Context

• The new fear after the treatment of COVID-19, especially in an ICU setting, is contracting a severe disease known as mucormycosis.

About mucormycosis

• This is a serious, but rare, fungal infection caused by a group of fungi known as mucormycetes.
• Also known as Black Fungus.
• It usually affects people who have poor immunity, and those with uncontrolled diabetes have the highest risk of developing it.
• Other risk factors of black fungus include steroid treatment, those who have malignancies, HIV/AIDS and those who have been treated with medicines such as deferoxamine for iron overload conditions.

Development of mucormycosis

• When the COVID-19 infection takes a more serious turn, heavy doses of steroids are given to the patient as a life-saving measure. Unfortunately, this can precipitate new onset diabetes in those who do not have diabetes, or substantially raise blood glucose levels in those persons who already have diabetes. This sets the scene for the development of mucormycosis.

Who can be infected with Mucormycosis/ Black Fungus?

1. Diabetes, especially with diabetic ketoacidosis
2. Cancer
3. Organ transplant
4. Stem cell transplant
5. Neutropenia 
6. Long-term corticosteroid use
7. Injection drug use
8. Hemochromatosis (excess of iron)
9. Skin injury due to surgery, burns, or wounds
10. Pre-maturity and low birth weight 

Types and diagnosis 

• Itis is of several types, of which the commonest is rhino-orbital-cerebral mucormycosis.
  • This starts as a common cold or sinusitis, but soon spreads to the eyes producing redness of the eyes, and later bulging of the eyes known as proptosis.
  • It may eventually lead to paralysis of some of the eye muscles, or even to blindness.
  • It can also spread to the brain, and if this occurs, the prognosis is very grave.
• Other forms of mucormycosis include the pulmonary form in which the lungs are mainly involved and less common cutaneous mucormycosis or disseminated mucormycosis, where it spreads throughout the body. The last two are also associated with very poor prognosis.
• Antifungal drugs such as Amphotericin B are used, but they are quite toxic and also expensive.
• If the involvement is extensive, radical surgery may be needed as a lifesaving measure in some cases, including removal of the jaw or the eye.

Source: The Hindu

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