Dr. Indica Sharma
Assistant Professor, Department of Veterinary Microbiology, IIVER, Rohtak
Looking at the whole world already swaying under the pain of deadly corona virus, now have to fight against not so common, the Black fungus infection, also known as Mucormycosis.
Mucormycosis is a rare though serious fungal infection caused by moulds of order Mucorales. The order includes genus Absida, Mucor, Rhizomucor and Rhizopus. These organisms are generally ubiquitous in nature and are found in the soil, plants, decaying organic matter, water, air. They infect both humans and animals. They also play a very important role in our ecosystem along with bacteria by decaying organic matter which in turn is utilized for the plants consumption.
These fungi invade the blood vessels, destroy them which in turn results in tissue necrosis and death. As these moulds live throughout the environment, their spores are present in the air. When the conditions are favourable, the spores germinate; hyphae invade the tissues, digest the host tissue and provide nutrition to the fungi. These organisms affect the lymph nodes of the respiratory and intestinal tracts. If the spores get lodged in the lung parenchyma, it causes destruction of the lung tissues. These fungi also gains entry into the nasal cavity affecting the nasal bones and sinuses. It also grows in oral cavity, eye sockets causing pain, buldging of eyes and loss of vision. Once it enters the cranial cavity it may block the major arteries and veins resulting in brain stroke.
COVID-19 associated mucormycosis
Fungal infections are devastating and now added as a new burden to the sufferings of Covid-19 patients. Black fungus has been reported in patients with Covid-19 infection or those who are at recovery stage.
These fungi generally infect immunocompromised patients or those with damaged tissue. The long term use of broad spectrum antibiotics, antiviral drugs, corticosteroids usually suppress the immune system. These broad spectrum antibiotics not only wipe out the pathogenic bacteria but also the protective commensal where as on the other hand, the use of steroids increases the blood sugar level. Fungus is thought to be transmitted by the humidifier water being given along with the oxygen. All the above factors make a perfect recipe for the mucormycosis infection.
Controlling the fungal infection requires the increased awareness, early diagnosis along with focus on the proper use of various drugs and controlling diabetes. It becomes necessary to educate the patients on taking precautionary measures like proper hand washing, avoid touching dirty surfaces, wearing of masks.
Treatment involves the use of intravenous antifungal drug Amphotericin B. Medicines must be used under prescription and medical supervision.