Mucormycosis, previously known as zygomycosis and (especially for rhino-orbital-cerebral mucormycosis, sometimes called black fungus ) ...
Mucormycosis, previously known as zygomycosis and (especially for rhino-orbital-cerebral mucormycosis, sometimes called black fungus) is a rare type of fungal infection that occurs through exposure to fungi called mucormycetes. These fungi commonly occur in the environment, particularly in leaves, soil, compost, and animal dung. Mucormycetes can enter the body through breathing, inhaling, and exposed wounds in the skin.
There are different types of mucormycosis, including
- rhino-cerebral (sinus and brain),
- pulmonary (lung),
- gastrointestinal,
- cutaneous (skin) and
- disseminated mucormycosis.
Who is at risk?
Mucormycosis is not contagious and the infection can happen to anyone at any age. Most people who come in contact with the fungi do not develop an infection. However, people with severely weakened immune systems are at increased risk of mucormycosis. These include people with:
- Diabetes, especially with diabetic ketoacidosis
- HIV/AIDS
- Cancer
- Organ transplant
- Stem cell transplant
- Low white blood cell count (Neutropenia)
- Long-term corticosteroid use
- High levels of iron in the body (hemochromatosis)
- Bad health from poor nutrition
- Uneven levels of acid in the body(metabolic acidosis)
- Injected drug use
- Pre-maturity and low birth weight
- Skin injury due to surgery, burns, or wounds
Symptoms of Mucormycosis:
The symptoms of mucormycosis depend on where the fungus is growing in the body.
Symptoms of rhino-cerebral (sinus and brain) mucormycosis include:
- Fever
- Headache
- Nasal or sinus congestion and pain
- Swelling on one side of the face
- Black lesions on the bridge of the nose or inside the mouth
Symptoms of pulmonary (lungs) mucormycosis include:
- Fever
- Cough
- Chest pain
- Shortness of breath
Symptoms of gastrointestinal mucormycosis include:
- Abdominal pain
- Nausea and vomiting
- Gastrointestinal bleeding
- Blood in the stool
- Diarrhea
Cutaneous (skin) mucormycosis can look like blisters or ulcers, and the infected area may turn black. Other symptoms include pain, warmth, excessive redness, or swelling around a wound.
The infection can also spread to other parts of the body through blood. This is called disseminated mucormycosis. Patients with disseminated infection in the brain can develop mental status changes or coma.
Mucormycosis Complications and Outlook:
Complications of mucormycosis include:
- Blindness
- Blind clots or blocked vessels
- Nerve damage
Mucormycosis can be deadly without treatment. Because the infection is so rare, the exact mortality rate isn’t clear. But researchers estimate that overall, 54% of people with mucormycosis die.
The likelihood of death depends on which part of the body is affected. The outlook is better for people who have sinus infections than it is for lung or brain infections.
Diagnosis of Mucormycosis :
Healthcare providers consider a patient's medical history, symptoms, physical examinations, and laboratory tests. Might collect a sample of fluid from the respiratory system in case of mucormycosis in lungs or sinuses.
Healthcare providers may perform tissue biopsy, in which a small sample of affected tissues is analyzed in a fungal culture.
Imaging tests like a CT scan or MRI scan of lungs, sinuses, or other body parts, depending on the location of the suspected infection.
Treatment of Mucormycosis:
Treated with prescription antifungal medicine, usually
- Amphotericin B
- Posaconazole
- Isavuconazole
These medicines are given through a vein or by mouth (Posaconazole, Isavuconazole).
In severe cases, surgery is recommended to remove infected or dead tissues to keep the fungus from spreading.
Prevention
There’s no way to avoid breathing in fungal spores because fungi are common in the environment. But we can do a few things to lower the chances of mucormycosis infection. It’s especially important if we have a health condition that raises the risk.
- Stay away from areas with a lot of dust or soil, like construction or excavation sites. If you can’t avoid these areas wear an N95 face mask.
- Avoid direct contact with water-damaged buildings and flood water after hurricanes and natural disasters.
- Avoid activities that involve close contact with soil or dust, such as yard work or gardening. If this isn’t possible,
- Wear shoes, long pants, and long-sleeved shirts while doing such activities.
- Wear gloves while handling soil, moss, or manure.
- Clean skin injuries with soap and water if they have been exposed to soil or dust.
If you get mucormycosis, be sure to take your medications as directed. If side effects cause problems or the infection doesn’t get better consult your health care providers.
COVID-19 associated mucormycosis
- Commonly referred to as black fungus, is the association of rhino-cerebral mucormycosis with COVID-19. It has been reported around the nose, eyes, and brain- a clinical manifestation sometimes referred to as “rhino-orbital-cerebral (ROC) mucormycosis”
- Mucormycosis can occur any time after the COVID-19 infection, either during the hospital stay or several days to a couple of weeks after discharge.
- The COVID-19 causes favorable alteration in the internal environment of the host for the fungus and the medical treatment given, unwittingly also assists fungal growth.
- Steroids reduce inflammation in the lungs for COVID-19 and appear to help stop some of the damage that can happen when the body’s immune system goes into overdrive to fight off coronavirus. But they also reduce immunity and push up blood sugar levels in both diabetics and non-diabetic COVID-19 patients. It is thought that this drop in immunity could be triggering these cases of mucormycosis.
- Some experts believe that the use of unsanitized oxygen cylinders and ventilators could have increased the risk of developing mucormycosis infection.
REFERENCE:
URL: https://www.cdc.gov/fungal/diseases/mucormycosis/index.html
COMMENTS