Black Fungus

Black Fungus

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Overview

The black fungus, also referred to as mucormycosis, is a rare infection that can be fatal in those with a weakened immune system. The fungal spores are commonly present in the air, soil, and decaying organic matter like leaves, compost piles, and rotten wood. It may enter the body through the nose, mouth, eyes and then advance to the sinuses, lungs, and brain. It can also occur on the skin after a burn, scrape, cut, or other skin trauma type.

What are the causes of Black Fungus?

This fungal infection may affect any person of any age group. As it is commonly present in the environment around us, it does not affect everyone. The impact is mainly on those with a compromised immune system wherein the body cannot fight off the body's external infectious agents. The following conditions may put you at risk for mucormycosis:

  • Uncontrolled Diabetes
  • Long term steroid use
  • Cancer
  • Weakness due to poor nutrition
  • HIV or AIDS
  • History of use of injectable drugs
  • Organ transplant
  • Stem cell transplant
  • Premature birth or low birth weight
  • Excess acid in the body (Metabolic acidosis)
  • High level of iron in the body (Haemochromatosis)
  • Individuals with chronic illness
  • Patients on oxygen support who require nasal prong, a mask or ventilatory support
  • Skin injury due to burns, cuts or wounds

In patients afflicted with Covid19, steroid use was a part of the treatment that hampered the overall immunity of the patients and predisposed them towards black fungus.

What are the symptoms of Black Fungus?

The signs and symptoms will vary according to the part of the body that is affected with black fungus:

  • Sinuses
  • Brain
  • Nasal and sinus congestion
  • Runny nose
  • Headache
  • Fever
  • Swelling on one side of the face
  • Black lesions on the upper side of the mouth or nasal bridge
  • Lungs
    • Cough with Fever
    • Chest pain
    • Breathlessness
    • Chest discomfort
  • Gastrointestinal Tract
      • Pain in abdomen
      • Nausea and vomiting
      • Internal bleeding
      • Diarrhoea
      • Blood in your stool
  • Skin
      • Blistered and red skin
      • Swelling
      • Blackish discolouration might appear
      • Warm and painful skin
  • Eyes
      • Pain and swelling in the eyes
      • Blurred vision
      • Eyelid loss

    Black fungus is a non-contagious infection that does not spread from one person to another.

How is Black fungus diagnosed?

If the medical team suspects black fungus, then they would perform the following:

  • Physical Examination: A comprehensive medical examination may be conducted to check for redness on skin, blackness or any other visible abnormalities. He might also enquire about your symptoms and try to find the possible source of infection. The medical team may also enquire about your medical history, any past illness or associated comorbidities.
  • Blood Tests: The doctors may advise various blood tests to assess the functioning of the internal organs like liver, kidney, the red blood cells & white blood cells count, and presence of any infection.
  • Sample of respiratory fluid: If there is a suspicion of the presence of black fungus in your sinuses or lungs, then the sample of fluid or mucus from your respiratory tract may be sent to a laboratory.
  • Tissue Biopsy: A small tissue from the infected tissue may also be sent to the laboratory for examination under a microscope or for fungal culture for black fungus.
  • Imaging investigations: In severe cases, the imaging investigations such as CT scans or MRI of the brain, chest, sinuses or any other body part may be advised according to the medical team.

How is black fungus treated?

As soon as the black fungus is diagnosed, treatment with antifungal medications. The medicines are meant to destroy the fungus, cease the growth of the fungal infection, and stop the overall spread to other parts of the body. The antifungal medicines may be administered into the vein directly by inserting an intravenous catheter.Initially, high dosages may be given intravenously if the infection is more, and when the infection is under control, these medications may be administered in the form of pills. It is vital to note the side effects such as burning in the chest, pain in the stomach, and breathing problems and report to the doctor so that the treatment plan can be adjusted accordingly.If required, surgical intervention might be suggested to remove the infected tissue to prevent further infection. This may include the removal of eyes or parts of your nose.

What are the complications of black fungus?

The black fungus may complicate if timely treatment is not taken or if the infection spreads to the lungs or brain.

  • The infection of black fungus can spread to other parts of the body through the blood, which is called disseminated mucormycosis. It can be fatal if it spreads to organs like the spleen or heart.
  • Complete loss of eyesight may also occur in a few cases. In such cases, there may be a risk of spread of infection of the brain due to which eyes have to be removed. Removal of the jaw is also advised if required.
  • There might be nerve damage in some cases.
  • Blood vessels may get blocked, or blood clots might also form.
  • In severe cases, when the brain is affected, there may be changes in the mental state, and you may advance into a coma.

Tips for Prevention

Black fungus is present in the environment and cannot be avoided entirely, but there are specific preventive measures that can be taken, especially if your immune system is weak:

  • Avoid places with construction work or areas with a lot of dust or soil, and even if you have to wear an N95 mask, preferably.
  • Avoid going in areas where they may be infected water like the ones affected due to natural calamities such as floods or hurricanes or water-damaged buildings.
  • Do not indulge in activities such as gardening that may involve direct contact with soil or dust. If you have to, please make sure to wear long gloves in your hands and wear proper footwear and long pants to avoid any direct contact with the soil.
  • If you have undergone a major procedure such as organ transplant or stem cell transplant that involves administering immunosuppressant medications. In that case, they might prescribe antifungal medicines to you as a preventive measure against mucormycosis and other similar fungal infections.

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