Black Fungus: What the scare !!!

Today with so much exposure to all kinds of knowledge on google and multiple social media platforms, we cannot differentiate the true from the false. The same thing happened with black fungus. There is so much information floating around and I have seen so many patients reaching the OPD just because of the fear!! The media was proactive in spreading the message, Initially, it was really mind-boggling, but it helped to a certain extent, people were more aware of it and landed very early. Initially, when the epidemic of Mucormycosis started it was really disheartening to see patients losing eyes and lives after surviving the onslaught of the Covid19 virus!!!

I still remember the first patient that landed with me was with a headache, loss of vision, and facial pain !! He had traveled from rural Maharashtra to get treated for the same. It was really difficult to explain to the patient the extent of the disease which had reached his brain and eyes because he was completely normal other than loss of vision!! That’s how difficult it is for the patient and the relatives to accept the outcome of black fungus infection!!

Post-covid patients who have the symptoms of, loss of vision / blurred vision or double vision, facial pain, headaches, nose bleed should visit the doctor immediately. The most important treatment modality is surgical debridement with anti-fungal medicine. Both treatments go hand in hand so, one cannot work without the other. Amphotericin B is the drug of choice and everyone knows that by now, but the unavailability of the drug had thrown many challenges. Thankfully the hospital I work in and especially BMC has taken a lot of effort to sort the issue!! It is very saddening to know that the mortality rate due to Mucor is as high as 50 to 60%, much higher than that due to Covid19.

The dilemma as a team we face is basically Sight vs Life. We have been hearing about sight first programs but, in this case, we have to sacrifice the eye to save the life!! Multiple predisposing factors like steroids, uncontrolled Diabetes, immunocompromised state, like people on chemotherapy, etc. ….but we are still struggling to know the exact cause of this epidemic suddenly in post-covid patients!! Spores of the black fungus or Mucor are in the environment, it’s when we inhale them and give them an environment conducive for the growth is when they attack us. So basically loss of mucosal immunity in post-covid patients is what probably leads to Mucormycosis or Black Fungus infection. The Black fungus being an Invasive Fungus it spreads very rapidly and hence Early detection is the Key!!!

So Prevention is better than cure!! Please use masks, maintain social distancing, avoid going to crowded places, and last but not least get immunized !!!!

Stay Safe ….