Black Fungus or Mucormycosis: Symptoms, Prevention & Treatment

What is a Black Fungus?

As the second wave of Covid-19 ravages India, a new term has been gaining much attention, and reports of a deadly condition called Black fungus have been on the rise. Mucormycosis or Black fungus is an old but rare infection that affects the recovering and recovered Covid-19 patients.

It is during the COVID-19 pandemic, several cases of pulmonary mucormycosis and its rise related to immunosuppressive treatment for COVID-19 were reported in India from December 2020.

Medically called mucormycosis, black fungus is a rare fungal infection caused by a group of fungal molds called the micromycetes or zygomycetes, or Mucorales.

This mold releases the spores into the air and the surrounding environment which when comes into contact with some people cause various problems.

It usually affects people who are very susceptible to allergic complaints and those with lowered immunity. People of any age may be affected, including premature infants who have compromised immunity.

How does Black Fungus spread?

The spores are spread by breathing in, eating contaminated or stale food, or when the spores come in contact with an open wound or cuts in the skin surface. It most commonly affects the sinuses and the lungs after inhalation of the fungal spores from the air.

Symptoms

The black fungus causes various symptoms depending on the part of the body that is infected. Some of the common symptoms are:

• Fever and headache
• Facial pain and problems with vision
• Swelling of the face, eye, and nose
• Cough and Shortness of breath
• Abdominal pain and vomiting
• Skin ulceration, swelling, and redness
• Dark scabbing in the nose
• Bloody sputum
• Changes in Mental status
• Coma

The symptoms that are specific to the site of fungal growth are as follows:

Rhinocerebral mucormycosis – The affection of sinuses and brain

• Swelling of the face
• Pain in the face
• Headache and problems with vision
• Nasal congestion
• Black lesions on nasal bridge and inside of the mouth
• Fever

Pulmonary mucormycosis – The affection of lungs

• Fever
• Cough and difficulty in breathing
• Chest pain
• Shortness of breath

Cutaneous mucormycosis – The affection of the skin

• Swelling and redness of the skin
• Blisters or ulcerations on the skin
• Blackish discoloration of the lesion
• Pain and warmth of the affected area
• Redness and swelling around the affected area

Gastrointestinal mucormycosis – The affection of gastrointestinal tract

• Abdominal and flank pains
• Nausea and vomiting
• Bloody vomit
• Gastrointestinal bleeding

Disseminated mucormycosis – The presence of spores in the blood flow

The spore invasion into the blood flow can cause blood clots and subsequent tissue death due to loss of blood supply. Disseminated mucormycosis typically occurs in people who are already sick from other medical conditions, so it can be difficult to differentiate the symptoms related to mucormycosis. People with disseminated infection of the brain can develop changes in the mental status and may lead to coma.

Who is at risk?

The risk factors include long-term debilitating medical conditions like diabetes, lymphoma, organ transplant, HIV/AIDS and long-term medications of corticosteroids or immunosuppressive therapy, kidney failure, long-term corticosteroids, cirrhosis of the liver, malnutrition, tuberculosis, and increased iron levels in the blood, etc. Some cases seem to have no apparent causes or risk factors.

People who come in contact with contaminated wound dressings, contaminated hospital bed sheets, negative-pressure rooms, water leaks, poor ventilation, contaminated medical equipment, and poor building works.

Prevention

One of the frequently asked questions regarding the coronavirus black fungus infection is “how to prevent black fungus”. Some of the few steps and precaution that can be followed are:

• Wearing a face mask while going out in dusty, crowded areas.
• Wearing a face mask in places with risk of exposure to dust, gardening, etc.
• Avoid moldy and wet apartments and rooms.
• Protecting the skin from exposure to soil and dust.
• Protecting the feet and hands when working with soil or manure such as gardening or certain outdoor work.
• Taking anti-fungal drugs as a preventative in cases of high-risk groups such as diabetics and organ transplants.

Treatment

• Black fungus treatment includes an inclusive approach
• Antibiotics and antifungals are the first lines of treatment.
• Surgical removal of the fungus ball.
• Hyperbaric oxygen has also been used as adjunctive therapy, as the higher oxygen pressure increases the potency of neutrophils to kill the fungus.
• Various ayurvedic formulations help to boost up the immunity
• Use of traditional home remedies such as ginger, garlic, pepper, and turmeric, etc.

How Homeopathy can help in treating Mucormycosis/Black fungus?

Due to the effect of heavy steroidal drugs given for treating the COVID-19 patients, the immunity is considerably reduced and there is a rapid increase in the rise of Black fungus in recovering and recovered patients from COVID-19. Considering this and preventing further damage to such patients’ immune systems, the department of AYUSH has come up with a homeopathic protocol for the prevention of mucormycosis.

Homeopathic medicines can be used as prophylactics for Covid-19 patients to help boost their immunity and to prevent further infections in high-risk groups.

It includes symptom-specific treatment and suggests a set of medicines based on the most recurring and common symptoms. Apart from the prescribed medicines, other medicines can also be given based on symptoms similarity.

Black fungus in COVID patients

With an overall mortality rate of 50%, Mucormycosis may be triggered by the use of corticosteroids, one of the main and life-saving treatments for severe and critically ill Covid-19 patients.

Steroids help to reduce the Covid-19 lung infection and fight off coronavirus. As an effect, these steroids reduce the body immunity by reducing the levels of lymphocytes and neutrophils in the blood and raise the blood sugar levels in both diabetics and non-diabetic Covid-19 patients. This gives a perfect environment for the fungal spores to settle in and grow. This growth leads to blockage of blood vessels and blood clots.

Conclusion

Black fungus is thus a rare but at present a dangerous condition affecting COVID patients. It is essential to boost up immunity and take proper precautions to prevent this infection. With an integrated and inclusive mode of treatment, proper diet, and personal hygiene, the rate of rising in infection can be controlled and further mortality is prevented. It is advised to follow the instructions of a registered medical professional for the treatment.