‘Black fungus’ or Mucormycosis: Here are three signs to watch out for

‘Black fungus’ or mucormycosis has been detected in thousands of patients who have recently recovered from COVID-19 in India. Doctors say that this fungal infection was a rare occurence prior to the pandemic. But in 2021, states such as Gujarat, Maharashtra, Kerala, Tamil Nadu etc have reported scores of cases, forcing governments to declare mucormycosis as a notified disease under the Epidemic Diseases Act, 1897.

If left untreated, mucormycosis can prove to be fatal. It is ‘angioinvasive’, which means that the fungus enters and blocks the blood vessels and cuts off blood supply to the tissue, says Dr Veerabahu, president of the Association of Oral and Maxillofacial Surgeons of India (AOMSI). When blood supply is cut off, the tissue dies and turns black - giving the infection its colloquial name - ‘black fungus’. Mucormycosis patients, especially serious cases, come with dead blackened tissue on their bodies, which has to be removed entirely.

Dr Sonal Anchlia, Professor and Head of the Department of Maxillofacial Surgery at the Govt Dental College and Hospital, Ahmedabad, who has been treating hundreds of mucormycosis cases says that the fungus is found in the border of the dead and live bone, and keeps killing off more bone by blocking blood.

In most cases in India, the fungus has been found to originate in the upper jaw or maxilla region. From here, it can spread rapidly to the nasal cavity, the eye socket and then to the brain, in a matter of days.

TNM spoke to several doctors who have said the COVID-19 recovered patients, particularly diabetics, are vulnerable to the infection. However the fungus has been found in very young and healthy patients, making it difficult to understand who is likely to be most at risk.

Nevertheless, here are a few things to watch out for: 

1. Check blood sugar level: Patients who have recently recovered from COVID-19 should keep a check on their blood sugar levels, says Dr Sonal. “A consistent pattern we have seen in patients is that their blood sugar levels are above normal, even if they weren’t diabetic. It could be COVID-19 itself which has weakened their immunity and increased their sugar levels, or other factors. We do not know for sure. But the best advice would be to take a Random Blood Sugar (RBS) test along with your other COVID-19 tests. A blood sugar level less than 140 mg/dL is considered normal. If the patient is found to be diabetic or pre-diabetic (between 140 to 199 mg/dL), then it is important to consult a doctor and take medicines, says Dr Sonal. 
2. Symptoms: Treating the infection early can prevent serious complications. Some early symptoms of the infection include tooth mobility, nasal discharge, eye pain, pustules on the gums and mouth etc, says Dr Pritam N Shetty, a Maxillofacial surgeon practising at Bhagwan Mahaveer Jain hospital in Bengaluru, and General Secretary, Association of Oral and Maxillofacial Surgeons of India. “If you feel your teeth moving for no reason, or any kind of nasal discharge, puss formations and if you have recently got COVID-19, you must consult a doctor,” he adds. Early symptoms of the infection include obstruction in the nose, swelling in the eye or cheeks, and black dry crusts in the nose, smelly black nasal discharge, face numbness, fever, cold, etc
3. Oral and nasal hygiene: Washing masks everyday or using new masks (if you wear use-and-throw ones) is important. “Keep your mouth and nose clean. This also means don’t touch the inside of your nose with your finger after touching any surface etc,” Dr Sonal says. 

It is important to remember that mucormycosis does not spread from person-to-person. 

Read: Mucormycosis FAQs: How the black fungal infection is contracted, symptoms and more

Read: Black fungal infection due to COVID-19 on the rise: Doctors talk on how to prevent it