A fungal infection that resulted in loss of eyesight was reported in New Delhi and several hospitals across India.  According to doctors the fungal infection in patients was triggered by Covid-19. The infection also resulted in removal of jaw and nose bone and five people died because of the infection.

The black fungus infection called Mucormycosis occurs when the body immunity system is too week because of severe illness. In this case, mucormycosis infection happened with patients who were tested positive and treated for current pandemic.

COVID-19 infections may be associated with a wide range of bacterial and fungal co-infections:

According to Dr. Manish Munjal, Seniro ENT surgeon “The frequency with which we are witnessing the occurrenc rof Covid-19 triggered mcormycosis with high morbidity and mortality is alarming.  Early clinical suspicion on symptoms such as nose obstruction, swelling in the eye or cheeks, black dry cursts in the nose needs prompt biopsy and antifungal therapy as soon as possible”

Dr Neha Sethi, ENT specialist, consultant at Dharmashila Naryana Superspeciality Hospital –“It is a fungal infection which starts in the nasal area, throat, and then soon spreads to the eyes, brain, and finally, the entire body. Once it starts infecting a patient’s brain, it becomes life-threatening. Its rapid spread worsens the condition which can lead to multiple organ failure as well if left untreated or not treated at the right time. In the process, it damages immunity, aggravates other diseases, and makes the patient infection-prone”

The same Mucormycosis was also reported from Ahmedabad in patients who recovered from Covid-19 with preexisiting conditions such as diabetes, heart and or kidney disease or cancer conditions. Our of 46 cases nine patients died by Mucormycosis infection.

Mucormycosis is a rare type of fungal infection caused by mold that belongs to Mucorales family It is present in soil, rotten wood, leaves, decaying organic matter such as leaves etc. When people encounter the spores, they can get infected in lung or sinus through spore inhalation. It can also infect skin by means of cut, burn, scrape or any type of skin wounds.

Rhizopus, Mucor, Syncephalasturm, Cunninghamella, Apophysomyces, Rhizomucor are prominent fungal species that are responsible for mucormycosis infection.

Types of mucormycosis (source: CDC)

1. Rhinocerebral (sinus and brain) mucormycosis is an infection in the sinuses that can spread to the brain. This form of mucormycosis is most common in people with uncontrolled diabetes and in people who have had a kidney transplant. 7-8
2. Pulmonary (lung) mucormycosis is the most common type of mucormycosis in people with cancer and in people who have had an organ transplant or a stem cell transplant.
3. Gastrointestinal mucormycosis is more common among young children than adults, especially premature and low birth weight infants less than 1 month of age, who have had antibiotics, surgery, or medications that lower the body’s ability to fight germs and sickness. 9-10
4. Cutaneous (skin) mucormycosis: occurs after the fungi enter the body through a break in the skin (for example, after surgery, a burn, or other type of skin trauma). This is the most common form of mucormycosis among people who do not have weakened immune systems.
5. Disseminated mucormycosis occurs when the infection spreads through the bloodstream to affect another part of the body. The infection most commonly affects the brain, but also can affect other organs such as the spleen, heart, and skin.

Symptoms:

1)Continuous headache,

2) heaviness and swelling in the facial area,

3) Badly swollen eyes

4) black spots around the swollen area

5) black spots inside nose

6) chocked throat etc.

Treatment: Endoscopy and CT scan helps to diagnose the infection.  Antifungal injection is given primarily. To remove fungal balls from affected organs surgery assistance might be needed. The course of treatment depends on the severity of the infection and will be decided by doctor.

Mucormycosis is a rare fungal infection. The severity of the infection depends on the immunity system of patients. Highly immunity compromised patients with preexisiting health issues such as severe diabetes, cancer or multiple surgeries could easily get infected by the fungal spores.

What is alarming is, fungus is infecting those who recovered from Covid. It means Covid-19 infections affects our immune system severely. Yes, we all are getting ready to receive the vaccine. Even after receiving the vaccine, we all must continue taking precautions to stop Covid -19 virus spread by maintaining social distancing, by wearing masks, washing hands frequently and avoiding huge gathering. If you or your near ones are covid survivor, tell them to go for regular health checkups to make sure there is not further complications including Mucormycosis infections.

References:

www.cdc.gov

https://www.e-ce.org/

https://link.springer.com/

https://pesquisa.bvsalud.org/