Explained: What is ‘Black Fungus’ and how dangerous it is for COVID-19 patients?

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Recently, India's COVID-19 task force issued an advisory on a rare fungal infection known as mucormycosis or black fungus after several cases were reported from different parts of the country.

The advisory stated the infection found in COVID-19 patients with low immunity (such as uncontrollable diabetes) and prolonged intensive care unit (ICU) stay may turn fatal if they failed to get proper medical attention.

Explained: What is ‘Black Fungus’ and how dangerous it is for COVID-19 patients?
Broad, wide-angle non-septate hyphae of the fungus Mucor, from the paranasal sinus of a patient with diabetes mellitus. Modified giemsa stain of frozen section. Photo: David A Litman/Shutterstock

What is mucormycosis or black fungus infection?

Mucormycosis is a serious but rare fungal infection caused by a group of molds called mucormycetes. These fungi live in the environment, particularly in soil and in decaying organic matter, such as leaves, compost piles, or rotten wood.

What are the reasons for black fungus infection?

People get mucormycosis by coming in contact with the fungal spores in the environment.

For example, infection can occur to sinus or lungs when someone breathes in these spores.

Who is more susceptible to black fungus infection?

People with low immunity - such as those with diabetes, cancer, organ transplant, stem cell transplant, neutropenia (low number of white blood cells), long term corticosteroid use, injection drug use, too much iron in the body, skin injury due to surgery, burns or wounds and prematurity and low birthweight - are more susceptible to infections.

Is mucormycosis contagious?

No, mucormycosis can’t spread from person to person or from people to animals.

Which body parts will be affected by the infection?

The infection mainly affects sinus, brain, lungs, intestine, skin, spleen and heart.

What is infection affecting sinus and brain?

It is known as rhinocerebral infection. In this case, the infection can spread to the brain. This form of mucormycosis is most common in people with uncontrolled diabetes and in people who have had a kidney transplant.

What are the symptoms of rhinocerebral mucormycosis ?

The symptoms include one-sided facial swelling, headache, nasal or sinus congestion, black lesions on the nasal bridge or upper inside of the mouth that quickly become more severe and fever.

What is the mucormycosis affecting lungs?

It is known as pulmonary mucormycosis. It is the most common type of mucormycosis in people with cancer and in people who have had an organ transplant or a stem cell transplant.

What are symptoms of pulmonary mucormycosis?

Fever, cough, chest pain and shortness of breath.

What is gastrointestinal mucormycosis?

It is more common among young children who have had antibiotics, surgery, or medications that lower the body’s ability to fight germs and sickness.

What are its symptoms?

Abdominal pain, nausea and vomiting, gastrointestinal bleeding

What is cutaneous (skin) mucormycosis?

This occurs after the fungi enter the body through a break in the skin. This is the most common form of mucormycosis among people who do not have weakened immune systems.

What are its symptoms?

Cutaneous (skin) mucormycosis can look like blisters or ulcers and the infected area may turn black. Other symptoms include pain, warmth, excessive redness, or swelling around a wound.

What is disseminated mucormycosis?

This occurs when the infection spreads through the bloodstream to affect another part of the body. The infection most commonly affects the brain. It can also affect other organs such as the spleen, heart, and skin.

What are its symptoms of disseminated mucormycosis?

Disseminated mucormycosis typically occurs in people who are already sick from other medical conditions.

How can I lower the risk of mucormycosis?

It is difficult to avoid breathing in fungal spores. But you can lower the chances of developing mucormycosis by following the below mentioned methods.

1. Avoid areas with a lot of dust. Use N95 masks.

2. Avoid activities that involve close contact with soil or dust.

3. Wear shoes, gloves, long pants and long-sleeved shirts while doing outdoor activities.

4. Clean skin injuries well with soap and water

Remember, there is no vaccine to prevent mucormycosis.

How is mucormycosis diagnosed?

Medical practitioners consider your medical history, symptoms, physical examinations and laboratory tests to diagnose mucormycosis. Tests include tissue biopsy, CT scan of your lungs, sinuses, or other parts of your body, depending on the location of the suspected infection.

How is mucormycosis treated?

Mucormycosis is a serious infection and needs to be treated with prescription antifungal medicine. These medicines are given through a vein or by mouth. Often, mucormycosis requires surgery to cut away the infected tissue.

(Source: The United States Centers for Disease Control and Prevention)

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