Mucormycosis "EMPOWER IAS"

Key Points

• Mucormycosis is also called Black Fungus or Zygomycosis and is a serious but rare fungal infection caused by a group of molds called mucormycetes.

 

Types of Mucormycosis:

• Rhinocerebral (Sinus and Brain) Mucormycosis: It is an infection in the sinuses that can spread to the brain. It is the most common in people with uncontrolled diabetes and in people who have had a kidney transplant.
• Pulmonary (Lung) Mucormycosis: It is the most common type of mucormycosis in people with cancer and in people who have had an organ transplant or a stem cell transplant.
• Gastrointestinal Mucormycosis: It is more common among young children than adults, especially premature and low birth weight infants less than 1 month of age, who have had antibiotics, surgery, or medications that lower the body’s ability to fight germs and sickness.
• Cutaneous (Skin) Mucormycosis: It occurs after the fungi enter the body through a break in the skin (for example, after surgery, a burn, or other types of skin trauma). It is most common among people who do not have weakened immune systems.
• Disseminated Mucormycosis: It occurs when the infection spreads through the bloodstream to affect another part of the body. The infection most commonly affects the brain, but also can affect other organs such as the spleen, heart, and skin.

 

Transmission:

• It occurs through inhalation, inoculation, or ingestion of spores from the environment.
• Mucormycosis does not spread between people or between people and animals.
• It usually occurs in people who have health problems or take medicines that lower the body’s ability to fight germs and sickness.

 

Symptoms:

• General symptoms are one-sided facial swelling and numbness, headache, nasal or sinus congestion, black lesions on nasal bridge or upper inside of the mouth, fever, abdominal pain, nausea and gastrointestinal bleeding.
• Disseminated mucormycosis typically occurs in people who are already sick from other medical conditions, so it can be difficult to know which symptoms are related to mucormycosis. Patients with disseminated infection in the brain can develop mental status changes or coma.

 

Diagnosis and Testing:

• Healthcare providers consider medical history, symptoms, physical examinations, and laboratory tests when diagnosing mucormycosis.
• If suspected of the infection, healthcare providers collect a sample of fluid from the respiratory system or may perform a tissue biopsy.
• In tissue biopsy, a small sample of affected tissue is analysed in a laboratory for evidence of mucormycosis under a microscope or in a fungal culture.

 

Who is at risk

• Patients who have been hospitalised for Covid-19 and particularly those who require oxygen therapy during Covid-19 illness are at a much higher risk of mucormycosis.
• However, there are some cases of mucormycosis in patients with asymptomatic Covid-19 infection.
• Before the pandemic, patients with uncontrolled diabetes were at a higher risk of mucormycosis.
• The risk of mucormycosis rises for these patients for two reasons.
• First is that Covid-19 further impairs their immune system.
• Second, they are given corticosteroids for their treatment it leads to a rise in their blood sugar level thus increasing their risk of mucormycosis.

 

Treatment

• Today, we have a number of drugs and anti-fungal medicines that can treat mucormycosis.
• These are given by IV or taken orally.
• Surgery is needed to remove the affected dead tissues along with antifungal therapy.