Mucormycosis

Causes Of Mucormycosis

Mucormycosis is an infectious disease caused by a group of fungi of the class zygomycetes and the order of mucorales.

These fungi can be found in the soil, animal excreta, compost piles, rotten leaves, wood and are widespread in nature. Despite their common presence in nature, these molds rarely create issues. 

However, they can induce severe, even life-threatening illnesses in people with weaker or compromised immune systems. The majority of people develop this sickness by inhaling mold spores. Infection occurs less frequently when spores enter the body through a cut or an open wound in the skin.

Know more about fungal infections. 
Click Here!

Risk Factors For Mucormycosis

Numerous factors, like poor hygiene, certain medications, and a compromised immune system, can increase your risk of mucormycosis. These factors include:

Risk factors for immunocompromised patients

• Hematological malignancies (blood cancer)
• Hematopoietic stem cell transplantation
• Solid tumors
• Organ transplantation
• Malnutrition
• Premature birth
• High dose of corticosteroids or immunosuppressants
• Prophylaxis with voriconazole and deferoxamine therapy
• Rheumatoid disorders
• Multiple blood transfusions
• Increased serum iron load
• AIDS, renal failure, and liver disorders
• Uncontrolled diabetes with ketoacidosis (high levels of ketones in the blood) and metabolic acidosis (too much acid in the blood)

What should a diabetic patient eat daily?

Read about the top 5 foods that people with diabetes should include in their diet. 
Click Here!

Risk factors for individuals with a normal immune system

• Fight-related injuries
• Prolonged hospital stay
• Natural calamities
• Injection drug use
• Contaminated medical instruments
• Skin injuries, burns, and trauma

Risk factors for individuals affected with COVID-19

Patients recovering from COVID‑19 are at a higher risk of susceptibility to mucormycosis because:

• There is an alteration of innate immunity due to decreased T cells.
• Post-treatment, COVID‑19 patients have increased levels of IL‑2 R, IL‑6, IL‑10, and TNF‑α, which contribute to immunosuppression.
• Administration of deferoxamine in patients with diabetic ketoacidosis can contribute to fungal growth. 
• Corticosteroid therapy can lead to glucose imbalance.

Are you at risk of mucormycosis post-COVID-19?
Click To Know!

Types of Mucormycosis

Mucormycosis can be classified into the following categories based on its anatomic localization:

1. Pulmonary mucormycosis: This is the most common type of mucormycosis. It affects the lungs and may occur in cancer patients and those who have had an organ or stem cell transplant.

2. Gastrointestinal mucormycosis: It affects the stomach and the intestines. It mainly occurs in young children who are premature or have taken antibiotics frequently. 

3. Rhinocerebral mucormycosis: It is a sinus infection that can spread to the brain. People with uncontrolled diabetes and those who have received a kidney transplant are more likely to develop this condition.

4. Cutaneous mucormycosis: This condition occurs when the fungus infiltrates the body through a crack in the skin. After a burn, scrape, cut, surgery, or other sorts of skin trauma, this type of infection can develop. This mucormycosis is the most prevalent type in people who don't have a compromised immune system.

5. Disseminated mucormycosis: This mucormycosis occurs when an infection travels from one body section to another through the bloodstream. The infection is usually found in the brain, although it can also damage the spleen, heart, and skin.

6. Uncommon form of mucormycosis: Other less common or unusual focal forms of mucormycosis include:

• • Endocarditis: Life-threatening inflammation of the inner lining of the heart's chambers and valves.

  • Osteomyelitis: It is an infection of bones. The infection can reach a bone by traveling through the bloodstream or spreading from nearby tissue.

  • Peritonitis: It is the inflammation of the inner lining of the stomach.

  • Pyelonephritis: It is an infection that generally begins in the urethra or bladder and travels to one or both of the kidneys.

Symptoms Of Mucormycosis

The symptoms of mucormycosis may vary depending on the body part affected. They may also depend on the severity of the infection. Some of the common signs and symptoms of mucormycosis based on the infection include:

1. Symptoms of rhino-orbito-cerebral mucormycosis

Non-ophthalmic (eye) symptoms

• Headache
• Fever
• One-sided facial swelling
• Nose bleed
• Nasal discharge
• Sinusitis
• Facial numbness
• Facial nerve paralysis (bell’s palsy)
• Ulcerations in the nose
• Toothache
• Bone destructions
• Alterations in the mental status
• Ophthalmic symptoms:

• Eye pain
• Decreased vision
• Paralysis or weakening of eye muscles
• Bulging of the eyes
• Irritation in the eyes
• Drooping of the upper eyelid over the eye
• Infection of the soft tissues of the eye socket
• Black lesions on the nasal bridge or upper inside of the mouth

2. Symptoms of pulmonary mucormycosis

• Fever
• Cough
• Chest pain
• Shortness of breath
• Blood while coughing

Painful mouth ulcers?

