New Delhi: As the country is reeling under the second wave of coronavirus infections, there is also a sudden spike in the cases of black fungus, also called mucormycosis. On Wednesday, according to an ANI report, the head of the neurology department of All India Institute of Medical Sciences (AIIMS) Delhi, Prof MV Padma Srivastava, said that the number of black fungus infections has crossed the 3-digit mark at the hospital and are increasing rapidly.Also Read - Covid-19: Centre Extends Insurance Scheme for Health Workers for Another 180 Days
What is black fungus?
Also known as ‘mucormycosis’, black fungus is a rare kind of fungal infection affecting 1 in 10,00,000 people, but with an overall mortality rate of 50 per cent. The disease is often characterised by hyphae growing in and around blood vessels and can be potentially life-threatening in diabetic or severely immunocompromised individuals. Also Read - Present Evidence Does Not Suggest That it is 'XE' Variant of Covid19, Say Reports
Dr Anita Mathew, Infectious Disease Specialist, Fortis Hospital, Mulund explains that mucormycosis is a serious but rare fungal infection caused by a group of mold called Mucormycetes. Also Read - Covid-19 Can Increase the Risk of Heart Disease in the Future? Yes it can- Know How
Why is black fungus so dangerous?
The doctor explains that black fungus can cause blindness, organ dysfunction, loss of body tissue, and even death if not treated on time. She says, “Active screening and early intervention are a must. It can affect areas from where it can be inhaled through the nose/ sinus/ lung. If it enters from a wound or skin, it can cause a local infection. But if it enters from the sinus, it can involve the eyes and brain. Poor control in Diabetes is the biggest cause for the rising number especially post-COVID. Also, patients with immune-compromised systems or those who have undergone transplants or people who are on immunosuppressants or on a ventilator for a long period of time are at higher risk.”
According to Dr Mathew, infection with mucormycosis should be suspected when there is:
- Sinusitis — nasal blockage or congestion, nasal discharge (blackish/bloody)
- Local pain on the cheekbone, one-sided facial pain, numbness or swelling
- Blackish discolouration over the bridge of nose/palate
- Loosening of teeth, jaw involvement
- Blurred or double vision with pain
- Thrombosis, necrotic skin lesion
- Chest pain, pleural effusion, worsening of respiratory symptoms
How can black fungus be treated?
Dr Mathew explains that the treatment of Mucormycosis involves a combination of surgical debridement of involved tissues and antifungal therapy. She says, “Intravenous (IV) Amphotericin-B is part of antifungal therapy. The usual starting dose is 5 mg/kg daily of Liposomal Amphotericin-B or Amphotericin-B Lipid Complex, and many clinicians will increase the dose up as high as 10 mg/kg daily to control this infection. But this cannot be taken without the doctor’s prescription and is to be administered only in an hospital setting. The duration of this treatment is three weeks, followed by oral medicines for another three to six weeks.”
Meanwhile the doctor also says that the screening of the infection should be ramped up. She explains, “screening for the black Fungus is a crucial step for early intervention. Also, elimination of predisposing factors for infection, such as Hyperglycemia, Metabolic Acidosis, immunosuppressive drugs, and Neutropenia, is also critical. Due to the difficulties in establishing a definitive diagnosis, many patients will be empirically treated for Mucormycosis because they have risk factors for infection and positive cultures and/ or compatible clinical syndromes. But this again will depend on the patient’s case.”
“Right now, the nation is battling the pandemic on several fronts. The new worry about the black fungus is only perpetuating the problem. While the governing authorities and healthcare providers have braced themselves to confront the problem, it is the duty of the citizens as well to protect themselves and their loved ones,” she adds.
How can we protect ourselves from black fungus?
The doctor says:
- The most effective way to prevent the black fungus is to wear a mask while venturing out, especially to gardens, dusty areas, where there is garbage bumping or food rotting.
- Secondly, wear long clothes and have less exposure to skin.
- Most importantly for diabetic and other immune-compromised people, controlling sugar levels and blood glucose is a must.
- People who are prescribed steroids should be constantly monitored and the dosage should be reduced in consultation with your doctor.
- Importantly, steroids must only be taken after consulting with your doctor – do not self medicate.