CHEARS

Are you familiar with BLACK FUNGUS INFECTION….how they become one of the leading and terrifying discussion between us? Are they post covid effect? Is it life-threatening? Black fungus are rare but dangerous fungal infection. “People should not be panic as diagnosis and treatment for the infection is readily available, “government said. They also asked for covid care centres to remain watchful about the black fungus in corona patients and immediately report to the directorate of public health.

Why the name BLACK FUNGUS- it causes blackening or discolouration over the nose, eyelids, skin and other affected areas. And the infection is also called as Mucormycosis, previously called as zygomycosis.most mucormycosis infections are life threatening and the risk factors include diabetic mellitus especially those who with ketoacidosis and neutropenia, which may extend into brain. Other high risk group are cancer patients especially those who are neutropenic and receiving broad spectrum antibiotics and individuals receiving immunosuppressive agents including steroids .pulmonary, cutaneous and gastrointestinal infections are also recognised.

Why in COVID 19 affected individuals? Steroids, a lifesaving treatment for severe and critically ill COVID patients could be a trigger for mucormycosis. Steroids reduce inflammation in the lungs for COVID 19 patients and help them to stop some damage that can happen when body’s immune system goes into over drive to flight off coronavirus. But they lowers immunity as well as they increase the blood sugar level in both diabetic and non-diabetic COVID 19 patients. “It’s thought that this drop in immunity could be triggering these cases of mucormycosis”-Dr.Akshay Nair, eye surgeon in Mumbai hospital too BBC News. Now a days this infection cases on rise in Maharashtra, Gujarat, Karnataka, Delhi, Mumbai and other parts of India.an estimated 500 cases occur in the United States annually.

Now a days black fungus is one of the most terrifying and common topic discussed among public. People should not get panic as diagnosis and treatment for the disease are readily available, government said. They also asked covid care hospitals to remain watchful about the black fungus in corona patients and immediately report to the directorate of public health.

It is commonly caused by exposure to mucormycetes mould, found in soil, plants, manure and decaying fruits and vegetables, damp environments such as summer season than winter. The most affected sites are nose, brain, lungs and skin. Based on the sites affected they can be classified as rhinocerebral,  pulmonary, cutaneous, gastrointestinal, disseminated and uncommon presentations. Rhinocerebral may manifest as headache,facial numbness,fever,nasal congestion which progresses to black discharge. Pulmonary mucormycosis have fever, dyspnoea and cough. Cutaneous may include dermal necrosis and black leisions.abdominal pain, nausea and vomiting are common symptoms for gastrointestinal mucormycosis. Disseminated forms involve kidneys, bone, heart and other locations.

Extreme malnutrition is also linked to mucormycosis, especially the gastrointestinal form. Iron is a growth stimulant for mucorales and deferoxamine acts as a siderophore that delivers iron to the fungi. All causes iron overload which is a risk factor for mucormycosis. In some rare cases no identifiable risk factors are seen.

Patients with mucormycosis should be treated in a tertiary care hospital with management of this condition and underlying riskfactors.other important considerations include management of diabetic ketoacidosis and neutropenia should be reversed. Wean steroids and other immune suppressants .the use of contaminated bandages and dressing causes cutaneous mucormycosis. Failure on examination or deterioration in pre-existing wounds may produce cutaneous and ultimately disseminated diseases.

In current practices Amphotericin B an antifungal agent licensed by FDA for the primary therapy of mucormycosis.debridment of necrotic tissue in combination with medical therapy are also mandatory for patient survival. Successful courses of Amphotericin B typically last for 4-6 weeks and the duration of therapy are highly individualized.Isavuconazole and Posaconazole are also recommended.posaconasole is used as an off label drug in patients who are intolerant to Amphoteric B.it is also used as step down therapy after initial control of the disease with amphotericin B.

In order to prevent this use masks in contaminated areas, wear shoes and gloves while handling soil, moss and manure. Maintain personal hygiene including thorough scrub bath as well as control diabetes and risk factors that may lead to black fungus infection.Be healthy and stay healthy. It’s time to awake and fight for the survival. Its bit late!!!

Don’t be panic, prevention is better than cure…..!!!!