Mucormycosis or black fungal disease is a rare fungal infection worldwide. Recently one in particular
fungal disease Mucormycosis (MCM) also known as zygomycosis. India suffering from this fungal infection
already in a deep covid19 crisis. The Rajasthan government has declared mucormycosis or black fungus
as an epidemic. Cases of black fungus and resultant deaths are also rising in states like Maharashtra,
Utter Pradesh, Uttarakhand, Haryana, Gujarat. The state had nearly 100 above cases of black fungus. This
black fungal disease caused by a filamentous fungus Mucormycetes which is present naturally in the
Keywords: Mucormycosis; Black fungus; Fungal infection
Mortality rate of black fungus disease or mucormycosis is high. The common fungus
Rhizopus oryzae is responsible for this fungal infection . The patients of diabetes mellitus,
hematopoietic disorder, malignancy is mainly affected by mucormycosis. It is a rare fungal
infection. The common species of mucormycetes is Rhizopus and Mucor . Usually, it is
not harmful to human but decreased their immunity. The lungs of such type of individuals
who are on medications for other health problems which reduces their ability to fight
environmental pathogens . These are some difficulties to manage the mucormycosis that
are their diagnosis is very difficult and treatment is surgery.
Following are the types of mucormycosis:
a) Rhino-cerebral mucor-mycosis: The rhino-cerebral mucormycosis is a rare infection
of sinuses, nasal passages, oral cavity, and brain. The infection result in death.
b) Gastrointestinal mucormycosis: It related to digestive system.
c) Cutaneous mucormycosis: It is common type of mucormycosis which mainly affect
the skin. It spreads throughout the skin and treat by surgery.
d) Disseminated mucormycosis: This type of fungal infection spread throughout the
body by blood circulation. It affects the brain, liver, spleen.
e) Pulmonary mucormycosis: It is a lungs infection. This type of fungal infection found
in patients of cancer, organ or stem cell transplanted  (Figure 1).
It is transmitted by breathing, inoculation and inhalation of
spores present in environment. Such types of spore enter in the
lungs and affect lungs. Mucormycosis not transmitted from human
to human and human to animal  (Figure 2).
Figure 2:Transmission of mucormycosis through breathing.
If patient has mucormycosis in their lungs or sinuses, then
sample of fluid collected from respiratory system and send to
a laboratory for diagnosis. Tissue biopsy may perform in the
laboratory in which a small sample of affected tissue is analyzed
for evidence of mucormycosis under a microscope or in a fungal
culture. There is also need imaging tests such as a CT scan of lungs,
sinuses, or other parts of body, depending on the location of the
Mucormycosis is a serious infection and needs to be treated
with prescription antifungal medicine, usually amphotericin B,
posaconazole, or isavuconazole. These medicines are given through
a vein (amphotericin B, posaconazole, isavuconazole) or by
mouth (posaconazole, isavuconazole). Other medicines, including
fluconazole, voriconazole, and echinocandins, do not work against
fungi that cause mucormycosis. Often, mucormycosis requires
surgery to cut away the infected tissue [5-10].
a) Use masks when visiting dusty construction sites.
Mucormycosis is an emerging infection in immunocompromised
patients like diabetic patient with neutropenia or neutropenic
presenting with rhino-orbitofrontal brain or lung unimproved
by appropriate antibiotic therapy. Other locations are less
characteristic. Diagnosis is suspected on clinical and radiological
features and confirmed by mycological and pathological
examination. Treatment consists of amphotericin B combined with
surgery. Morbidity and mortality are high due to the invasive nature
of the frequent underlying malignancy, hence the importance of
early and appropriate management [10-30].
Professor, Chief Doctor, Director of Department of Pediatric Surgery, Associate Director of Department of Surgery, Doctoral Supervisor Tongji hospital, Tongji medical college, Huazhong University of Science and Technology