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Deadly “Black fungus” threatens people in India recovering from COVID-19

2021-05-13

Patients in India recovering from COVID-19 are being threatened by a dramatically increased incidence of a rare fungal infection which can be deadly if not treated in time. It’s known as the “black fungus” and is properly called mucormycosis. This organism can invade the nose and sinuses, spreading to the eyes and causing blindness, or even to the brain, with death an almost inevitable result. The BBC posted a report about this on May 9, 2021.

Specialists in India are seeing a four to five-fold increase in diagnosis of this rare condition, corresponding to an overwhelming wave of COVID-19 infections recently. Many COVID patients are being treated with steroids in the hospital as a last resort in treating severe coronavirus disease, which suppresses their immune systems and leads to susceptibility to the “black fungus.”

Mucormycosis is an opportunistic pathogen, that is, it lurks in the environment and attacks when the body is not able to mount a normal defense. Usually, its spores and growing mycelia are present in soil and decaying matter. Several species and genera of fungi are responsible for this disease, especially the Mucor and Rhizopus species. The Centers for Disease Control and Prevention (CDC) has fact sheets on mucormycosis which give more information.

The fungus is kicked into the air with dust and dirt particles from the ground and inhaled into the nose, where it grows when the victim does not have a strong enough defense against infections. The growing fungus invades the tissues of the nose and sinuses, eventually penetrating the eye or brain. Once it has reached far enough, treatment with anti-fungal antibiotics will not save the victim. Surgical excision (removal) of the infected tissues is necessary. This may include removing the eye if the fungus has penetrated far enough.

A key sign of this infection is a black discoloration around the nose and eyes. Once this appears, the disease is far advanced and usually requires surgery to save the patient’s life. Ophthalmological surgeons have noticed a dramatic increase in requests for removal of the eye recently in India.

One reason that this has appeared particularly in India is that poor patients can obtain steroids (cortisone-like drugs) without a prescription at Indian pharmacies. Some steroids, like dexamethasone, are very cheap to buy in generic forms, making them attractive to those who cannot afford a doctor.

This convenience has led to overtreatment of coronavirus symptoms with steroids among indigent patients. Relief of symptoms of the virus, however, leads to an increased susceptibility to secondary infections, one of which is mucormycosis.

The pandemic has led to increased stress on medical systems around the world. Poor countries are likely to suffer even more than developed, wealthy countries. This will become even more dire as the virus spreads in poorer countries.

photo by Ohmydearlife via pisabay.com (actually it’s a fly agaric)

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