Dr. PN Renjen, Stroke Neurologist, Institutes of Neurosciences, Indraprastha Apollo Hospitals, New Delhi
In the second wave of COVID 19 in India, mucormycosis commonly known as black fungus has been one of the most reported post COVID complication effecting multiples parts and organs of the body including the brain. It has also been declared as an epidemic by several states in the country. Typically, Mucormycosis is not contagious and people do not develop symptoms on contact with an infected person.
However, people undergoing treatment for organ transplant, heart diseases, cancer, COVID 19, health conditions that severely weaken the immune system as at a greater risk of getting this infection. It is affecting COVID patients more due to prolonged administration of steroids and subsequent immunocompromised state of health. It is reported more in patients who have other comorbidities like diabetes, renal failure, cancer or who have undergone kidney/liver transplant and in patients who have been administered steroids for a long time.
Generally, mucormycosis infection spread through bloodstream to affect another part of the body. When mucormycosis affects organ and tissues of the body, it causes nerve damage leading to blood clots. When these blood clots spreads to another part of the body they cause damage to other parts. Similarly when these clots spread to the brain they cause tumours manifested with stroke.
The most common place where black fungus can affect is face. It enters the body through nostrils then to sinuses and can extend from there to eyes and brain. Other forms of the disease may infect lungs, stomach and intestines, and skin. It generally spreads through breathing in infected spores, eating contaminated food or getting spores of it on an open wound.
Symptoms of Infection
Symptoms of this infection depends on the part of the body which is affected. It commonly affects the sinuses and brain. The symptoms then can be:
- Runny Nose
- One-sided facial swelling and pain
- Tissue death
Some of the patients in which black fungus is reported in the brain tissue also had symptoms like:
- Brain Stroke
Infection with fungi causes severe complications in patients with low immunity and the involvement of Central Nervous System leads to fatal consequences. Some of the neurological problems are listed below.
- Cerebral Abscesses
- Stroke syndrome
Educating patients about the symptoms is crucial as it will help in early detection of the disease.
Diagnosis for Black Fungus
Healthcare professional by considering the patient history, symptoms and physical examination and some laboratory tests can detect the infection.Diagnosis of Black fungus is simple, it can be:
- Endoscopy through telescope
- Culture or biopsy
- CT scans
- MRI, for knowing the extent of the disease
Prevention for Black Fungus
Normally, the body immunity is perfectly able to deal the Mucormycosis. But in the scenario of pandemic the risk can be avoided by:
- Controlling the risk factors well
- Avoiding prolonged use of steroids
- More caution for patients with co-morbidities
- Wearing mask and regular hygiene of it
Treatment for Black Fungus
- Anti-fungal treatment
- Surgery for removal of the infected part to prevent rapidly invasive infection
To summarize, Mucormycosis treatment needs a multidisciplinary approach. Firstly, prevention and secondly, if get infected then early diagnosis of the disease can help patient in recovering from it.