Read in detail about how to prevent them and home remedies to treat them. 
Click To Read!

3. Symptoms of gastrointestinal mucormycosis

• Abdominal pain
• Nausea
• Vomiting
• Gastrointestinal bleeding
• Diarrhea
• Abdominal distention (enlarged and swollen abdomen due to fluid accumulation)
• Perforations (holes) in intestine or stomach

4. Symptoms of cutaneous (skin) mucormycosis

• Erythematous (red) to purple lesions that become necrotic
• Ulcers
• Tender nodules
• Lesions filled with pus
• Pain, warmth, excessive redness, or swelling around a wound

5. Symptoms of renal mucormycosis

• Fever
• Lower back pain
• Decreased urine output
• Blood in the urine

Diagnosis Of Mucormycosis

If you experience any symptoms of mucormycosis, such as nasal congestion, nasal pain, fever, cough, or skin necrosis, then consult a doctor immediately.

The doctor might recommend further investigation if your symptoms fail to show any improvement post-treatment or if you experience symptoms such as swelling or internal bleeding. The tests include:

1. Physical examination: As the first step, your doctor will physically examine you for signs of fungal infection. They may order various diagnostic tests if they find any blackened tissue or suspect damage to the organs, they may order various diagnostic tests. Nasal Endoscopy is used for the detection of Rhino-orbito-cerebral mucormycosis.

2. Laboratory tests: Tests done to detect acidosis and iron load include:

1. • Complete blood count (CBC): To detect neutropenia (decreased levels of white blood cells in the blood).

   • Blood glucose: To check for diabetes.

   • Bicarbonate and electrolyte: To detect hemostasis (body's natural reaction to an injury that stops bleeding and repairs the damage). 

   • Arterial blood gasses (ABG): To determine the level of acidosis and direct corrective treatment.

   • Iron tests: To test the availability of iron mass which has been shown to have high levels of ferritin and low iron binding capacity.

   • Other laboratory tests: Tests like staining using potassium hydroxide (KOH) and Calcofluor, fungal culture, and Polymerase chain reaction (PCR). 

3. Imaging tests:

• Magnetic resonance imaging (MRI scan): An MRI is a diagnostic tool that uses  a magnetic field and computer-generated radio waves to generate cross-sectional and high-resolution images of different body parts. 

• Computed tomography (CT scan): A CT scan combines a series of X-ray images taken from different angles to deliver high-quality cross-sectional images of different body parts. In rhino-sinus mucormycosis, CT is the investigation of choice to study the invasion of bone and soft tissue abscesses, and extension to the nervous system.

• Biopsy: In a biopsy, a small piece of tissue is extracted from the affected organ. It is then sent to a laboratory to detect the presence of fungal infection or evaluate the extent of scarring and damage.

Get your lab tests done with us, where the patient’s comfort and safety are the utmost priority.
Book Now!

How To Prevent Mucormycosis

1. Eat a well-balanced diet: Consuming a diet rich in vitamins and minerals will help strengthen your immunity and protect you from infections. Also, eating a diet low in processed and packaged foods, trans fats, and sugar may improve your symptoms and prevent the disease from worsening.

Are you wondering what the importance of a balanced diet is? Understand 6 tips to reap maximum benefits from it.  
Tap To Know!
2. Wear masks: Mucormycosis is mainly contracted from spores that are present in the air. By wearing masks every time you step outside, you may be able to prevent the dust particles or spores from entering your body. Additionally, wearing full-sleeved shirts and trousers while visiting a dusty place may also prevent the fungus from coming in contact with your skin.

Are you using suitable masks? 
Click To Read!
3. Maintain appropriate personal hygiene: Maintaining personal hygiene can go a long way in preventing mucormycosis. Wash your body regularly and make sure that you promptly treat any cuts or scrapes on your skin.

4. Judicious use of steroids: Steroids have anti-inflammatory effects that can help control inflammatory and autoimmune disorders. However, their prolonged use is known to suppress immunity in the long term. Low immunity makes it easier for several fungi and bacteria to invade your body. 

Read more on do’s and don'ts of oral steroids’ use.
Click To Read!
5. Use clean water for humidifiers in oxygen therapy: Oxygen therapy is a treatment to provide oxygen to people with breathing difficulty. This treatment is provided extensively to patients with severe symptoms of COVID-19. The therapy uses water and humidifiers to provide breathable oxygen to a patient. However, if the water used for the treatment is unclean, it may increase one’s chances of inhaling mucormycosis-causing spores. To prevent it, use pure water and clean the humidifiers regularly. 

