What is Black fungus infection?
Black fungus, also known as Mucormycosis, is a rare but dangerous infection. Black fungus is caused by getting into contact with fungus spores in the environment. It can also form in the skin after the fungus enters through a cut, scrape, burn, or another type of skin trauma.
Fungi live in the environment, particularly in soil and decaying organic matter such as leaves, compost piles, rotten wood, and so on. This fungal infection is caused by a type of mould known as ‘mucromycetes’. It should be noted that this rare fungal infection affects persons who have health issues or who use drugs that weaken the body’s ability to fight the infections.
Doctors believe mucormycosis, which has an overall mortality rate of 50%, may be being triggered by the use of steroids, a life-saving treatment for severe and critically ill Covid-19 patients.

Black fungus symptoms-
The symptoms of black fungus will vary depending on where the fungus is growing in your body. They may include the following:

    • Fever
    • Cough
    • Chest pain
    • Shortness of breath
    • Swelling on one side of your face
    • Headache
    • Sinus congestion
    • Black lesions on the top of the nose or the inside of the mouth
    • Nausea and vomiting
    • Belly pain
    • Gastrointestinal bleeding
    • Blood in your stool
    • Diarrhea

If your skin is infected, the affected area may appear blistered, red, or swollen. It may turn black, feel warm, or be painful. Through your blood, the infection can also spread to other parts of your body. This is referred to as disseminated black fungus (mucormycosis). When this occurs, the fungus can attack organs such as your spleen and heart. In severe cases, you may experience mental changes or fall into a coma. It can even be fatal.

Black Fungus Risks ?
People who fall into the following categories are more likely to develop black fungus:
Uncontrolled diabetes, diabetic ketoacidosis, and diabetics taking steroids or tocilizumab.
Patients taking immunosuppressants or receiving anticancer treatment, as well as those suffering from a chronic debilitating illness
Patients taking high doses of steroids or tocilizumab for an extended period
Cases of COVID-19 Severity
Patients on oxygen who required nasal prongs, a mask, or a ventilatory support

How Black fungus effects COVID patients?
Mucormycosis is a rare but serious fungal infection. While the cases of this infection were relatively less, the Covid-19 outbreak has given a boost to the spread of this infection. It is commonly known as black fungus, the infection is now detected among Covid-19 patients across India. With a significant increase in fungal infection cases, the government has mandated that all states have to report suspected and confirmed cases of mucormycosis to the Integrated Disease Surveillance Programme (IDSP).
Now let’s take a look at what this infection is and why it is caused more frequently among Covid-19 patients. The infection is rare, but once a person is infected, the fungus manifests in the skin or can affect the brain or lungs, many cases of this infection have been reported in Covid-19 patients?

Why is it occurring in COVID-19 patients ?

Mucormycosis can occur after COVID-19 infection, whether during the hospital stay or a few weeks after discharge.
The COVID-19 generates a sudden change in the interior environment of the host for the fungus, and the medical treatment administered unknowingly promotes fungal development. COVID-19 causes harm to the airway mucosa and blood vessels. It also causes a rise in serum iron, which is required for the fungus to grow. Broad-spectrum antibiotics not only kill potentially harmful bacteria but also beneficial commensals. Although antifungals such as Voriconazole prevent Aspergillosis, Mucor survives and grows due to a lack of resistance. Long-term ventilation decreases immunity, and there is conjecture that the humidifier water that is delivered along with the oxygen transfers the fungus.

Black Fungus Treatment:
Mucormycosis treatment must be fast and aggressive. The concern is due to the fact that by the time even a presumptive diagnosis is made, the patient has often suffered significant tissue damage which cannot be reversed.
Most patients will need surgical and medical treatment.
Most infectious disease experts say that without aggressive surgical debridement of the infected area, the patient is likely to die.
Medicines play an important role. Two main aims are sought simultaneously: antifungal drugs to slow or stop the fungal spread and drugs to treat debilitating underlying diseases.
Amphotericin B (initially intravenous) is the usual drug of choice for antifungal therapy.
Posaconazole or isavuconazole can treat mucormycosis.
Patients may even require an intravenous antifungal procedure lasting 4 -6 weeks.
Patients with underlying diseases like diabetes need to be in optimal control of their diabetes.
Patients normally on steroids or taking deferoxamine (Desferal; used to remove excess iron from the body) are likely to have these drugs stopped because they can increase the survival of fungi in the body.
Patients may need additional surgeries and usually need anti-fungal treatment for an extended period (weeks to months) depending on the severity of the disease