Also known as Black Fungus, Mucormycosis is an opportunistic infection (infection happens when the immune system is weak due to various reasons). The disease came to public attention after many cases were reported in the post Covid-19 scenario.
Is it a new disease?
No. It’s not.
Does it happen only in Covid-19 patients?
No. Currently Covid-19 is the main reason. It also happens in uncontrolled diabetes, after prolonged steroid use, patients using immune-suppressant medications, patients of organ transplants, patients of cancer etc.
Are all Covid-19 patients at risk of mucormycosis?
No. Covid patients with uncontrolled diabetes, Covid patients with prolonged and high-dose steroid use, those using contaminated equipment, damp masks, and those living in unhygienic and crowded places are at particularly increased risk.
Is it a mild infection?
No, it is a rapidly progressive, severely destructive, organ or life-threatening disease. Mortality rate is in the order of 40 to 80 percent.
What are the symptoms of Mucormycosis?
Facial pain, swelling, headache, running nose, sinus tenderness, blood stained nasal discharge, black dis-coloration around the eyes, inside the nasal cavity, palate, tooth pain, loosening/falling of teeth, double vision, blurring of vision, loss of vision, blood stained or black sputum can all in various combination can be the presenting symptom.
What are the tests to detect the presence of Mucormycosis?
In a predisposed patient with symptoms suggestive of Mucormycosis, immediate medical intervention is necessary. Tests conducted are nasal endoscopy, biopsy of suspicious tissues, fungal stain with special stains, MRI of nose, sinuses, orbits, and brain.
What are the treatments available?
Surgical treatment is the mainstay.
Are there any drugs available?
Yes. Amphotericin B is the drug of choice, but drugs alone do not cure the disease, drugs along with surgery ensures the best chances of survival. Other drugs are posaconazole and isavuconazole, but less effective compared to amphotericin. These drugs can be used for those not tolerating amphotericin.
What are the different forms of mucormycosis seen?
Rhino orbito cerebral mucormycosis is the most common form affecting the nose, sinuses, orbits, eyes, brain. Other forms are pulmonary, gastrointestinal etc.
What is the major side effect of amphotericin?
Nephrotoxicity (can damage the kidneys). So this is given in centers with experience in dealing with such health conditions.
Is there any other fungal infection Covid-19 patients are more susceptible to?
Yes. Covid-associated aspergillosis is one such systemic fungal infection.
Dr Wilson AP, the author, is Consultant – Internal Medicine at KIMSHEALTH