This presentation explains about the all aspects of mucormycosis ( black fungus )

1. MUCORMYCOSIS
YENDA MANISHANKAR

2. INTRODUCTION
• Mucormycosis (sometimes called zygomycosis) is a serious but rare fungal infection caused by a group of molds called
mucormycetes. These fungi live throughout the environment.
• They live in soil and in decaying organic matter, such as leaves, compost piles, or rotten wood.1
• People get mucormycosis by coming in contact with the fungal spores in the environment. For example, infections
involving the lung or sinus can occur after someone breathes in spores.
• These forms of mucormycosis usually occur in people who have health problems or take medicines that lower the body’s
ability to fight germs and sickness.

3. TYPES OF MUCORMYCOSIS
• Cutaneous (skin) mucormycosis occurs after the fungi enter the body through a break in the skin.
This type of infection might occur after a burn, scrape, cut, surgery, or other types of skin trauma.
This is the most common form of mucormycosis among people who do not have weakened immune
systems
• Rhinocerebral (sinus and brain) mucormycosis is an infection in the sinuses that can spread to the
brain. This is most common in people with uncontrolled diabetes and in people who have had a
kidney transplant.4–5
• Pulmonary (lung) mucormycosis is the most common type of mucormycosis in people with cancer
and in people who have had an organ transplant or a stem cell transplant.
• Gastrointestinal mucormycosis is more common among young children than adults. Premature and
low-birth-weight infants less than 1 month of age are at risk if they have had antibiotics, surgery,
or medications that lower the body’s ability to fight germs and sickness.6-7
• Disseminated mucormycosis occurs when the infection spreads through the bloodstream to affect
another part of the body. The infection most commonly affects the brain, but also can affect other
organs such as the spleen, heart, and skin.

4. Black Fungus Risks:

5. SYMPTOMS OF BLACK FUNGUS

6. Prevention for Black Fungus

7. • How does someone get mucormycosis?
– People get mucormycosis through contact with fungal spores in the environment. For example, the lung or sinus forms of the infection can occur after someone
inhales the spores from the air.
– A skin infection can occur after the fungus enters the skin through a scrape, burn, or other type of skin injury.
• Is mucormycosis contagious?
– No. Mucormycosis can’t spread between people or between people and animals.
• How can I lower the risk of mucormycosis ?
– It’s difficult to avoid breathing in fungal spores because the fungi that cause mucormycosis are common in the environment. There is no vaccine to prevent
mucormycosis.
– For people who have weakened immune systems, there may be some ways to lower the chances of developing mucormycosis.
• Protect yourself from the environment
– Try to wear better mask while working in the yard with higher dust prone areas.
– Avoid direct contact with water-damaged buildings and flood water after hurricanes and natural disasters.
– Avoid activities that involve close contact to soil or dust, such as yard work or gardening. If this isn’t possible then Wear shoes, long pants, and a long-sleeved shirt when doing outdoor activities such as gardening,
yard work, or visiting wooded areas.Wear gloves when handling materials such as soil, moss, or manure.To reduce the chances of developing a skin infection, clean skin injuries well with soap and water, especially if
they have been exposed to soil or dust.
• Antifungal medication. If you are at high risk for developing mucormycosis (for example, if you’ve had an organ transplant or a stem cell transplant), your healthcare provider may
prescribe medication to prevent mucormycosis and other mold infections. 7,8 Doctors and scientists are still learning about which transplant patients are at highest risk and how to best
prevent fungal infections.

