Black Fungus and the Eye

The recent #coronavirus pandemic has resulted in a growing concern regarding another serious condition known as #mucormycosis or #blackfungus infection.

Black fungus can affect various organs of the body such as the lungs, gastrointestinal tract, skin. But in this post, I’ll be discussing the form of mucormycosis that affects the nose, eyes and brain also known as rhinocerebral-orbital mucormycosis.

What is black fungus?

Black fungus is a fungus of the family Mucoraceae that includes the genera Mucor, Absidia, and Rhizopus. These are scientific names for a fungus that is commonly present everywhere around us, including the soil, decaying vegetable matter or even the molds on a moist wall.

Why did the coronavirus pandemic cause a sudden rise in black fungus cases?

Although black fungus is present everywhere around us and almost everyone is exposed to it, it doesn’t cause an infection in people with an intact immune system.

Black fungus infection is seen in patients with lowered immunity such as diabetics, cancer patients, patients who have undergone organ transplant and are on immunosuppressive drugs, patients who suffer from immunosuppressive conditions and in patients who are suffering from other diseases like coronavirus.

“Covid infection lowers your immunity making you susceptible to black fungus. The risk is increased if the patient also suffers from another co-morbid condition like diabetes, cancer, etc.”

Also, the use of steroids in Covid patients to bring down the inflammation also lowers the immunity, making the patient more susceptible to black fungus infection.

What are the symptoms of black fungus infection?

Early symptoms

In early stages, black fungus affects the nose and sinuses.

1. Nasal stuffiness

2. Nasal discharge

3. Fever and malaise

Late Symptoms

The eye is involved in later stages of black fungus infection.

1. Swelling of the face and around the eyes

2. Blurred vision

3. Double vision

4. Bulging of the eyes

Signs of brain infection

These signs indicate severe disease and the prognosis is often poor.

1. Altered consciousness

2. Paralysis

3. Seizures

How does the black fungus cause disease?

The microscopic structure of the black fungus consists of thread like structures called mycelia.

These thread like structures (mycelia) block the small blood vessels and cut off the blood supply locally causing tissue necrosis. That’s why, patients suffering from black fungus infection have a black “eschar” which is a plaque of necrosed tissue.

As the fungus invades more important organs like the eye and the brain, it becomes more dangerous and life threatening.

What is the treatment for black fungus infection?

Treatment is difficult since the fungal mycelia block the blood supply to the infected area, therefore, most drugs given orally or through injection fail to reach the infected area.

Amphotericin B is the drug of choice in early stages.

Posaconazole is a newer drug that is under trial for use in black fungus infection.

Surgery remains the mainstay of treatment. The operating surgeon manually removes all the tissue infected by the fungus, leaving healthy tissue behind.

However in late stages, when the fungus as already invaded important structures that cannot be removed surgically, the infection may prove to be fatal.

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