6. Use antibiotics/antifungals judiciously: Antibiotic and antifungal medicines are prescribed to fight various bacterial and fungal infections. However, their regular use may make the bacteria and fungus resistant to them. Therefore, you should take these medicines only after consulting your medical provider.

Every infection is not necessarily a bacterial infection. Know when you need to take antibiotics and when you don’t!
Tap Here!
7. Visit your doctor regularly: You must visit your doctor regularly, especially if you suffer from any lifestyle or an autoimmune disease, like diabetes, blood pressure, or obesity. Get tested at regular intervals to ensure optimal health and functioning of your body. Apart from this, contact your doctor if you have recently suffered from COVID-19 and notice any symptoms of mucormycosis.

8. Check your medicines: Certain medicines can act as immunosuppressants and lower your immunity when consumed. A lowered immunity may serve as a gateway and increase your risk of developing mucormycosis. Check with your doctor whether the medicines prescribed are suitable for long-term consumption and won't put you at risk of developing any other illness.

9. Do not miss any signs and symptoms: All cases with blocked noses should not be considered cases of bacterial sinusitis, particularly in immunosuppression patients or those with COVID‑19 on immunomodulators. Appropriate investigations like KOH staining and microscopy, culture, and MALDI‑TOF, should be carried out to detect fungal causes.

Prevention of mucormycosis associated with COVID-19

1. In hospitals:

   • Ensure quality control of oxygen supply.

   • Proper sanitization of oxygen cylinders.

   • Preserve a hygienic hospital atmosphere.

   • Use disposable oxygen humidifiers.

   • Use clean distilled water in oxygen humidifiers and concentrators.

   • Follow better risk messaging strategies.

   • Proper use of medical checklists (like Mucor).

   • Increase the number of testing facilities.

   • Increase mass urine testing for diabetes.

2. Personal safety:

   • Maintain personal hygiene during and post-COVID-19.

   • Increase awareness during hospital discharge after recovery from COVID-19.

   • Avoid self-medication and panic-driven practices.

   • Judicious use of social media for attaining health information.

   • Barrier mask covering the nose and mouth.

   • Get vaccinated for COVID-19.

Know everything about COVID 19 vaccination!
Read Now!

Specialist To Visit

Mucormycosis symptoms are often challenging to deal with and may be confused with those of some other medical condition. If you experience nasal congestion or chest pain that seems different or worse than usual, consult a doctor. Also, if you experience swelling or blackening of skin tissue, do not think twice before visiting your doctor’s clinic to know the exact cause and get it treated. 

Specialists that can help manage mucormycosis include:

• General physician

• ENT specialist

An ENT specialist is a doctor with special training in diagnosing and treating diseases of the ear, nose, and throat.

Consult India’s best doctors online 
Click Here!

Treatment Of Mucormycosis

The medications used to treat mucormycosis work by inhibiting its growth and spread. Some of the most common ways in which mucormycosis is treated are as follows:

1. Intravenous antifungal medications: Depending on the severity of the infection, your doctor may begin intravenous administration of antifungal medications as soon as you are diagnosed with mucormycosis. In this treatment, an IV tube is introduced into your body, which injects high doses of antifungal medications directly into your bloodstream. You may be hospitalized for this particular treatment. Antifungal medications which are provided intravenously include amphotericin B and liposomal amphotericin B products ≥ 5mg/kg

2. Surgical debridement: In this method, the doctors will surgically remove the affected tissue to stop the spread of infection to other body parts. This treatment may cause changes in the structure or shape of the affected area. In some cases, the surgical removal of the affected lung lobe or skin tissue has completely cured the infection without needing any other treatment. This is because the infection had not spread and was removed before it worsened.

3. Oral antifungal medications: These medicines work by inhibiting the growth of cell walls in the fungus and eradicating them. It is essential to control the spread of infections to different body parts. Initially, the patient is provided with antifungal medications intravenously, but once the infection is in control, they are switched to oral antifungal medications. Examples of oral antifungal medications include posaconazole and isavuconazole

4. Immunostimulating drugs: A recent study reported the benefit of treatment with the checkpoint inhibitor nivolumab and interferon-Υ for an immunocompetent patient with extensive abdominal mucormycosis unresponsive to conventional therapy.

Management of mucormycosis in COVID-19 patients

To manage mucormycosis in patients with COVID-19, the following points are to be considered:

• Make an early disease diagnosis.

• Do not miss early signs

• Optimal and judicious use of systemic corticosteroids.

• Rationale use of antibiotics.

• Supervised use of drugs that may increase infection risk.

• Maintain glycemic control.

• Classify according to possible, probable, and proven infection.

• Segregate patients based on COVID-19 disease status.

• Timely therapy initiation.

