symptoms and be careful. The government has also issued of a list advising people about the Do’s and Don’ts for preventing Black Fungus.

Do’s:

  • Use masks whenever visiting dusty areas/construction sites
  • Control hyperglycemia
  • Monitor blood sugar levels and diabetes post Covid-19 discharge
  • Use steroids judiciously – correct time, correct dosage
  • Use clean, sterile water for humidifiers during oxygen therapy at home
  • Use antibiotics and/or antifungals judiciously
  • Try to strengthen your immune systems by taking necessary vitamins and minerals
  • Wear shoes, long trousers, long sleeved shirts and gloves while gardening
  • Do not have cuts and bruises exposed to dusty, mould environment

Don’ts:

  • Do not miss or ignore (many cases) the warning signs
  • Do not consider all the cases with blocked nose as cases of bacterial sinusitis, particularly in context of immunosuppression and/or Covid-19 patients on immuno-modulators.
  • Do not hesitate to seek aggressive investigations, as appropriate (KOH staining & microscopy, culture, MALDITOF) , for detecting fungal infection
  • Do not delay and waste time to start the treatment of black fungus. (4)

Reference List:

  1. The Guardian, “Black Fungus Disease Linked to Covid-19 Spreads Across India”.
  2. Times of India (2021), “Black Fungus: Causes, Symptoms, Treatment & Prevention”.
  3. Financial Express (2021), “Black Fungus: Doctors Explain Causes, Symptoms, Treatment and Precautionary Measures”.
  4. DeccanHerald (2021) “Black Fungus on the Rise: Here’s a List of Do’s & Don’ts”.

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