What is the Black Fungus all about?

Black Fungus

While India struggles hard to deal with the ravaging second wave of Covid-19, there are reports of a spate in cases of black fungus-a rare infection, among the people who have recovered or are recovering from Covid-19. Dr VP Pandey, head of the hospital’s department of medicine, recently told BBC that the “Black Fungus infection is becoming almost as challenging as the pandemic. Unless patients get immediate and proper treatment, the mortality rate can go as high as 94%.” 

What is Black Fungus and how is it caused?

Black Fungus, Mucormycosis, is an infection that is caused due to exposure to fungi known as micromycetes. Micromycetes occur commonly in the environment, such as in soil, leaves, decaying fruits and vegetables, animal dung and compost. They enter the human body while breathing or through exposed skin wounds and can affect the sinuses, the lungs and the brain. 

Black Fungus or Mucormycosis is not a contagious disease, many people who come in the fungi’s contact may not even develop the infection. Nevertheless, people who have a weak immune system are at more risk of this disease. It can be life-threatening for people who are Covid positive, diabetic or are cancer patients or people with HIV/Aids. 

Who is at risk of developing Black Fungus?

Black Fungus is a rare disease, however, there are certain groups of people who are more at risk of this deadly disease than others. People with medical problems or those who take medicines that can lower the body’s strength to battle with germs are considered to be more vulnerable This includes people who have:

  • Cancer
  • Covid -19 patients, or those who have recently recovered (treated with steroids/ anti-inflammatory medicines)
  • Diabetes
  • Skin injuries
  • HIV
  • Organ transplant
  • Have recently had a surgery

Can Black Fungus be prevented?

Following the below-mentioned guidelines can help in preventing black fungus:

  1. Try to stay indoors as much as possible
  2. Exercise regularly, stay active
  3. Keep your home/ surroundings free from dust and dampness
  4. Maintain good oral and nasal hygiene
  5. When going out of your home wear an N-95 mask
  6. Wear a mask when visiting dusty areas/construction sites/ open grounds
  7. Wear shoes, pants, long sleeves shirts and gloves when working in the garden or gardening or working with soil, manure or moss
  8. Take scrub baths, maintain personal hygiene
  9. Control your diabetes
  10. After treatment Covid-19 treatment, keep monitoring your blood glucose
  11. Try and decrease the use of steroids
  12. Discontinue the use of immunomodulating drugs
  13. Stay well hydrated 

Post recovery of Covid, if a patient has facial pain, stuffy nose, facial pain, bloody nasal discharge or any other symptoms (mentioned below), medical help should be taken immediately. 

What are the conditions that appear due to Black Fungus?

Patients who suffer from black fungus mostly have a stuffy or bleeding nose along with swelling and pain in and around the eyes followed by drooping of eyelids and blurred vision which is followed by loss by loss of vision.

There are certain warning signs such as Mucormycosis: 

  1. Pain along with redness around the nose, eyes
  2. Fever
  3. Cough and cold
  4. Headache
  5. Bloody vomits
  6. A change in the mental status
  7. Shortness of breath

Apart from these, Mucormycosis also has the following symptoms:

  1. Nasal blockage or congestion
  2. Toothache
  3. Blurred or double vision with pain 
  4. Blackish/ bloody discharge from the nose
  5. Pain in the cheekbone, facial pain on one side of the nose
  6. Discolouration over the bridge of the nose
  7. Tooth becoming loose
  8. Necrosis, skin lesion
  9. Pain in the chest
  10. A deterioration in the respiratory and lung function

Doctors say most of the patients arrive late when they are on the verge of losing their eyesight. At this stage, their eyes have to be removed surgically so that the infection can be stopped from reaching the brain. Some people have also lost vision in both their eyes. In some cases, the jaw bone of the patients had to be removed to stop the spread of infection. 

What is the relationship between Covid-19 and Black Fungus?

Mucormycosis can happen post-Covid infection. It could be days after hospital discharge or even during the stay at the hospital. Due to Covid, there is damage caused to the patient’s blood vessels and airway mucosa, which can bring an increase in the serum iron that facilitates the fungus to grow. Steroid medicines raise blood sugar levels. Antibiotics that are broad-spectrum wipe out the pathogenic bacteria and protective commensals. 

Sometimes long-term on the ventilator can reduce the patient’s immunity as it has been speculated that the fungus is transmitted by water in the humidifier that is given with the oxygen. All these conditions make it an easy ground for a mucormycosis infection.

How can Black Fungus be treated?

It may be possible to treat black fungus with antifungals. However, a patient could also require surgery at any point in time. Dr Pandey also said that more than 80% of the patients need surgery immediately. 

According to doctors, it is very important to keep diabetes under control, reduce the use of steroids and stop the use of immunomodulating drugs. For maintaining an adequate system of hydration in the lungs, the treatment may start with an infusion of regular saline. This may eventually lead to an infusion of drugs such as amphotericin B as well as antifungal therapy, for a period of a minimum of 4 to 6 weeks.

Doctors have also emphasised the need of controlling hyperglycemia and monitoring the glucose level in the blood especially after taking Covid-19 treatment. Judicious use of steroids, at the right time and inadequate doses, is essential. 

What is White Fungus?

Cases of white fungus are also being reported. Considered to be as fatal as black fungus, the white fungus spreads to different parts of the body and causes severe damage to the lungs, brain, skin and mouth. It generally develops in the private parts or the tongue and then spreads to the different body parts such as the lungs, food pipes and brain. Here is a look at the common symptoms:

  1. Cough
  2. Fever
  3. Diarrhoea
  4. Dark spots on the lungs
  5. Decrease in oxygen level
  6. Skin lesions
  7. White patches in the mouth

Following the tips given below can help in preventing white fungus:

  1. Maintaining a healthy immune system enables the body to fight such infections
  2. Keep your surroundings clean and dust-free

So far, the white fungus was regarded to be an infection that could be cured by common medicines. However, in the recently reported cases, this kind of fungal infection has shown damage that was not seen earlier. Delay in the treatment can make matters worse. 

What is Yellow Fungus?

Also called mucor septic, the yellow fungus causes infection. The main cause behind the growth of the yellow fungus is poor hygiene. Stale food is also a reason behind the growth of fungus. Yellow fungus is different from white and black fungus as it starts internally. It causes leakage of pus and causes delayed healing of wounds. Yellow fungus arises within the body and thus, the diagnosis and treatment often get delayed. This delay can even lead to an organ failure in some patients.
The symptoms of yellow fungus are as follows:

  1. Feeling lethargic
  2. Low appetite
  3. Sunken eyes
  4. Sudden weight loss

Protection from yellow fungus may be possible through the following measures:

  1. It is important to follow good hygiene habits
  2. Keep your surroundings clean
  3. Each fresh and home-cooked food
  4. Do not keep stale food inside the house
  5. Maintaining low humidity can also help prevent fungus formation

The Bottom Line

Black, White and Yellow Fungi are rare but serious fungal infections. The infection is lethal, and it is imperative that early diagnosis and prompt treatment is made available to the patient. People must keep themselves aware and seek only trusted information and healthcare services. Only together can we improve the situation and win this battle against Covid and these deadly fungi. 

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