Black fungal infection aka Mucormycosis – Doctor Explains all about fatal infection
Symptoms of black fungal infection: Early recognition of symptoms such as swelling of the eyes, jaw, or teeth, bloody discharge from the nose, severe headache, or visual changes such as double vision or sudden blindness can aid in early diagnosis and timely treatment.
In recent days, there has been an increase in the detection of a rare but deadly fungal infection known as Mucormycosis or, more generally, “black fungus” in patients with Covid-19. It appears on the skin and also affects the lungs and brain. Doctors treating patients with Covid-19 have indicated the potential risks of this new emerging complication in the battle against the prevailing coronavirus pandemic. The National Covid-19 Task Force has published an emerging evidence-based consultation on the infection. With the infection spreading across the country, how serious is the risk? Is it related to covid? How much of that is the hype? what is the truth?
What is Black Fungal Infection aka Mucormycosis?
Mucormycosis is a common fungus, found primarily in soil and decaying plants, but rarely infecting humans. We are all exposed a lot to these fungi during our daily activities, but our immune system is very effective in preventing infections. However, uncontrolled diabetes and immunosuppression are the two most common scenarios in which patients develop this infection.
Why did you show up now? What does it have to do with Covid-19?
Uncontrolled diabetes and immunosuppression are the most common scenarios in which patients develop this infection. With a death rate of 50%, this infection is to be feared and the incidence of COVID-19 can multiply by many. India appears to be the only country that has seen an increase in these cases in the Covid-19 pandemic. What drives this fatal infection is uncertain, but may be related to patient-specific factors (diabetes, steroid use) as well as the virulence of the virus (suppression of the patient’s immunity and reduced lymphocyte count). In the western scientific literature, the association of Covid-19 with Mucormycosis (black fungal infection) is anecdotal and only cluster cases (less than 50) have been reported after a hurricane or tsunami.
Its recent occurrence reflects a gap in our health system and hygiene conditions. Most cases of black fungal infestion follow a common theme: all patients have had Covid 19, have received steroids, or have diabetes or uncontrolled sugars during treatment,their lymphocyte count is low, reflecting weak immunity. Steroids given too early, often, or for too long can have an adverse effect on blood sugar and immunity, increasing susceptibility to mucormycosis disease.
How do you recognize the symptoms?
Early recognition of symptoms, such as eye swelling, jaw or tooth pain, bloody discharge from the nose, severe headache, or visual changes such as double vision or sudden blindness, can help with early diagnosis and prompt treatment. .
Mucormycosis (Black fungal infection) is known to spread through blood vessels and can spread to the lungs, skin, and brain surprisingly quickly if not diagnosed early. Examination by an ENT specialist, eye specialist and MRI confirm the diagnosis.
Covid’s treatment guidelines warn against the use of steroids if the patient’s oxygen saturation is greater than 95% in ambient air. Self-medication with steroids should be avoided or used without a doctor’s full instructions. It cannot be overemphasized that blood sugar needs to be closely monitored with a home glucose meter for every patient receiving steroids in the treatment of Covid-19. Other factors that contribute to black fungal infection formation are elevated blood ferritin levels due to Covid 19 infection, the need for dialysis, and prolonged immunosuppression with an IL6 inhibitor drug
What are some of the myths about Mucormycosis?
Mucormycosis is not a black fungal infection. From a medical point of view, black fungi are a type of yeast that contains the pigment black melanin in the walls. Mucormycosis causes ennegregating tissues by altering the blood supply, and the media has falsely reported that this black appearance is a black fungus.
There is no scientific evidence that oxygen tubing, oxygen supplies, or humidifiers are responsible for its diffusion or source. Unlike Covid-19, it is not contagious and it is not transmitted from person to person. Not all Covid patients are susceptible, and it is extremely rare in Covid patients who have not received steroids or who have had diabetes under full control.
How much does the treatment cost?
The burden of treating patients with mucormycosis (black fungal infection) is enormous. It usually requires multiple surgeries that can lead to high rates of illness. Eye removal can lead to blindness in patients. If fungi invade the brain, you have an 80% chance of death (rhino cerebral mucormycosis). Patients often require valuable ICU resources and ventilated beds after surgery.
The cost of daily antifungal treatment and antibiotics can range from INR 20,000 to 40,000 per day and hospital treatment will last at least two to three weeks after surgery. Patients also need a multidisciplinary approach that may not be available in all settings and suboptimal treatment can lead to increased morbidity.
What should be done to prevent Mucormycosis?
The entire focus should be on the prevention of mucormycosis. Preventive strategies must be combined with COVID treatment. Good diabetes and prediabetes care is essential to prevent infection.
Vaccination to reduce the severity of Covid eliminates the need for steroids. Good blood sugar control during Covid-19 infection is also important, limiting steroids only to hypoxic patients and with tight glucose control. In the recovery phase of COVID-19, active symptom monitoring and examination by an ENT Specialist can be of great help in the prevention or early treatment of Black fungal infection.