Mucormycosis: A serious problem after COVID-19 illness in few cases



At present COVID-19 is ruling affecting the world badly. Many people are disturbed in many ways by an ongoing pandemic. Still, there is no proper solution for the disease.

Still, there are many researches to be done as the disease is new to the world. Many complications and new symptoms and diseases are appearing during or after COVID-19 illness. At present, a disease known as mucormycosis is buzzing in the media. Few cases of mucormycosis are being reported in different areas, especially in patients who have recovered from COVID-19 but also have diabetes and low immunity.

Although this disease is not new to the world, the number of patients with the rare disease has risen in the last few days. With this, many rumors are once again spreading up. So it is important to have a scientific understanding of the disease. Let’s discuss it.

What is mucormycosis infection?

Mucormycosis is a type of fungal disease, earlier also known as Zygomycosis. Generally, species like Rhizopus, Mucor, Absidia, Cunninghamella are mostly implicated.

These fungi are commonly found in the soil, in our environment, mostly in the decaying leaves, manure, or organic matter lying on the ground. Particles of this fungus or fungal spores are also present in the air. But this disease generally doesn’t make ill people with normal immunity. People who have low immunity and other chronic and debilitating illnesses can get the infection and the infection can be serious also.

Who can get mucormycosis disease?

People with weakened immune systems are more likely to get the disease. Especially people with diabetes and diabetic ketoacidosis, cancer, organ transplants, very low levels of WBC, long-term use of steroid medication, HIV or AIDS, high levels of iron also known as hemochromatosis, deep wounds on the skin, etc. all these cases are at higher risk of getting an infection of this fungus.

Generally what happens in COVID-19 diseases is that during coronavirus illness patient may have cytokines storm. Which may be dangerous for the life of the patient. To reduce these cytokines storm steroids and other immunosuppressive medicines are given which weakens the immunity of that person. So after recovering from COVID-19, the person with low immunity and other debilitating diseases as mentioned above may have chances of getting mucormycosis infection.

How is mucormycosis transmitted?

As mentioned earlier, microscopic particles of the fungus which are present in the soil and air can enter the body through the nose. Apart from this deep wounds of the skin can also give way to this fungus. However, the good news is that the disease doesn’t spread from one person to another.

How to avoid getting a mucormycosis infection?

To avoid the infection of this fungus, wearing masks is advised.

Apart from this, if people at higher risk who have to come in contact with soil or dust such as during farming or gardening, etc., then they should take a little precaution such as wearing full sleeves clothes, wearing shoes, wear gloves while working in mud.

If there is a wound on the skin, wash it off with soap and water.

What are the symptoms of mucormycosis?

If the fungus enters through the nose and spreads to the sinuses as well as the brain, then the affected patient has symptoms such as swelling of the affected side of the face (you can see one of the mucormycosis pictures above), congestion of the nose or sinuses or eye, pustular discharge from nose, blackish lesions at the nasal bridge, headache, etc.

If the fungus enters the lungs, symptoms such as fever, cough, difficult breathing, chest pain can be present.

If it penetrates the skin, it becomes like an ulcer or blister and the part can also get black including swelling and redness of the affected area of skin.

If the disease gets disseminated in the other parts of the body such as the brain, the patient may have changes in mental status, seizures, or may also go into a coma.

How to diagnose mucormycosis infection?

Nasal endoscopy: If the nose and sinuses are examined, there is a foul odor from the nose, and there is a strange greenish discharge inside the nose, the chances of mucormycosis are increased. Endoscopy also has a facility to take the biopsy. A tissue biopsy is taken and histology is done to detect mucormycosis infection.

Lab testing of saliva, sputum, and nasal discharges can be done.

CT scans or MRI: This can detect where and how many parts of the body are affected by fungus and then it will help to decide how to perform surgery.

What is the treatment for mucormycosis?

Early diagnosis and early start of antifungal medications are important to treat this infection. Liposomal Amphotericin B Injection is given as per guidelines. If this drug does not work, caspofungin which is a lipopeptide antifungal drug available as caspofungin acetate can be given with it.

In many cases surgery for debridement is necessary. In some cases, complex surgery with removal of affected tissues like sinuses, eye, or palate is necessary to prevent further spreading of the infection and to save the life patient.

If the patient is better with intravenous therapy, then one can be shifted to oral antifungal treatment.

Common available antifungal medicines to treat mucormycosis are amphotericin B, posaconazole, isavuconazole.

What is the prognosis of mucormycosis disease?

Generally, many people ask, is mucormycosis curable? In medical terms, usually we call it a prognosis of any particular disease. In mucormycosis, the prognosis is poor in many cases and the mortality rate is also high, but it depends on its form, severity, and condition of the patient. If it’s diagnosed earlier with immediate start of treatment, the prognosis may be good. There are mortality rates of 30% to 70% in rhinocerebral form, while in disseminated mucormycosis mortality rate is highest.

What is pulmonary mucormycosis?

When lungs are involved with mucormycosis infection, it is referred to as pulmonary mucormycosis. Fever, cough, breathlessness, and chest pain are major symptoms in this case.

Cases of mucormycosis are rare but the mortality rate is very high. The disease is not new, but in the last few days, patients who have recovered from COVID-19 have seen an abnormal incidence of the disease. So the disease has been discussed, but with the right information, the disease can be fought. This disease is rare. So there is no need to be afraid of it. If you belong to a risk group, be careful, consult your doctor and follow the government guidelines of your country.

This article is only for information purposes only. Please take the advice of your doctor if you have any queries and problems. Till then take care and have a healthy day.

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