Everything You Need to Know about Black Fungus

With the rising cases of the coronavirus, there is another disease known as black fungus or mucormycosis that is influencing the recovered coronavirus patients. From skin damage to deep lung infections, from the severe gastrointestinal system to full-blown infection into the bloodstream causing death, this fungal infection is creating a scare across the world, India being one of its main targets. This fungus lives in the environment all over the globe, particularly in soil, rotten wood, compost piles, or leaves.

What is black fungus?

Mucormycosis is a rare infection, caused by a group of molds called micromycetes. It may affect the digestive tract, respiratory system, or skin. Black fungus or mucormycosis has been observed in China and India, often among patients with cancer, diabetes, or other health conditions that risk their immune systems. Now, COVID-19 patients, with diseases like cancer, kidney disease, and diabetes are in danger of this infection. Also, patients with serious mucormycosis cases have a decreased immune system.

Symptoms of black fungus

The symptoms of mucormycosis will differ depending on where the infection is developing in your body. The symptoms may include:

• Diarrhoea
• Blood in your stool
• Gastrointestinal bleeding
• Vomiting and Nausea
• Belly pain
• Black lesions inside of the mouth or on the top of the nose
• Sinus congestion
• Headache
• Swelling in the face
• Shortness of breath
• Chest pain
• Cough
• Fever

If a person’s skin is infected, the infected area may look swollen, red or blistered. It may be painful, feel warm, or turn black. Through the blood, the fungal infection can also spread to other body parts. This is classified as disseminated mucormycosis or black fungus. When this happens, the infection can attack organs such as the eyes, heart and brain. In serious cases, a person may fall into a coma or experience mental changes. There is no denying that black fungus can be deadly.

How does black fungus enter the body?

Black fungus refers to the kind of fungi that commonly lives on rotten vegetables or in the ground, which can enter a human body through wounds, cuts, surgeries, eye injuries, burns, etc. This fungus can reach your skin without displaying any signs for days before it actually begins to cause trouble. Thus, individuals who have been affected by the fungus may not even be aware of what happened to them until they begin experiencing any symptoms.

The most familiar way these fungi get into the body is by breathing in dirt and other microscopic particles of the outdoor ambience. So, patients with a decreased immune system should not be careless about their susceptibilities while doing outdoor activities or gardening.

However, the reason for this infection in India is assumed to be the rampant utilization of steroids to cure corona patients and the unhygienic process of providing oxygen to them.

Is black fungus contagious? How serious is this disease?

Black fungus is not communicable and cannot spread from individual to individual. As far as the severity of this infection is concerned, it is curable if observed early. However, as the infection increases and its treatment is delayed, black fungus might invade the lungs, jaw, throat, eyes, and brain tissue of the patient. Depending upon the harshness, the infected body parts should be surgically separated to save the sufferer’s life.

What to do if you suspect black fungus or mucormycosis?

If the symptoms are existing, a doctor should be consulted. Antifungal drugs should not be consumed without consulting a physician first.

Be cautious for symptoms like;

• Blurry/declining vision
• Altered behaviour
• Headache
• Shortness of breath
• Bloody vomiting/spit
• Swelling, redness, pain in eyes
• Fever

The black fungus can often be analyzed by testing the fluid collecting in lungs and sinuses with biopsy or cytology of tissue samples. Still, this infection has particular factors, so diagnosis is simple. However, cytology examinations may go improper because the cells of the fungus look like yeast cells. So, some individuals might have wrong negative results even when they have a fungal infection in their body, which can’t always be detected on diagnostic examination.

Who faces the higher risk?

As per the guidelines of the Indian Council of Medical Research, IMCR, people with serious health conditions, or those consuming drugs that reduce their immunity to combat against environmental fungus are most likely to be vulnerable to the ills of mucormycosis.

It has also been analogized that coronavirus sufferers who are put on continued oxygenation support are also a danger to fight against mucormycosis disease.

There have also been worries that the infection is the most harmful for corona positive people fighting serious diabetes. Poor blood glucose control and uncontrolled blood sugar levels make this infection effortless for sufferers to contract a serious illness and effortless for fungi to spread and develop symptoms.

