Mucormycosis Symptoms & Treatment During Covid-19 | OurNewEarth

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Black Fungus or Mucormycosis is a great risk
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Background

• There has been a significant rise of fungal
  infections in COVID-19 patients from India.
  Mucormycosis or Black Fungus is an opportunistic
  infection, in which spores of the fungus take
  hold of tissues in immunocompromised patients,
  such as those who have contracted COVID-19 or are
  on immunosuppressants such as steroids. The Union
  Health Ministry of India recently declared
  Mucormycosis as an epidemic in India. 
• Mucormycosis is a serious infection caused by
  group of molds called Mucormycetes. Rhinocerebral
  mucormycosis (black fungus) is an infection that
  affects the sinuses and can also spread to the
  brain. This fungus usually resides in the nasal
  mucosa and then germinates to spread from the
  nose into the eye and brain in diabetics,
  immunocompromised patients and people who have
  had renal transplant. Transmission generally
  occurs through inhalation, inoculation, or
  ingestion of the spores. These fungal spores are
  mostly present in the environment particularly in
  soil and on inhalation and in people with weaker
  immune system it can spread through bandages,
  linens, water leaks, poor air filtration,
  nonsterile instruments, and open wounds. 
• The fungus damages cells and nerves and cuts off
  blood supply as it spreads. The lack of blood
  supply turns tissue black, earning the disease
  the misnomer black fungus. In the recent times,
  there is a significant rise in the cases of
  Mucormycosis in COVID and post COVID patients.
  The probable causes would be increased usage of
  steroids in the treatment of COVID, inadequate
  monitoring of blood sugar level, altered innate
  immunity, immune dysregulation, and invasion of
  the vessels and formation of clots.
• Given a large number of COVID 19 cases across the
  India, Mucormycosis is something that should be
  taken seriously and both patients and caregivers
  should be made aware of it.

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Symptoms and Signs of Mucormycosis

• Sinus headache
• Facial pain
• Stuffy nose
• Blood nasal discharge
• Blurring of vision
• Double vision
• Dental pain or loosening of teeth 
• Facial swelling
• Facial skin coloration
• Ptosis (closure of eyelid)
• Proptosis (swelling of the eyeballs) 
• Restricted eye movements
• Palatal blackish discoloration
• Brownish discharge from the nose

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Detection Examination of Mucormycosis

• Complete blood count
• Blood sugar test
• Renal function test
• Deep nasal swab- KOH staining to detect the
  fungus
• Nasal endoscopy and biopsy
• MRI gadolinium and,
• CT scan of the Nose and PNS 

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Prevention of Mucormycosis

• Avoiding areas with a lot of dust, as the fungus
  spores exist in dust and old construction
  material.
• Ensuring the patient always wears a good mask.
• Taking extreme contact and droplet precautions
  and maintain strict hand hygiene. Spores spread
  through droplets and coughs and can infect
  anybody with low immunity.
• Ensuring strict control of blood sugar. COVID-19
  and steroids used as treatment, push up the sugar
  level in the body. This elevated sugar level is
  food for the fungus to grow.
• Avoid using steroids for home isolation patients
  especially when you cannot monitor blood sugar
  levels.
• Maintain nasal hygiene of patients and wash it
  through saline daily. This clears out dust
  particles and fungus spores.
• Maintaining hygiene of the equipment used for
  oxygenation - nasal prongs, nasal canula, masks
  for ventilation. As equipments not used for long
  may have dust particles along with fungal spores.
• Linen can carry fungal spores too and therefore
  should be cleaned daily thoroughly.
• Keeping a close watch for early symptoms and
  reporting to an ENT surgeon.

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Conclusion

• If symptoms are ignored in the early stages, the
  consequences can be very serious. In advanced
  stages the fungus can affect the sinus bones
  leading to their removal, if it enters the eye,
  the eyeball will have to be removed, and further
  if it affects the brain, it will be fatal. Hence
  it is very important for its early detection,
  diagnosis, and prompt institution of treatment.

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