Mucor mycosis or Black Fungus is commonly seen in COVID-19 patients, especially in recovery phase or getting re-admitted after discharge. It is a rare fungal infection caused by a group of moulds called mucormycetes, present in environment and commensal in nasal passages and throat. It does not cause disease in the healthy individual. However, patients who are immune-compromised, on immune suppressive drugs like steroids, have uncontrolled diabetes, prolonged ICU stay or prolonged oxygen therapy, the fungus grows exponentially causing disease in throat, eyes, brain and other body organs. The infection is being reported in COVID patients and hence need to be carefully monitored. The warning symptoms include nasal discharge/crusting, facial pain, red eye, eyelid swelling, fever, cough, chest pain, abdominal pain or altered mental sensorium. The precautions to be followed in order to prevent mucor mycosis infection are:
- Judicious use of steroids: The steroids should be used judiciously (adequate dose and duration) as chronic use of steroids make the person more prone to infections. Steroids to be started only after prescription from the doctor.
- Maintain blood glucose: Proper glycemic control is required for diabetics especially after recovering from COVID 19 infection.
- Oxygen therapy: Use clean, sterile water for humidifying oxygen that is given to the patients. The hospitals must ensure frequent changing of oxygen tubing to reduce infection.
- Maintain personal hygiene: Take scrub bath daily and wear clean clothes. Do gargles with saline and douche with Betadine solution to keep good oral health.
- COVID appropriate behavior: Make it a habit to always wear a mask when outside to prevent from inhaling spores
- Maintain environmental hygiene: Keep your home environment fungus and spore-free. Clean your refrigerator regularly and dispose of rotten/spoilt/expired foods immediately.
- Boost your immunity: Eat home-cooked healthy food, take zinc and vit c tablets. Avoid junk food. Maintain hydration. Take steam inhalation to keep the respiratory tract moist.
- Monitor health: Keep a track of your health and focus on keeping your blood sugar, blood pressure, weight and cholesterol in control
- Be alert: Take extra precaution if you are immune-compromised, have an underlying disease or had a surgery or transplant. Do not miss warning signs of mucor mycosis. Early diagnosis is necessary for better prognosis.
There is no vaccine and use of prophylactic antifungal therapy for preventing mucor mycosis. Treatment includes surgical debridement, anti-fungal therapy and supportive medical therapy.