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What is MUCORMYCOSIS a.k.a BLACK FUNGUS INFECTION? Causes, Reason, Symptoms, Risk population, Treatment ,Severity and Prevention

Just when 2020 was about to end and people were looking towards positive 2021, a disease came into news- MUCORMYCOSIS also known as THE BLACK FUNGUS INFECTION.
Lets see What is severity of this fungus? if this a new disease? and Is this a potential next pandemic?

MUCORMYCOSIS (also known as ZYGOMYCOSIS or GLOMERULOMYCETES) is a fungal infection.
This fungus is an opportunistic fungus and is generally present as saprophyte in our surrounding environment in soil or bread
This is not a new disease but rather an old one. It is one the common causes of fungal infection in immuno-compromised individuals.
What is MUCORMYCOSIS a.k.a BLACK FUNGUS INFECTION? Causes, Reason, Symptoms, Risk population, Treatment ,Severity and Prevention

It is currently famous as BLACK FUNGAL INFECTION because the lesion presents as a black mass inside the nose.

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What is the CAUSE OF MUCORMYCOSIS?

MUCORMYCOSIS is caused by any of the following fungus.
  • RHIZOPUS
  • MUCOR
  • ABSIDIA
  • RHIZOMUCOR

WAY OF INFECTION

As discussed, this fungus is present in soil and surroundings, so accordingly there can be multiple ways of entry for this fungus
  • inhalation
  • injury
    • fungus present in soil may enter through trauma

Keep in mind -

MUCORMYCOSIS IS NOT CONTAGIOUS.

it can not spread from person to person

SYMPTOMS OF MUCORMYCOSIS

MUCORMYCOSIS mostly presents as - RHINO-OCULO-CEREBRAL disease

This BLACK FUNGAL INFECTION has the capacity to spread to other organs through blood vesels.

It will start invading your blood vessels and lead to endothelial damage and thrombosis and soon involve other organs.
And as more organs get involved, its severity increase and chances of survival decreases

Symptoms depend on the organ or involvement. This usually start from nose
  • NOSE
    • nasal congestion
    • black colour collection
  • ORBITAL CELLULITIS
    • redness and swelling surrounding eyes
    • this may also cause one sided face swelling
  • LUNGS
    • cough
    • breathlessness
  • BRAIN
    • delirium
    • seizures (fits/convulsions) 
    • coma
  • SKIN
  • INTESTINES
    • abdominal pain
    • vomiting 
    • gastrointestinal bleeding
    • SPLEEN

WHO ARE AT THE RISK OF MUCORMYCOSIS ?

NOT EVERYONE CAN SUFFER FROM BLACK FUNGAL INFECTION.

This is an opportunitic infection meaning it will cause disease only if your immunity is low.
The normal human immunity is enough to tackle this fungus. As discussed earlier, this is present in our surrounding as an environmental saprophyte. So there are chances many of us might have got the fungus but there were no symptoms, thanks to your immunity!!!

Thus MUCORMYCOSIS occurs only in those who have low immunity
These include patients with-
  • DIABETES MELLITUS
    • uncontrolled diabetes
  • RENAL DISEASES
    • end stage renal diseases
  • TRANSPLANT RECIPIENTS 
    • those who have recieved organ transplant
  • STEROID USERS
    • high dose steroids for medical or non-medical reasons
    • long time users
  • NEUTROPENIA
    • decreases neutrophils in blood
  • COVID
    • especially in immunocompromised state
  • DISEASES DECREASING IMMUNITY
    • certain blood cancers.
    • cancer treatment - radiotherapy or chemotherapy
  • BURNS patient
  • IRON THERAPY
    • patients who are on iron therapy as this fungus get attracted to excess iron.
    • This is for those who consume excess of iron due to medical reasons and does not mean you should stop consuming iron. 

TREATMENT OF MUCORMYCOSIS

This disease is fought on medical and surgical fronts depending on the symptoms and case presentation.
It requires ANTIFUNGALS, SURGICAL DEBRIDMENT and controlling the leading factor.
What is MUCORMYCOSIS a.k.a BLACK FUNGUS INFECTION? Causes, Reason, Symptoms, Risk population, Treatment ,Severity and Prevention

SEVERITY OF MUCORMYCOSIS

MUCORMYCOSIS is an emergency situation. It is mostly neglected in the starting stages.

As discussed earlier, mucormycosis can spread through blood vessels, and when this fungus starts to invade vessels, not much time is left with the patient!! 
As more organs get involved, its severity increase and chances of survival decreases.

This infection has a HIGH DEATH RATE (50%). Death rate is more in people with very low immunity and patients in which this disease has spread to multiple organs (>90% death rate). If not disseminated, death rate is <10%.

If untreated, the chances of survival are less than 5%. 
Medicines and surgery do help a lot in decreasing death rate. But don't show effect in highly disseminated cases or in patients with very low immnunity.

HOW CAN WE PREVENT FROM MUCORMYCOSIS?

  • keep your immunity high
  • keep your diabetes in control
  • use mask to prevent inhalation of fungus
For people with low immunity-
  • wear mask while going out
  • avoid getting in contact with dust
  • Consult your doctor to start anti-fungal

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That's all for this topic !!

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SOURCES-
  1. https://www.cdc.gov/fungal/diseases/mucormycosis/symptoms.html
  2. Textbook of Essentials of medical parasitology and ananthanarayan by apurba sastry.
  3. Epidemiology and outcome of zygomycosis: a review of 929 reported cases by Maureen M Roden and others DOI: 10.1086/432579
  4. Epidemiology and clinical manifestations of mucormycosis by George Petrikkos DOI: 10.1093/cid/cir866
  5. Novel Perspectives on Mucormycosis: Pathophysiology, Presentation, and Management by Brad Spellberg and others

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