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What is Black Fungus or Mucormycosis

Updated: May 20, 2021

Hospitals across the country have been reporting cases of a rare coronavirus-linked fungal infection, Mucormycosis, that affects the sinuses, the brain, and the lungs and can be life-threatening in diabetic or severely immune-compromised individuals such as cancer patients or people with HIV/AIDS.

What is Mucormycosis? It is a fungal infection mainly affecting people with medical health problems that reduces their ability to fight environmental pathogens. What does Mucormycosis do? The fungal infection mainly affects people who are on medication for other health complexities that impair the ability to fight environmental pathogens, according to the Indian Medical Council of Medical Research (ICMR). The inhalation of fungal spores from the air affects the lungs and sinuses of such individuals. How do patients get infected with Mucormycosis? Patients with comorbidities or uncontrolled diabetes and those who are on voriconazole therapy or immunosuppression by steroids or even prolonged stay in Intensive Care Units (ICU) can get predisposed to the fungal infection What are the symptoms of Black Fungus or Mucormycosis? Mucormycosis begins to manifest as skin infection in the air pockets located behind our forehead, nose, cheekbones, and in between the eyes and teeth. It then spreads to eyes, lungs and can even spread to the brain. It leads to blackening or discoloration over the nose, blurred or double vision, chest pain, breathing difficulties and coughing of blood. How to prevent Mucormycosis? Some of the preventive measures that needs to adopted to prevent contracting Mucormycosis are: • Use of masks while visiting dusty construction sites. • Wearing shoes, long trousers, long sleeve shirts and gloves while handling soil (gardening), moss or manure • Maintaining personal hygiene, including thorough scrub bath • The disease can also be managed by controlling diabetes, discontinuing immunomodulating drugs, reducing steroids and extensive surgical debridement to remove all necrotic materials. The ICMR has issued a guideline to doctors on the steps to follow in preventing the fungal infection from afflicting immunocompromised individuals. In order to spread awareness around the disease, the government also released a set of instructions to follow the prevent infections. Here are the dos and don'ts to reduce the risk of infections, as released by the ICMR: Dos: • Control hyperglycemia, • Monitor blood glucose level post-Covid-19 discharge and in patients with diabetes, • Use steroids judiciously. Timing, doses and duration should be correct, • Use clean, sterile water for humidifiers during oxygen therapy, • Use antibiotic or antifungals judiciously, Don’ts:

• Miss warning signs and symptoms, • Consider all the cases with a blocked nose as cases of bacterial sinusitis, particularly in the context of immunosuppression and/or Covid-19 patients on immunomodulators, • Hesitate to seek aggressive investigations, as appropriate (KOH staining & microscopy, culture, MALDI-TOF), for detecting fungal etiology, • Lose crucial time to initiate treatment for mucormycosis

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