8. Where Mucormycosis Comes From ?
The fungi that cause mucormycosis live in the environment:
– Mucormycetes, the group of fungi that cause mucormycosis, are present throughout the environment, particularly in soil and in association with decaying organic
matter, such as leaves, compost piles, and animal dung.
– They are more common in soil than in air, and in summer and fall than in winter or spring.
– 2-4 Most people come in contact with microscopic fungal spores every day, so it’s probably impossible to completely avoid coming in contact with mucormycetes.
– These fungi aren’t harmful to most people. However, for people who have weakened immune systems, breathing in mucormycete spores can cause an infection in
the lungs or sinuses which can spread to other parts of the body.
Types of fungi that cause mucormycosis:
– Several different types of fungi can cause mucormycosis. These fungi are called mucormycetes and belong to the scientific order Mucorales.
– The most common types that cause mucormycosis are
– Rhizopus species and Mucor species.
– 5 Other examples include
• Rhizomucor species
• Syncephalastrum species
• Cunninghamella bertholletiae
• Apophysomyces
• Lichtheimia (formerly Absidia),
• Saksenaea, and Rhizomucor

9. Diagnosis and testing for Mucormycosis
How is mucormycosis diagnosed?
– Healthcare providers consider your medical history, symptoms, physical examinations, and laboratory tests when diagnosing
mucormycosis.
– Healthcare providers who suspect that you have mucormycosis in your lungs or sinuses might collect a sample of fluid from your
respiratory system to send to a laboratory.
– Your healthcare provider may perform a tissue biopsy, in which a small sample of affected tissue is analyzed in a laboratory for
evidence of mucormycosis under a microscope or in a fungal culture.
– You may also need imaging tests such as a CT scan of your lungs, sinuses, or other parts of your body, depending on the location of
the suspected infection

10. Do's and Don’ts to reduce the risk of Black fungus infection (mucormycosis)
DO’S DONT
• Control hyperglycemia
• Monitor blood glucose levels after COVID-19 administration, as
well as in diabetics
• Steroids should be used with caution: Correct timing, doses, and
duration
• Use sterile and clean water in humidifiers during oxygen therapy
• Use antibiotics/ antifungals carefully
• Do not ignore warning signs and symptoms
• Don’t consider that all cases of the blocked nose are caused by
bacterial sinusitis, particularly in immunocompromised patients
or COVID-19 patients on immunomodulators
• For detecting fungal etiology, do not be afraid to conduct
aggressive investigations (KOH staining and microscopy, culture,
MALDI-TOF)
• Do not spend much time before starting treatment for
mucormycosis

11. Treatment for Mucormycosis
• Mucormycosis treatment must be fast and aggressive. The concern is due to the fact that by the time even a presumptive diagnosis is made, the patient has often
suffered significant tissue damage which cannot be reversed.
• Most patients will need surgical and medical treatment.
• Most infectious disease experts say that without aggressive surgical debridement of the infected area, the patient is likely to die.
• Medicines play an important role. Two main aims are sought simultaneously: antifungal drugs to slow or stop the fungal spread and drugs to treat debilitating
underlying diseases.
• Amphotericin B (initially intravenous) is the usual drug of choice for antifungal therapy.
• Posaconazole or isavuconazole can treat mucormycosis.
• Patients may even require an intravenous antifungal procedure lasting 4 -6 weeks.
• Patients with underlying diseases like diabetes need to be in optimal control of their diabetes.
• Patients normally on steroids or taking deferoxamine (Desferal; used to remove excess iron from the body) are likely to have these drugs stopped because they
can increase the survival of fungi in the body.
• Patients may need additional surgeries and usually need antifungal treatment for an extended period (weeks to months) depending on the severity of the disease.

12. Black Fungus Preventions:
Preventive measures to be followed:
– Humidifier cleaning and replacement (for those using Oxygen Concentrators)
– The humidifier bottle should be sterilized with normal saline and refilled on a regular basis.
– Masks should be disinfected regularly, and they should not be used for weeks.
– Those who use steroids should also monitor their blood sugar levels.
– During the COVID-19 therapy, mortified oxygen should be utilized
– Practicing good hygiene and maintaining the cleanliness of their surroundings
– Brushing and gargling daily is extremely beneficial.
– If you have recovered from COVID, it is critical to wear masks to prevent the infection from entering the body.
– Diabetics patients must keep their diabetes under control and monitor their blood glucose levels
– These must be monitored, especially after infection with Covid-19. Steroid use is to be reduced, and immunomodulating drugs are to be discontinued