Recently, there have been a number of reports of mucormycosis, a rare but sometimes fatal fungal infection, spreading throughout hospitals in India. According to MSN, the fungal illness is becoming especially prevalent in patients with COVID-19. Because many of these patients are already immunocompromised, it is important to raise awareness of the fungal infection. This could ultimately help doctors prevent, identify, or treat infected patients. Additionally, this fungal infection can be debilitating and cause lasting damage, so identifying patients at risk could improve patient outcomes.

Within India, this rare fungal infection is beginning to spread. In particular, doctors note that prolonged steroid use could place patients at a higher risk. For patients dealing with COVID-19, steroids are a crucial part of treatment. Patients with COVID-19 requiring hospitalization are also more immunocompromised. As a result, doctors are seeing patients leave the intensive care unit (ICU) and later return with dangerous fungal infections.

Beyond patients with COVID-19, others are at risk of mucormycosis infection. Other at-risk groups include patients with diabetes, those being treated (or who have been treated) with chemotherapy, and those requiring long-term respiratory assistance. Thus, patients in these groups should be monitored during treatment.

In March 2021, Liposomal Amphotericin B (LAmB) was approved for use in India for patients with mucormycosis.

Mucormycosis

According to the Center for Disease Control and Progression (CDC), mucormycosis, sometimes or previously known as zygomycosis, is:

a serious but rare fungal infection caused by a group of molds called mucormycetes. [The] types of fungi which typically cause mucormycosis include Rhizopus species, Mucor species, Rhizomucor species, Syncephalastrum species, Cunninghamella bertholletiae, Apophysomyces species, and Lichtheimia (formerly Absidia) species.

Normally, these fungi can be found in soil, leaves, compost piles, or cottonwood. This is because they thrive in decaying organic matter. When people come in contact with these fungi, they can breathe in spores. Fungi can also enter into the body through skin trauma, such as cuts or scrapes. Once infected, mucormycosis can cause a host of health issues. Typically, this fungal infection is most common in patients with other health-related conditions or who are taking immune-suppressing medications.

Altogether, there are a few forms of mucormycosis: cutaneous (affecting the skin), gastrointestinal, pulmonary, rhinocerebral (affecting the brain and sinuses), or disseminated (spread throughout the body). However, the most frequent infections are pulmonary and cutaneous. Symptoms vary based on which form of mucormycosis is present. Some symptoms may include:

• Fever
• Cough
• Headache
• Nasal congestion and/or sinus pain
• Chest or abdominal pain
• Gastrointestinal bleeding
• Shortness of breath and/or difficulty breathing
• Excessive redness, pain, warmth, or swelling around a wound
• Blisters or ulcers which turn black
• Nausea and vomiting
• Facial swelling on one side of the face
• Eye pain and/or vision loss
• Black lesions in the nose or mouth

Without treatment, mucormycosis can be fatal. In many cases, treatment includes orally or subcutaneously administered anti-fungal therapy. However, in extreme infections, surgery may be required.