Mucormycosis or Black Fungus is a fungal infection, usually seen in elderly diabetics with poor sugar control. It may occur in younger COVID-19 patients as well, especially following prolonged steroid use. Pulmonary mucormycosis affects the lungs, resulting in breathlessness, cough and fever, while cutaneous and gastrointestinal variants affect the skin and digestive system. Rhinocerebral mucormycosis affects the nose, sinuses, eyes and brain. The fungus causes tissue death by obstructing blood supply.
RISK FACTORS
1. Uncontrolled diabetes, particularly in elders
2. Immune deficiency or immunosuppression
3. Use of steroids to treat COVID-19, leading to high blood sugar and decreased immunity
4. Unclean water in humidifiers for patients on oxygen
5. Burns and trauma
SIGNS
1. Blocked nose, crusting and nasal discharge (often blood stained or dark, and from one nostril)
2. Facial numbness and swelling
3. Headache
4. Black spots or blisters in the nostrils, on the hard palate (inside the mouth), or near eye
5. Redness and swelling/bulging of eye
6. Drooping of eyelid
7. Limitation of eye movements
8. Double vision
9. Blurred vision
PRECAUTIONS
1. Keep blood sugar under control.
2. Do not self-medicate. Use steroids only as prescribed by your doctor.
3. Closely monitor blood glucose levels if using steroid, even if you are not diabetic.
4. Ensure clean water in the humidifier if the COVID-19 patient is on oxygen support. Clean it regularly.
5. Be careful about hygiene for the COVID-19 patient.
6. Get immediate treatment for any oral ulcers, especially with discoloration
7. Watch out for symptoms like blocked nose, nasal discharge and droopy eyelids a few days after recovery from COVID-19.
8. Contact your doctor immediately in case of any symptoms. Do not waste time with home remedies.
Inputs from
Dr. Manish Munjal, Senior Consultant, ENT, Sir Gangaram Hospital, Delhi
