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Infectious Diseases 2023

Mucormycosis (black fungus): what é, symptoms and treatment

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Mucormycosis (black fungus): what é, symptoms and treatment
Mucormycosis (black fungus): what é, symptoms and treatment

Mucormycosis, popularly known as black fungus disease or black fungus, is a rare infectious disease caused by the fungus Rhizopus spp., which can be found naturally in the environment, mainly in vegetation, soil, fruits and in decomposition products, which can lead to the appearance of symptoms after spores of this fungus are inhaled.

Symptoms of mucormycosis are more frequent in people who have a more compromised immune system, with headache, fever, discharge from the eyes and nose, redness of the face and, in more severe cases where the fungus reaches the brain, seizures and loss of consciousness may also occur.

The diagnosis of mucormycosis is made by a general practitioner or infectious disease specialist through computed tomography and fungal culture and treatment is usually done with the use of injectable or oral antifungal drugs, such as Amphotericin B.

Symptoms of Mucormycosis

The symptoms of black fungus infection may vary according to the general state of the person's immune system and the organ that has been affected by the fungus, this is because the fungus after inhalation can be restricted to the nose or move to others organs such as eyes, lungs, skin and brain. In general, the main signs and symptoms of mucormycosis are:

  • Stuffy nose;
  • Pain in cheekbones;
  • Nose cartilage loss, in the most severe cases;
  • Green nasal discharge;
  • Difficulty seeing and swelling in the eyes, when there is ocular involvement;
  • Cough with phlegm or blood;
  • Chest pain;
  • Difficulty breathing;
  • Seizure;
  • Loss of consciousness;
  • Difficulty speaking.

Furthermore, when the fungus reaches the skin, reddish, hardened, swollen, painful lesions may appear, which, in some situations, may become blisters and form open, black-looking wounds.

In more advanced cases, a person with mucormycosis may have a bluish coloration of the skin and purplish fingers, and this is due to the lack of oxygen caused by the accumulation of fungi in the lungs. In addition, if the infection is not identified and treated, the fungus can quickly spread to other organs, especially if the person has a severely compromised immune system, reaching the kidneys and heart and putting the person's life at risk.

Who is most at risk

The fungus responsible for mucormycosis can be found naturally in the environment and can be easily fought by the immune system. However, when there are changes in the immune system, there is a greater risk of developing signs and symptoms of infection and, therefore, Rhizopus spp., is considered an opportunistic fungus.

Thus, mucormycosis can occur more easily in people with decompensated diabetes with ketoacidosis, HIV carriers, who use immunosuppressive drugs or who have undergone transplants, for example. In addition, there are reports of cases of mucormycosis in patients undergoing treatment or cured of COVID-19.

Mucormycosis and COVID-19

Mucormycosis is a rare disease, but it happens more easily in people who have a compromised immune system and, therefore, can happen in people with COVID-19.

Despite being a rare infection associated with COVID-19, mucormycosis is quite serious, because in addition to the person already having the most compromised immunity and directed to the fight against SARS-CoV-2, there is a need to prolonged hospitalization and use of medications that can also interfere with the action of the immune system and create a more favorable environment for the fungus.

Types of mucormycosis

Mucormycosis can be divided into several types according to the location of the fungal infection, and they can be:

  • Rhinocerebral mucormycosis, which is the most common form of the disease in which the fungus affects the nose, sinuses, eyes and mouth;
  • Pulmonary mucormycosis, in which the fungi reach the lungs, this being the second most common manifestation;
  • Cutaneous mucormycosis, which consists of the dissemination of fungal infection in parts of the skin, which can even reach the muscles;
  • Gintestinal mucormycosis, in which the fungus reaches the gastrointestinal tract.

There is also a type of mucormycosis, called disseminated, which is rarer and occurs when fungi migrate to various organs of the body, such as the heart, kidneys and brain.

How the diagnosis is made

The diagnosis of mucormycosis is made by the general practitioner or infectious disease specialist through the evaluation of the person's he alth history and computed tomography, which serves to verify the location and extent of the infection. Sputum culture is also performed, which is based on analyzing lung secretions to identify the fungus related to the infection.

In some cases, the doctor may also request a molecular test, such as PCR, to identify the species of fungus and, depending on the technique used, the amount present in the body, and magnetic resonance imaging to investigate whether the mucormycosis has reached the structures of the brain, for example. These exams should be done as soon as possible, because the faster the diagnosis is made, the more chances there are to eliminate the infection.

Treatment of mucormycosis

Treatment for black fungus infection must be done quickly, as soon as the disease is diagnosed, so that the chances of cure are greater and must be done according to the doctor's recommendation, and the use may be indicated. of antifungals directly into the vein, such as Amphotericin B, or Posaconazole, for example.It is important that the drugs are used according to the doctor's recommendation and that the treatment is continued even if there are no more symptoms.

In addition, depending on the severity of the infection, the doctor may recommend surgery to remove the necrotic tissue caused by the fungus, this procedure being called debridement.

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