Not All need to panic from ‘Black Fungus’

Chances of Mucormycosis are high only in a specific group of patients, and not every person is at risk.

Recently the social media is all hyped up about the increased incidences of Mucormycosis (black fungus). Consequently, everyone’s WhatsApp and social media posts have flooded with information about black fungus, creating a panic that has led everyone to think that they are the next target of this disease. As a result, productive hours are misspent worrying, and there is an increase in unnecessary requests by patients for diagnosis to clear their doubts regarding Mucormycosis.    

This write-up is an attempt to create awareness amongst the public about who is AT RISK for this disease so that the remaining of you guys do not waste your precious hours fearing contracting this disease. The facts stated are to the best of the knowledge of the author based on evidence-based scientific data.      

What is Black Fungus? 

Mucormycosis is a fungus organism that is ubiquitous and can be found on decaying vegetation in the soil. Agents of mucormycosis are common in the environment. They are relatively frequent contaminants in the clinical microbiology laboratory; all humans have ample exposure to these fungi during day-to-day activities. The fact that mucormycosis is a rare human infection reflects the effectiveness of the human immune system. Even if it occurs, it enters the bloodstream via the lungs and hence is not communicable. 

Cause for recent panic 

An infection of the immunosuppressed in the covid era there has been a rise in the cases primarily due to the following 3 reasons:  

1.Concurrent or recently (<6 weeks) treated Severe COVID-19 or prolonged stay in ICU  2.Uncontrolled diabetes mellitus, Chronic granulomatous diseases, HIV/AIDS, or primary immunodeficiency states  3.Use of Immunosuppression by steroids (any dose use for >3weeks or high dose >1week), Tocilizumab, other immunomodulators, or therapy used with transplantation 

Unsupervised use of steroids through injections from day 1 of any fever is one of the major factors responsible for an upsurge in the incidences of the infection. In medicine, a general Dictum states the use of steroids in the initial phase of any infection type. 

If you are not in any of the following categories, DO NOT WORRY.

When to Suspect 

It does not mean that the disease is not dreadful, and hence if you or any of your near and dear had recovered from COVID, especially if they had a moderate to a severe problem associated with the use of steroids, especially having Diabetes as a comorbid disease should look out for the following signs and seek consultation from an ENT or Neuro Specialist 

• Abnormal black discharge or crusty dryness, or bleeding from the nose • Nasal blockage / Sinusitis 
• Headache or eye pain 
• Swelling around the eyes, double vision, redness of the eye, loss of vision, difficulty in the closing eye, inability to open the eye, prominence of the eye 
• Facial numbness or tingling sensation, difficulty in chewing or opening the mouth 
• Fever or vomiting

Words of Wisdom 
Viral messages circulating claiming Mucormycosis can occur by eating raw fruit or wearing the same mask for a few days are myths and carry no scientific evidence. For anyone who feels that they have one of the above-stated risk factors or are immunosuppressed, the rule of thumb is to seek a medical consult rather than wasting precious hours on self-treatment and diagnostics. Specialists can guide you and rule out this disease the best. Consult an ENT specialist, Ophthalmologist, Neurologist, Pulmonologist, or Intensivist, looking after COVID patients.  
Stay Safe 

-Dr. Aditya Sharma 
Consultant Ophthalmologist 
Amar Shakti Clinics, Sector 7C, Chandigarh 
www.amarshakticlinics.com