Home-care For Mucormycosis

Home remedies for mucormycosis

Though mucormycosis is treated under medical supervision, here are a few home remedies that can be helpful in management of mucormycosis. However, use them only after consulting your healthcare provider:

1. Probiotics and yogurt (Dahi): Yogurt and other probiotics are high in beneficial bacteria, which can help prevent many fungal diseases. Fermented foods are a good source of probiotics as well. If these don't work, try taking probiotic supplements with higher concentrations of healthy bacteria. 

Read about 8 reasons to add dahi to your diet.
Read Now!
2. Tea tree oil: It is one of the most potent natural treatments for fungal infections. It has antifungal and antibacterial properties. Mix it with any carrier oil, such as coconut or olive oil, and apply it to the diseased area three to four times a day.

3. Coconut oil (Nariyal ka tel): Coconut oil, even in its unheated state, is an effective antifungal agent. Apply three times a day on the skin of the affected area.

4. Turmeric (Haldi): Turmeric has antibacterial and anti-inflammatory properties. It can be consumed orally with water or warm milk. 

5. Neem: It can be consumed as an oral supplement. You can also boil neem leaves in water for 2 to 3 minutes to make neem water. This water has antimicrobial qualities and is incredibly beneficial for fungal-infected areas. Application of a mixture of neem oil, chalmogra oil and sesame oil in equal parts on the infected area can also be beneficial. 

6. Aloe vera: It is a tried-and-tested natural remedy for treating any skin ailment. It not only profoundly cures the tissue but also heals and calms the skin.

7. Apple cider vinegar: Antifungal activities are found in apple cider vinegar. You can drink it by mixing two teaspoons in warm water or dabbing it on your skin with a cotton ball dipped in it. Doing this three times a day should yield positive outcomes.

Shop from an extensive range of apple cider vinegar! 
Explore Now!

Complications Of Mucormycosis

Mucormycosis is a severe disease. If left unattended, it may cause several long-term issues and even death. Some of the complications that may occur if mucormycosis is left untreated are:

1. Brain infection: If the fungus spreads to the brain, it can cause severe brain infection. This infection, in turn, may cause brain hemorrhage or stroke.

2. Paralysis: As the name suggests, mucormycosis infection may cause paralysis of your body. 

3. Pneumonia: Mucormycosis, if left untreated or unattended, can spread to the lungs and lead to pneumonia.

4. Hemorrhages: It is a condition in which the blood vessel in a particular organ ruptures due to infection. Untreated mucormycosis can spread to the brain, spleen, lungs, or heart and lead to hemorrhages.

5. Seizures: A seizure is a sudden electrical activity in the brain that can cause uncontrolled movements in the body’s muscles. The spread of mucormycosis infection to the brain may also lead to seizures.

6. Death: In rare cases, mucormycosis can be life threatening.

Mucormycosis is an aggressive, severe, and rare fungal infection affecting several COVID-19 patients. Read more on why it is important to take greater care if you have a chronic illness. 
Read Now!

Living With Mucormycosis

If you suffer from mild mucormycosis, it can be treated immediately with antifungal medications. However, if the infection is chronic and has spread to different body parts, then in addition to diet and lifestyle changes, you may also need to undergo surgery to manage the disease and prevent any long-term complications. Also, post-discharge from the hospital, if you are taking prescribed medications, it is wise to pay timely visits to your doctor as advised. 

Surgical management of mucormycosis may require complete debridement of infected tissue leading to loss of vital body parts in the process. Rehabilitation of these defects can restore the lost function. Rehabilitation also needs to be backed up by occupational therapy. 

Psychological issues can manifest as an aftermath of a surgical debridement procedure for Mucormycosis. The following measures can be taken to address the same:

• Routine preoperative counseling 

• Addition of psychiatrists and clinical psychologists to the treating team

• Additional supportive psychotherapeutic sessions

• Help from support groups and other people on management of post-recovery phase

All these interventions can help to improve the overall quality of life.

Try these 10 tips to keep yourself happy in difficult times. 
Tap To Know!

Black fungus v/s yellow fungus v/s white Fungus

Although used interchangeably, these three terms have different meanings.

1. Black fungus: Also known as mucormycosis, it is a fungal disorder characterized by the intake of mucor through the air or contaminated food or water. This infection causes the blackening of tissue in the affected area and is highly fatal.

2. Yellow fungus: Yellow fungus spreads through polluted settings and occurs when a patient inhales mold from the environment. In terms of how it spreads, it differs from both black and white fungal infections.The yellow fungus assaults the body's internal organs and disrupts vital physical processes. The yellow fungus causes far more severe damage. As a result, people should begin observing its symptoms from the first day and seek medical advice.

3. White fungus: Candidiasis, often known as white fungus, is a fungal infection caused by Candida. This infection causes white-creamy patches on the affected areas, hence the name.