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Mucormycosis in post-COVID Cases

What is mucormycosis?

Mucormycosis also commonly referred to as the ‘black fungus’ is a rare but life-threatening fungal infection caused by a group of moulds called mucormycetes. These fungi are present throughout the environment. It most commonly affects the sinuses, brain or the lungs after inhaling fungal spores from the air.


How does it spread?                                            

Mucormycetes are present in the environment, particularly in soil and mostly lives and grows in decaying organic matter, such as leaves, compost piles, and animal dung.

People with weakened immune system breathing in mucormycetes spores can get affected with an infection in the lungs or sinuses which can then spread to the eyes and brains eventually proving to be fatal.

A skin infection can also occur after the fungus enters the skin through a scrape, cut or a burn.

What are the symptoms of Mucormycosis?

  • One sided swollen face
  • Facial pain
  • Fever
  • Nasal congestion/ stuffy nose
  • Headache
  • Black lesions on nose or inside of the upper part of the mouth
  • Blurring of vision
  • Swelling around the eyes
  • Chest pain

Who is more prone to Mucormycosis?

Mucormycosis can be mainly seen in people who have health issues or are dependent on medications that lower the body’s ability to fight germs and sickness. These include people with:

  • Diabetes, especially with diabetic ketoacidosis
  • Cancer
  • Organ transplant
  • Stem cell transplant
  • Neutropenia 
  • Long-term corticosteroid use
  • Injection drug use
  • Skin injury due to surgery, burns, or wounds
  • AIDs.
  • Critically ill covid patients

Why are covid patients at risk of Mucormycosis?        

There have been many cases of covid 19 patients being affected by mucormycosis. Studies show that the reason behind this is the use of long term steroids. Steroids reduce inflammation in the lungs and help stop the damage that can happen when the body’s immune system goes into overdrive to fight off coronavirus. By doing so, they also reduce the body’s immunity and increase the blood sugar levels in both diabetic and non-diabetic Covid-19 patients. These factors contribute in causing this fungal infection in post- covid patients .

Are all covid patients at risk ?

Not all covid patients are at risk of contracting mucormycosis. Those on :

  • Long term steroid use
  • Long term immunosuppressants (tocilizumab )
  • Prolonged intensive care unit (ICU) stay
  • Fluctuating sugar levels post covid
  • Suffering from co-morbidities

are at a high risk of developing mucormycosis.

How to catch it early ?

All high risk post covid patients much get a regular nasal examination done with their ENT doctor. Those with any of the above mentioned symptoms must visit their ENT / Opthalmologist for a check up immediately.

An MRI scan can pick up the diagnosis of mucormycosis and show how much the disease has spread. On basis of this treatment can be started.

What is the treatment for mucormycosis ?

Depending to on stage of involvement:

If only sinuses are involved : A debridement or FESS ( Functional endoscopic sinus surgery) is done along with injection of IV Amphotericin B ( anti- fungal ) is given.

If the eye is involved : orbital exenteration ( procedure in which the entire eye is removed ) is needed.

Once involving the brain – it can be very lethal.

Since the spread of the disease is rapid and involvement of the brain occurs within a few days time, it is wise to get a regular checkup with your Opthalmologist to prevent yourself from such morbidities.

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