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Mucormycosis: The most frequently asked questions
1.What is mucormycosis?
Also known as Black fungus. Is an opportunistic infection (infection happens when the immune system is weak due to various reasons). Came to public attention after many cases were reported in the post covid scenario.
2. Is it a new disease?
No. It’s not.
3. Does it happen only in covid patients?
No. Currently covid is the main reason. Also happens in uncontrolled diabetes, after prolonged steroid use, patients using immuno suppressant medications, patients of organ transplants, patients of cancer etc.
4. Are all covid patients at risk of mucormycosis?
No. Covid with uncontrolled diabetes, Covid with prolonged and high dose steroid use, those using contaminated equipments, damp masks, living in unhygienic and crowded places are at particularly increased risk.
5. Is it a mild infection?
No, its rapidly progressive, severely destructive; organ or life-threatening disease. Mortality (death rate) is in the order of 40 to 80%.
6. What are the symptoms of mucormycosis?
Facial pain, swelling, headache, running nose, sinus tenderness, blood stained nasal discharge, black

discolouration around the eyes, inside nasal cavity, palate, tooth pain, loosening/falling of teeth, double vision, blurring of vision, loss of vision, blood stained or black sputum can all in various combination can be the presenting symptom.
7. What are the tests to detect the presence of mucor mycosis?
In a predisposed patient with symptoms suggestive of mucor mycosis; immediate medical intervention is necessary. Tests conducted are nasal endoscopy, biopsy of suspicious tissues, fungal stain with special stains; MRI of nose, sinuses, orbits, brain is also informative.
8.What are the treatments available?
Surgical treatment is the mainstay.
9.Are there any drugs available?
Yes. Amphotericin B is the drug of choice, but drugs alone does not cure the disease, drugs along with surgery has the best chance of survival. Other drugs are Posaconazole and isavuconazole, but less effective compared to amphotericin.
Can be used for those not tolerating amphotericin.
10.What are the forms of mucormycosis seen?
Rhino orbito cerebral mucormycosis is the most common form affecting the nose, sinuses, orbits, eyes, brain. Other forms are pulmonary, gastrointestinal etc.
What is the major side effect of amphotericin?
Nephrotoxicity (can damage the kidneys). So this is given in centers with experience in dealing with such health conditions.
12. Is there any other fungal infection the covid patients are more susceptible?
Yes. Covid associated aspergillosis is one such systemic fungal infection.

Dr Wilson AP
Consultant- Internal Medicine

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