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Killer Fungal Infection

31-May-2021

By Samrajya Basnyat

Source: https://web.stanford.edu/~siegelr/fungi/mucorales.html

With Covid-19 rampaging through the Southern Asian countries, an old predator has risen from its slumber. Dormant for ages and striking at certain opportunities throughout history; the fungal infection is the oldest disease with varying fatality rates.

After beating Covid-19, the patients in the recovery phase have contracted this infection. There are 3 types of fungi disease spotted in India: Black, White, and Yellow. From decaying fruits, vegetables, soil, and the air itself; these fungus spores are present everywhere in nature. This phenomenon is also known as ‘Environmental Contamination’. AIIMS chief, Dr. Randeep Guleria warns of confusion amidst the fungal infections. He states, “The reason behind these infections is quite similar which points to weakened immune systems.” He mentions the correlation between the names designated to each fungus is due to its symptoms shown in organic bodies of the infected.

Black Fungus:
 
Source: https://www.bbc.com/news/world-asia-india-57027829
Mucormycosis, commonly known as Black fungus, belongs to the Mucorales family. India’s top Virologist Dr. Gagandeep Kang mentions the fungus belongs to the family Mucorales which is considered opportunistic, meaning they usually infect people with compromised immune systems. Weak immune systems trace to conditions like Cancer, Diabetes, overuse of steroids, etc. Specifically, the Black fungus has been recorded in recovering Covid-19 patients. With a fatality rate of 50 percent, even if operated after infection, compared to Covid-19 which has a recovery rate of around 90 percent.
These infections take place through air, wounds, and spoiled food through which fungus spores travel into the body affecting the lungs. The most common place for Black Fungus infections are the nose and sinus areas. When blood flow is restricted in these areas, a black discoloration is shown on the skin surrounding the nose from which the name Black fungus is obtained. The infection could spread to the eyes and brain resulting in blindness, headaches, and seizures.
Symptoms:
The progression time for symptoms is less than a week for severely immunocompromised patients. Symptoms depend upon the infected areas with the most common infection transmitting through the air.
1. For Rhinocelebral (Sinus and Brain) Mucormycosis: Toothache, Headache, Nasal or sinus congestion, Fever and Black lesions on the nose bridge.
2. For Pulmonary (Lungs) Mucormycosis: Fever, Cough, Chest pain, and shortness of breath.
3. For Cutaneous (Skin) Mucormycosis: Blisters or infected areas may turn black. 
4. For Gastrointestinal Mucormycosis: Abdominal pain, Nausea, Gastrointestinal bleeding, and Vomiting.
Prevention:
Dr. Gagandeep Kang says “The Black fungus infections are rare even for compromised immune systems.” She mentioned that keeping the environment around us clean and reducing the overuse of steroids, immunosuppressant drugs, zinc, steam, and antibiotics is adequate to prevent infection.
Dr. Rajeev Jayadevan, a leading Gastroenterologist of Kerala, analyzed 210 patients with the black fungus and found 100 percent of the patients were on antibiotics while steroids were not used in 14 percent of the patients.
He concludes, the three potential factors enabling fungi to thrive in nature are:
1. Overuse of antibiotics,
2. Excessive steam inhalation
3. Zinc supplements

White Fungus:

Source: https://pharmaceutical-journal.com/article/ld/aspergillosis-causes-types-and-treatment
Aspergillus, commonly known as White fungus, is mostly observed on food items such as bread. Even immunocompetent people could, rarely, have this particular fungal infection. Allergic Bronchopulmonary Aspergillosis is an infection caused by the white fungus in the lungs. The area of infection for ‘White Fungus’ also includes the eyes or the ears. For a healthy individual, Aspergillus infection can be cured even without treatment if the infection is superficial. Usually, in systemic infection, the fatality rate ranges from 20-40 percent, mostly for immunocompromised people.  
Symptoms:
In the case of White fungus, the symptoms are similar to covid –
1. Cough
2. Breathlessness
3. Chest pains
4. Some patients report headaches and swelling.
5. Tongues of patients become white.
6. White patches are seen in the oral cavity and food pipes.
Prevention methods for ‘White fungus’ infections are similar to ‘Black fungus’ infections where misuse of steroids is the lead cause.
 

Yellow Fungus:


Source: https://www.sentinelassam.com/national-news/now-yellow-fungus-cases-reported-in-india-after-black-and-white-fungus-539744
Similar to Black and White fungus infections, the Yellow fungus has a slight tweak to its infection process. Fatal and deadlier than its counterparts; it begins internally where the symptoms are not visible until it’s too late. Dr. B.P Tyagi, an ENT (Ear-Nose-Throat) specialist in Uttar Pradesh’s Ghaziabad, said that the yellow fungus trait often leads to a delay in its diagnosis. This characteristic makes it tedious to manage and exponentially fatal as early diagnosis is a necessity in its cases.
Symptoms:
1. Loss of appetite, lethargy, and weight loss.
2. Sunken eyes due to malnutrition and organ failure
3. Slow healing of wounds
4. Oozing of pus from the wounds
5. Necrosis (cell injury that leads to the death of cells and living tissues).
Precautions: 
The precautions are similar to the above fungus infections. Maintaining a clean environment and hygiene is enough to prevent it.

Treatment:
Hence the good news is that these fungal infections are not contagious. They cannot be transmitted to other people through human contact. Dr. Tyagi mentioned the treatment for fungal infections is the Amphotericin-B injection.
 

With the Black, White, and Yellow fungus cases rising to nearly 9000 in India, prevention was perceived as the best method.
 

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