Mucormycosis: Doctor explains types of black fungus, medical tests to diagnose them

The panic with the sudden rise in the cases of Mucormycosis (also known as Black Fungus) has gripped the country with people suffering from Coronavirus particularly vulnerable to the disease. The fungal infection majorly targets patients who have low body immunity because they are on medication or suffering from comorbidities. The self immunity among such patients is so low that the environmental pathogens affect their lungs and sinuses after they are inhaled by the body during respiration.

Who are most vulnerable to Black Fungus ?
Dr Minal Vohra, Consultant Endocrinologist, BeatO, told the Indian Express that people with uncontrolled diabetes and weak immunity due to intake of steroids and long stay in ICU are more vulnerable to the disease. Dr Vohra also said that patients who have undergone recent transplants, malignancies and voriconazole therapy are also susceptible to the disease.

Dr Vohra explained that the use of steroids, which is being prescribed to moderate to severe Coronavirus patients, reduced body immunity. She also said that while the steroids are very effective in controlling body inflammation in the lungs, the drug increases the blood sugar levels among diabetic as well as non-diabetic patients.

Warning against complacent behaviour among patients vulnerable to Black Fungus infection, Dr Vohra said that by the time patients actually recognise the infection it has already reached the vital organs of the body and therefore there should be high suspicion of Black Fungus infection among patients likely to contract the disease.

Are there any prevalent types of Black Fungus infection?
According to the Indian Express report, among Coronavirus patients two kinds of Black Fungus infection have been reported namely- Rhino-Orbito-Cerebral Mucormycosis (ROCM) and Pulmonary mucormycosis. The prevalence of both these types has been reported in patients who have already recovered from Coronavirus as well as those undergoing Covid-19 treatment currently.

So far as the ROCM type infection is concerned, the infection typically affects the nose, eyes and brain of the patients. The infection starts its progression from the nose and quickly reaches the bone cavity around the eye. Patients can read the signs of RCOM infection in three stages. During the first stage, nasal blockage and congestion is experienced by the patient as well as pain inside the nose. The patient might also develop swelling and numbness on her face.

During the second stage of the infection as the infection reaches the bone cavity around the eye, the patient also experiences headache and orbital pain. The patient will feel as if the back and front portion of the eye is causing pain. Since the severity of the infection has increased in the second stage, patients may even encounter blurred vision, partial blindness or complete blindness in one or both eyes.

During the third stage, the infection reaches the jaw of the mouth and patients also start experiencing tingling, chilling or burning sensation in their whole body. Fever, unstable body walk, unconsciousness and black spots on the skin near the nose or eye may also manifest among patients whose infection has spread to the brain.

Pulmonary mucormycosis
The second kind of Black Fungus infection primarily affects the lungs and respiratory system and is most prevalent among patients whose immunity has been weakened due to a number of factors.The common symptoms of Pulmonary mucormycosis are fever, cough, shortness of breath and intense chest pain. As the condition of the Pulmonary mucormycosis worsens some patients might also experience the presence of blood in their cough.

What tests are done to confirm Black Fungus cases?
In the case of the ROCM infection type, patients must undergo the MRI PNS (para nasal sinuses) with brain contrast study. On the other hand, for the Pulmonary mucormycosis patients simply need to undergo a plain CT scan.