June 2021

BLACK FUNGUS Mucormycosis is commonly known by the of Black fungus, it was previously known as zygomycosis because it has characters similar to the class zygomycetes of kingdom fungi such as cell wall made up of chitin, method of asexual reproduction, gametangial copulation, diploid and multinucleated(coenocytic) body and unbranched mycelium (a group of hyphae). Some of the members of class zygomycetes are Rhizopus, mucor/pinmold, that’s why the disease is named as mucormycosis. As the name of the disease is revealing, it is a fungal infection caused by the fungi called mucormycetes. It belongs to the kingdom: fungi, phylum: Mucoromycota, order: Mucorales, family: Mucoraceae and genus: Mucor. https://foxfoster.com/wp-content/uploads/2021/06/Virus-66101-1.mp4 HISTORY OF BLACK FUNGUS :- The very first case of the mucormycosis was reported in the year 1855. Later on, the disease was reported to be found in lungs in the year 1876 by Furbringer. After several researches and studies, it was in the year 1943, the disease was reported in three cases including severe sinus, brain and eye involvement in association with the diabetes. Afterwards, the disease had been reported during natural disasters. Until the half of the 20th century, the disease was treated using potassium iodide. The survival was better in those who were getting medical treatment along with the surgery. It affects less than 1.7 per million population each year. It is rare but is 80 times more widespread in India. CAUSE OF BLACK FUNGUS: The fungal infection is caused by the fungi called Mucormycetes. The maximum number of cases is due to the Rhizopus and Mucor. We can come in contact with this while eating contaminated food, touching the articles responsible for the development of fungus like soil or by inhalation of the mold spore or a group of molds known as mucormycosis. It can also enter through the cuts or wounds present on the skin and may also be present in the decomposed organic matters like manure, rotten fruits and vegetables. Who may be the next victim? Everyday we are exposed to large number of infectious diseases. But, only a few of them get exposure to the disease. Why? It’s because of the fact that our body is able to defend itself from most of the foreign agents and this overall ability of the host to fight the disease‐ causing organisms, conferred by the immune system is called immunity. Persons having less immunity or you can say one with weak immune system may be at risk or those having the health condition like diabetes, cancer, etc. Mainly the COVID‐19 patients are fighting severe condition of mucormycosis due to their less ability to fight from the disease. According to the reports, there were 7,250 infected, 219 deaths in India due to the Black fungus as on 21st May, 2021 and the graph is increasing day by day. Patients taking immunosuppressant medications or one with comorbidities to fight off the pathogens are more prone to this fungal infection. SYMPTOMS OF BLACK FUNGUS: ‐ The infection generally begins with the nose or mouth and then reaches the central nervous system through the eyes. It is not a contagious disease. The symptoms mainly depend upon the site of infection including fever, headache or one‐sided eye pain, cough, runny nose, loss of smell, shortness of breath, diarrhea, blood in stool, tummy ache, vomiting, nausea, blood clot inside a blood vessel, swelling on one side of the face, sinus congestion, bleeding from the gastrointestinal tract, chest pain, one eye may look bulging out and swollen, vision may also be blurred. Severe infection occurs in those with serious medical condition like cancer, AIDS or HIV, diabetes (not under control), organ transplant, use of steroid in the long term, addiction of drug, poor nutrition, etc. Depending upon the site of infection mucormycosis is classified into six types: ‐ Lungs (pulmonary): ‐ Mainly in people with cancer or an organ transplant. Sinuses and brain (rhinocerebral): ‐ Commonly in those with high diabetes or one with a history of kidney transplant. Stomach and intestine (gastrointestinal): ‐ Mostly among premature and low birth weight infants having less ability to fight infection. Skin (cutaneous): ‐ Generally in people with leukaemia (is a group of blood cancer that usually begins in the bone marrow), HIV, high diabetesor one who uses drug injection. Widespread: ‐ spread of infection to other parts or organs of body through the blood. Less commonly affected parts. Diagnosis and Treatment of Black Fungus: ‐ Diagnosis is by biopsy (a medical test commonly performed by the surgeon to examine the extent or presence of a particular disease). The doctor will ask your medical history and you will be examined physically or MRI, CT scans can be conducted to know which organ or tissue is infected by the fungus. If you have a history of sinus, then doctor will take a sample of fluid from your nose or throat and based upon it, your treatment will be started. The treatment is mainly done with Amphotericin B. Amphotericin B is given in the vein for the first 14 days, and afterwards if the patient is recovered then is treated with pills but if the patient is not recovered then Amphotericin B is continued for some more days. In case, it becomes very serious then the doctor may recommend you a surgical debridement (surgery for removing the infected tissue to improve the healing potential) in order to stop the fungus from spreading to other parts of the body. Complications of black fungus: ‐ According to the researchers, 56% people die with mucormycosis. But it depends on the organ or part which is affected. In severe cases it may lead to blindness, nerve damage, blood clots. Due to the blood clot inside a blood vessel, there is a loss of blood supply to the surrounding tissues leading to the death of these tissues. The infection can be spread to the other parts or organs of your body through the blood which results in direct attack of the fungus to the vital