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| Photo by Viktor Forgacs on Unsplash |
Mucormycosis:
The 'black fungus' maiming Covid patients in India
Doctors believe mucormycosis, which has an overall
mortality rate of 50%, maybe being triggered by the use of steroids, a
life-saving treatment for severe and critically ill Covid-19 patients.
Its death rate is around 50%. What is this Black Fungus disease? How does start? How can it be prevented? Come let's find out in today's post. To make this post,
What is this Black Fungus? Is it a new disease after Covid-19?
One of the top virologists in India again. Dr Gagandeep Kang says: This isn't a new disease. These fungal infections did happen before. And they're happening now as well.
The formal name of the Black Fungus disease is Mucormycosis. It is an infection of the Mucorales fungal family. Those fungi belong to the Mucorales family. And fungi of this order are found almost everywhere. In soil, in the environment, in decaying fruits and vegetables, and in normal fruits and vegetables, They are very common.
Dr Gagandeep Kang says: It is a fungus. Anywhere you see, this fungus is already there. So it's called an Environmental Contaminant.
Mucormycosis: the black fungus hitting Covid-19 patientsDoctors Fungi in the Mucorales family are considered
opportunistic, meaning they usually infect people with an impaired immune system, or with damaged tissue.
This disease comes under the category of Opportunistic Infections, friends. These infections do not cause trouble in normal conditions but whenever these viruses, bacteria and fungi get the opportunity they attack and infect people. When do they get the opportunity? When the immune system of person is weak.
This Mucorales fungus is normally found in a lot of places in our environment and if it gets inside the body of a fit and healthy person then there will be no problem at all. They wouldn't even know that they have this fungus in their body. But if the immune system of the person is compromised, if the immune system is weak, and there can be many reasons for the weakening of the immune system, then the person can get infected.
What are the chances that a person with a compromised immune system may get it?
Dr Gagandeep Kang says: Even then it is a rare disease. Because if your environment is clean then such diseases do not occur, generally. The environment should be clean and people should not be using steroids. And the other drugs that suppress the functions of the immune system, which are known as Immunosuppressants, when they are used as a part of any treatment, then Mucromycosis may happen.
So suppose there is a young and healthy person who does not have any medical problems, neither diabetes nor anything else, is the chance that they may catch this infection next to impossible?
Dr Gagandeep Kang says: It is very very very rare.
So what are the reasons for a weak immune system? If you have any other disease, like cancer and you're getting chemotherapy treatment it weakens your immune system. If you have diabetes. Or if you're getting treatment for Covid-19 or you're using steroids for a long period of time. Or you're overusing steroids. That can lead to a weak immune system as well.
Taking advantage of this, the fungus can get inside your body and get you infected. And there can be several ways of getting inside your body. One, through the air. When you breathe, there are numerous spores of this fungus in the air. They can enter your lungs and infect you. Two, through food. If the food is spoiled or has decaying fungus on it. It can reach your stomach and cause an infection. Another way is through wounds. If the spores contaminate your wound. But the most common way is through the air. They infect your lungs when you breathe them in. The area of nose and the sinus, are the most common areas where mucormycosis infection happens. And when the blood flow is restricted here the skin gets discoloured, often into a black colour. This is why it is called Black Fungus. It isn't that the fungus is really black-coloured. Instead, it is the symptom this area starts looking black is the reason why it is known as Black Fungus. From here the infection can spread to the eyes and brain as well. It can cause blindness, headaches and seizures as well.
How long does it take to spread? From the infection till the symptoms start showing.
Dr Gagandeep Kang says: When people are very immunocompromised, then the progression time is less than a week. So the person gets to know that they are infected within a week.
Symptoms of rhinocerebral (sinus and brain) mucormycosis include:1.
1. One-sided facial swelling
2.
2. Headache
3.
3. Nasal or sinus congestion
4.
4. Black lesions on the nasal
bridge or upper inside of the mouth that quickly become more severe
5. 5. Fever
If you do get infected, the symptoms that you might come across depends on the area of the body where the fungus is growing. If we talk about the area of the sinus then you may get toothaches, blurry visions, headaches, nasal congestions black lesions may form here and you may also get a fever.
If this infection started spreading from your lungs then you may get a fever, cough, chest pains, bloody vomit or cough, or shortness of breath.
If your skin is infected if any wound gets infected then the area around the wound will start turning black. If it starts from your stomach, which is known as gastrointestinal mucormycosis then you'll get abdominal pains, nausea, and vomiting.
But as I told you, the most common is getting infected while breathing. So the first category of symptoms that I told you about you need to concentrate on them primarily.
Dr Gagandeep Kang says: The symptoms are very general. A biopsy is required to diagnose them. And if there is an infection in the lungs x-rays and CT scans are needed.
This is a very dangerous disease for anyone catching it. The death rate is very high, as I told you already. The mortality rate is 50% but if it gets very severe, then the death rate may reach 90%. But the good news is that this disease is very rare. Immunocompromised people who do not have good immunity even rarely get the disease. And if you are a fit and healthy person if your immune system is good, then you do not have to worry at all.
As a treatment, anti-fungal medicines are given to the patients. but currently, in our country, there is a shortage of anti-fungal medicines too. Because this disease is spreading so fast throughout the country, in states like Rajasthan and Telangana, Black Fungus has already been declared an epidemic. And there have been notifications from the Central Government as well All the States have been warned about this disease.
The second method of treatment is surgery. The infected tissue is removed from the body. Often, in several patients, it meant that their entire jaw had to be removed. Or someone's eye had to be removed because it was infected. Such cases are also seen.
Dr Gagandeep Kang says: If you have diabetes then you need to control it. The sugars should be tightly controlled. And the second thing is that only people who need to take steroids should be given any. So if your doctor says that you need to take steroids ask them why. Because, as I've seen, there is a widespread tendency for inappropriate steroid treatment. And only because of this we are seeing Mucormycosis in India and nowhere else. It isn't that the other countries do not have mucor.
So in the document that we prepared, we wrote that only if the oxygen saturation falls below 90 steroids should be given.
Dr Gagandeep Kang says: Only after dropping below 90%, we consider it to be changing from moderate to severe. Only then is steroid treatment started. But the people overusing it are also taking it when it's above 90%. Oh, nearly everyone is. I have seen it prescribed even at 99% saturation.
