Hospitals across India have been reporting several cases of Mucormycosis, a rare fungal infection, affecting patients who have recently recovered from COVID-19.
Mucormycosis or black fungus is an aggressive and invasive fungal infection caused by a group of molds called mucormycetes. It can affect various organs but is currently manifesting as an invasive rhino-orbito-cerebral disease, affecting the ear, nose, throat, and mouth. It is not contagious but can cause a lot of damage internally and can be fatal if not detected early.The common name 'black fungus’ is in reference to the blackening that is characteristic of the disease.
Coronavirus black fungus infection: Signs, symptoms and everything we know about the deadly fungal infection
What makes the black infection so deadly?
Black fungus infection has officially been declared an epidemic in Rajasthan and several other states are recording an unproportionate number of cases, most of them linked to COVID complications.
Now, while fungal infections aren't exactly rare or new like COVID-19, the precedence of cases has gone high in recent times. The infection seems to be most impactful for those suffering from severe COVID-19 patients and making those recovered from COVID-19 to land up in hospitals yet again, with odd facial deformities.
Dr Mridul K Daga, Professor and Intensivist, Maulana Azad Medical College, New Delhi shares, “In pre COVID times too, we used to see 1-2 cases in intensive care but now we have been hearing about many more cases though it isn’t as common in Delhi as certain other parts of the country.”
What exactly is the black fungus infection?
Black fungus infection, or the lethal mucormycosis, is caused by a group of moulds called 'mucormycetes', which is present in the air and causes complications when an ill patient inhales these, which then spreads into the sinus cavities, lungs and chest cavities.
Who faces the highest risk?
As per ICMR guidelines, patients with comorbidities, or those taking medications that suppress their immunity to fight off environmental pathogens are most likely to be susceptible to the ills of black fungus.
It has also been likened that COVID-19 patients who are put on prolonged oxygenation support are also at risk to face mucormycosis infection- poor contaminated water resources used for the production of medical oxygen, environmental factors could all be to blame.
There have also been concerns that the disease is the most dangerous for COVID-19 patients battling severe diabetes. Not only do uncontrolled blood sugar levels make it easier for patients to contract severe illness, but poor blood glucose control also makes it an easier surface for fungi to thrive, and spread symptoms.
Dr Sunil Kumar, Director General Health Services, India also adds that the fungi has the potential to thrive and cause damage under unsanitary conditions, "Moisture in the environment, unclean environment in which patients are treated and oxygenated can be a big source of infection. The organism lives with us and act up when we are immunocompromised,” adding that the problem, which existed regionally, has now doubled up. India alone has accounted for over 71% of black fungus casualties this year.
What are the symptoms one needs to be careful of?
Black fungus carries a high mortality rate of 50%. However, if the disease is diagnosed in time, it can be treated well. According to doctors, the disease primarily infects the face, which is referred to as 'rhino-orbital-cerebral mucormycosis' and may even cause distinct facial deformities, associated with the disease. Apart from that, the disease may also affect the sinus passage and cause acute swelling and inflammation. Here are some distinct symptoms which patients should be on the lookout for:
Black crusts around the nose
Facial deformity is the most talked about symptom of the disease. Mucormycosis can prove to be quite dangerous if left untreated, and mutilate a patient's nose, jaw or alter the vital facial structure. The formation of black crusts, swelling in and around the nasal passage and the eyes is a peculiar feature. In many severe cases, surgeries maybe even required to remove jaw bone or the nose.
Headaches and swelling in/and around the forehead
One of the most severe complications with black fungus happens when it spreads to the brain and causes nervous inflammation. Acute headaches, swelling, redness, pain in the forehead could be the earliest signs. Doctors also warn that the infection can impair cognitive function, and critical symptoms, such as memory loss, delirium and changes in one's mental state also need attention at the earliest.
Swelling in the cheeks, eyes or parts of the face
Swelling, local pain on the cheekbone, or experiencing one-sided facial pain or sort of numbness could also be primary markers of the infection right now. Apart from swelling, the fungal infection could also affect skin health and give rise to multiple lesions, necrosis like symptoms.
Vision loss/ partial blindness
Black fungus infection can badly impact the vital nerves in the body and cause ocular damage as well. Some patients report undergoing symptoms like itchiness, redness in the eyes, eye pain, partial blindness and loss of vision. In some cases, the infection can also lead to permanent loss of vision.
Pulmonary infections
Since the moulds can be inhaled by the patient, the fungus growth can spread sporadically across the respiratory passage and affect the lungs, causing severe symptoms. This is what doctors refer to as 'pulmonary mucormycosis'.
Pulmonary complications can start off as nosebleeds, nasal blockage, cause a reduction in facial sensation. Cough, fever, chest pain, which are also some respiratory symptoms associated with COVID-19 can also be seen with mucormycosis.
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