By Dr. Kala Subramaniam
Fungi are common in the environment. People breathe in or come in contact with fungal spores every day without getting sick. However, in people with weak immune systems, these fungi are more likely to cause an infection.
What is mucormycosis or black fungus?
Mucormycosis is a fungal infection that mainly affects people who have other medical conditions or are on medications for other health problems that reduce their ability to fight environmental pathogens.
Why is mucormycosis discussed more now ?
In the current pandemic, some of the patients who get treated for COVID 19 have one or more risk factors for developing this fungal infection.
Who is at risk of developing mucormycosis?
Mucormycosis is rare, but it’s more common among people with health problems or take medicines that lower the body’s ability to fight germs and sickness. Certain groups of people are more likely to get mucormycosis, like those with
- Uncontrolled diabetes
- Immunosuppression by prolonged steroid use and few other medicines
- Prolonged stay in ICU
- Cancer
- Organ transplant
- Skin injury due to surgery, burns, or wounds etc
How does someone get mucormycosis?
People get mucormycosis through contact with fungal spores in the environment. The lung or sinus forms of the infection can occur after someone inhales the spores from the air. A skin infection can occur after the fungus enters the skin through a scrape, burn, or other type of skin injury.
When to suspect?
The following are some of the symptoms
- Sinusitis – nasal blockade or congestion, 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, jaw involvement
- Blurred or double vision with pain;
- fever,
- skin lesion; blackish discoloration of skin ( hence the name black fungus)
- Chest pain ,blood in the sputum, worsening of respiratory symptoms
- Altered mental status
What are the ways to prevent mucormycosis generally?
- Monitor your blood sugar levels and keep it under control
- Those who have recovered from COVID 19 continue to monitor and maintain your blood sugars under control and at all times
- Do not self medicate with steroids or antibiotics or antifungals. If you develop any other health issue please consult your doctor
- Try to avoid areas with a lot of dust like construction or excavation sites. If you can’t avoid these areas, wear a mask while visiting such places.
- Avoid direct contact with water-damaged buildings and flood water after hurricanes and natural disasters.
- Avoid activities that involve close contact to soil or dust, such as yard work or gardening. If this isn’t possible, Wear shoes, long pants, and a long-sleeved shirt when doing outdoor activities such areas. Wear gloves when handling materials such as soil, moss, or manure.
- To reduce the chances of developing a skin infection, clean skin injuries well with soap and water, especially if they have been exposed to soil or dust.
- Maintain personal hygiene including thorough scrub bath
Is mucormycosis treatable?
Yes. There are antifungal medicines available to treat this condition. But do not self medicate. Consult your doctor for treatment.
Is mucormycosis contagious?
No. Mucormycosis cannot spread between people or between people and animals.
Is there a vaccine to prevent mucormycosis?
No, there is no vaccine to prevent it
Are there medicines to avoid developing this condition?( prophylaxis),
No, patients need not take any specific medicine to prevent this condition .
But there are some precautionary measures that could be taken as mentioned above to prevent developing it.
What are the other fungal infection common in COVID 19 infection.
COVID 19 associated pulmonary asergillosis (CAPA) : usually occurs in patients with severe COVID-19 (e.g., patients on ventilators in ICUs) patients often have non-specific symptoms and can cause severe illness
Invasive candidiasis : blood stream infection by the fungus candida
The risk factors and preventive measures are similar.
Always keep your blood sugar levels under control . Follow all the precautions even after recovery. When in doubt consult your doctor and do not self medicate
https://www.cdc.gov/fungal/diseases/mucormycosis/risk-prevention.html
https://www.icmr.gov.in/pdf/covid/techdoc/Mucormycosis_ADVISORY_FROM_ICMR_In_COVID19_time.pdf