Context: Recently, the black fungus is being detected relatively frequently among Covid-19 patients in some states.

• The experts in the national Covid-19 task force have issued an evidence-based advisory on the disease with a number of black fungus cases detected in Delhi, Maharashtra and Gujarat.

About Black Fungus disease

• It is a rare but serious fungal infection known as mucormycosis.
• It is caused by a group of moulds known as mucormycetes present naturally in the environment.
• It mainly affects people who are on medication for health problems that reduces their ability to fight environmental pathogens.
• The sinuses or lungs of such individuals get affected after they inhale fungal spores from the air.
• The types of Mucormycosis are: Rhinocerebral (Sinus and Brain), Pulmonary (Lung), Gastrointestinal, Cutaneous (Skin), and disseminated Mucormycosis.

Effects of Black Fungus disease

• The warning signs include pain and redness around the eyes or nose, with fever, headache, coughing, shortness of breath, bloody vomits, and altered mental status.

According to the advisory, infection with mucormycetes should be suspected when there is:

• Sinusitis: nasal blockade or congestion, nasal discharge (blackish/bloody);
• Local pain on the cheek bone, one-sided facial pain, numbness or swelling;
• Blackish discoloration over bridge of nose/palate;
• Loosening of teeth, jaw involvement;
• Blurred or double vision with pain;
• Thrombosis, necrosis, skin lesion;
• Chest pain, pleural effusion, worsening of respiratory symptoms.

The experts advise that one should not count all cases of blocked nose as cases of bacterial sinusitis, particularly in the context of immunosuppression and/or Covid-19 patients on immunomodulators.
Treatment of Black Fungus disease

• It is treated with antifungals and mucormycosis may eventually require surgery.
• The doctors have said that it is of utmost importance to control diabetes, reduce steroid use, and discontinue immunomodulating drugs.
• The treatment includes infusion of normal saline (IV) before infusion of amphotericin B and antifungal therapy, for at least 4-6 weeks.