Black Fungus: Causes, Symptoms, and Treatment

Imagine waking up with a swollen face or blurred vision. You go to a doctor only to discover it’s not just a simple infection. Black fungus, or mucormycosis, is a rare yet dangerous condition that demands immediate attention. 

What is Black Fungus (Mucormycosis)?

Black fungus is a serious fungal infection caused by molds called mucormycetes. These molds are naturally found in the environment, especially in soil, decaying leaves, and compost.

The infection primarily affects people with compromised immune systems. It can enter the body through inhalation, cuts, or wounds and rapidly spreads to the sinuses, lungs, or brain.

Types of Black Fungus

Black fungus presents in several forms, depending on the body part it infects. 

1. Rhinocerebral Mucormycosis
   This black fungus type affects the sinuses and brain. It often starts in the nasal passages and can spread to the eyes or brain.
2. Pulmonary Mucormycosis
   Common in individuals with weakened lungs, this type primarily affects the respiratory system. It is more prevalent in patients with conditions like COVID-19 or chronic illnesses and immunocompromised situations.
3. Cutaneous Mucormycosis
   This occurs when the fungus enters the body through cuts or wounds. It causes skin infections that can turn severe without treatment.
4. Gastrointestinal Mucormycosis
   Though rare, this type impacts the stomach and intestines. It is more common in malnourished individuals or premature babies.
5. Disseminated Mucormycosis
   This severe form occurs when the infection spreads to multiple organs, including the brain, heart, and spleen.

Black Fungus Causes

Understanding the black fungus causes can help identify and address risk factors early. 

Here are the primary causes:

1. Weakened immune system
2. Uncontrolled diabetes
3. Prolonged use of steroids
4. COVID-19 complications
5. Exposure to contaminated surfaces

Symptoms of black fungus in eyes

The eyes are among the most vulnerable areas for black fungus infections. Key symptoms of black fungus in eyes include the following.

1. Swelling and redness
   The infection often causes swelling around the eyes, accompanied by redness or tenderness.
2. Blurred or double vision
   Patients may experience blurred vision or see double due to the fungus spreading in the orbital region.
3. Eye pain
   Persistent pain in and around the eyes is a warning sign of black fungus eye involvement.
4. Black discoloration
   In advanced cases, black patches or necrosis may appear near the eyes or nose.
5. Reduced eye movement
   Difficulty in moving the eyes or eyelids can signal the infection’s spread.

How to diagnose Black Fungus

There are various diagnostic measures needed to detect black fungus at an early stage, including:

1. Physical examination
   Doctors begin with a physical examination, focusing on symptoms like swelling, redness, or blackened tissue. They may also check for other signs, such as fever or pain. 
2. Imaging tests
   Imaging techniques like CT scans or MRIs are often used to identify the spread of the infection in the sinuses, brain, or lungs. These scans provide a clear view of the affected areas.
3. Endoscopic biopsy
   In cases of suspected sinus infection, an endoscopy may be performed to take a tissue sample for laboratory testing. This helps confirm the presence of the fungus.
4. Laboratory culture
   A sample of the infected tissue or fluid is cultured in a lab to identify the type of fungus. Mucormycetes can be difficult to grow, but specialised labs can confirm the diagnosis.
5. Blood tests
   Blood tests may reveal elevated levels of certain markers that indicate fungal infection, though they are not always conclusive.

Treatment for Black Fungus (Mucormycosis)

Treating black fungus, or mucormycosis, requires a multi-faceted approach. Nethradhama Super Speciality Eye Hospital offers specialised care for black fungus, especially in cases affecting the eyes. 

Antifungal medications: The primary black fungal treatment is antifungal medication, such as amphotericin B. This medication targets the fungi directly, helping to stop its growth and spread. It’s typically administered intravenously for severe cases.

Surgical intervention: In cases where the infection has caused tissue damage, surgery may be needed to remove infected areas. This is particularly important when the fungus affects the sinuses, eyes, or brain. 

Risk Factors of Black Fungus

Several risk factors can increase the likelihood of developing this infection. One of the most significant risk factors is having uncontrolled diabetes, especially in those with diabetic ketoacidosis. High blood sugar levels make the body more susceptible to fungal growth. 

Another key risk factor is the prolonged use of steroids. They suppress the immune system and make it harder for the body to fight off infections. People undergoing organ transplants, cancer treatments or other chronic conditions are also at a higher risk due to their weakened immunity. 

Prevention of Black Fungus

Preventing black fungus, or mucormycosis, starts with managing the risk factors that make individuals more vulnerable. 

One of the most important prevention measures is controlling diabetes and keeping blood sugar levels in check. 

Another key preventive step is minimising the use of steroids unless absolutely necessary. For those who need steroids for medical reasons, doctors should carefully manage their dosage. 

It’s also important to avoid exposure to environments where mucormycetes thrive, such as damp or mouldy areas. Wearing protective gear, like masks, when working in such environments can help. 

In hospitals, proper hygiene and sterilisation practices can reduce the chances of black fungus infections, especially in patients recovering from COVID-19 or undergoing treatments that suppress immunity. Patients who have undergone organ transplants or chemotherapy should be extra cautious. 

Conclusion

Black fungus is a serious condition that requires prompt diagnosis and treatment. 

With proper care, including antifungal medications, surgery, and managing risk factors, it is possible to overcome the infection.