It is also added by Dr Sunil Kumar, Director General Health Services, India that the fungus is most likely to develop and cause harm under unclean conditions. “Moisture in the climate, polluted environment in which sufferers are cured and oxygenated can be a great source of disease. The organism stays with us and shows off when we have a reduced immune system, ” adding that the danger, which stayed regionally, has presently doubled up.

Why is the spread of the black fungus rising?

Black fungus or mucormycosis infection can occur if the rooms and purely ventilated and dirty masks are worn.

Black fungus mainly affects individuals who take drugs or have health problems that decrease the body’s capacity to fight illness and germs. The individual’s immunity is suppressed after coronavirus treatment, which makes them weak to this fungal infection. Covid-19 patients and Individuals with diabetes are at high risk of growing an infection.

It is said by Dr Mohan Nerker, the director of a seven-star hospital that immunosuppressed and diabetic patients are most likely to be infected by fungal diseases like black fungus or mucormycosis.

” Many corona-positive people have begun consuming drugs through self-treatment with no control and monitoring of sugar. Some were also being instructed by incompetent physicians, with drugs provided without checking parameters, and that is dangerous. Oxygen cylinders with tap water in the flow meters are also utilized by many individuals which may also have directed to fungal diseases like mucormycosis or black fungus. Also, an unclean atmosphere and unhygienic lifestyle can attract diseases and lead to health issues.” Said Dr Nerker.

Treatment

The treatment needs multidisciplinary proficiency because the fungal disease spreads through the brain. It involves surgically separating all infected and dead tissue. In some people, this may cause loss of an eye or upper jaw.

The treatment may also involve a 30-45 days course of intravenous treatment. Since the black fungus can have an impact on many parts of the body, treatment needs a team of surgeons, dentists, ophthalmologists, ENT specialists, intensivist neurologists, internal medicine specialists, microbiologists, and others.

Medicines utilized to treat mucormycosis

Amphotericin B Liposomal is being utilized for the therapy of fungal disease.

Each infected person would need 60 vials of injection.

Why is Black Fungus occurring in covid-19 patients?

The black fungus can arise any time after coronavirus infection. A person can be affected either during the hospital stay or some days or weeks after release.

Coronavirus causes a favourable change in the internal milieu of the host for the infection and the therapy provided, unintentionally also abets the growth of fungus. Coronavirus harms the blood vessels and airway mucosa. It is also responsible for the growth in the serum iron which is very crucial for the black fungus to thrive. Drugs like steroids boost blood sugar. Broad-spectrum antibiotics eliminate the protective commensals and the potentially pathogenic bacteria. Long-term ventilation suppressed immunity and there are theories of the mucormycosis infection being carried by the humidifier water being provided along with oxygen.

How to prevent the occurrence of black fungus?

Medication is undoubtedly good for treating an infection, but it is better to take precautions to prevent the occurrence of the disease first-hand. People can be protected from this severe infection through precautions. Given below is some information for black fungus or mucormycosis prevention.

In a hospital:

• Cleanliness and good hygiene should be maintained. Daily oral hygiene maintenance with povidone-iodine gargle and mouthwash should be done.
• While overseeing oxygen, water humidification should be clean and there should not be any leaks from the humidifier.

Once discharged:

• Don’t go outside unnecessarily
• Opt for some gentle home exercises, after consulting your doctor
• Control your blood sugar level
• The surrounding should be clean and free from dampness and dust
• Maintain nasal and oral hygiene
• An N-95 mask must be worn while going out
• Avoid grounds, fields, and construction areas
• Plants and soil are the areas that can spread the black fungus. Hence it is better to avoid gardening and working with soil. If unavoidable, boots, rubber gloves and masks should be used.

Conclusion

As time passes, we get to see newer and more serious diseases related to COVID-19. Mucormycosis is one such harmful fungal disease detected mostly among coronavirus sufferers across health centres in India. Individuals suffering from diabetes, patients relying on humidified oxygen and steroids for a long time, and coronavirus infected persons with pre-existing diseases are the most defenceless ones to this disease. Besides, cancer patients and people depending on long-term immunity reduction drugs are also susceptible to black fungus infection.

Thus, it is important to be cautious and aware of the above-stated symptoms and health complications. Early diagnosis will help in initiating the right treatment at the right time, thereby saving many lives.