Black Fungus: Causes, Symptoms, Prevention And Ayurvedic Management

We are battling with a significant rise in COVID-19 cases in the second wave. A severe and rare fungal illness, the black fungus, is seen in a few recovering coronavirus patients causing a double blow.

We will discuss what is a black fungal infection, its causes, symptoms, treatments, and preventative measures in this blog.

What Is Black Fungus?

Black Fungus is a fungal infection caused by a group of moulds called mucormycetes present abundantly in the environment [1]. It mainly affects the sinuses, lungs, skin, and brain. This causes the blackening or discoloration over the affected areas, hence the name- Black fungus.

The risk of catching this opportunistic infection is high in persons with compromised immunity. 

Black Fungus Causes:

Black fungus spores are present almost everywhere in the environment. One can contract it from any common thing like air or soil.  Various types of equipment used in hospitals like adhesive bandages, wooden tongue depressors, hospital linens, non-sterile equipment, or inadequate air filtration led to outbreeding of mucormycosis.[2] Contamination of the oxygen cylinders or pipes and humidifiers used in ICUs expose patients to these fungi. It can also form in the skin after the fungus enters through a cut, scrape, burn, or another type of skin trauma. If you are immune compromised, then infections get more opportunities to get in.

People having diabetes, hypertension, kidney, or heart failure often have weak immunity. When these patients get hospitalized due to severe COVID-19 disease, doctors prescribe steroids to reduce infection. These steroids reduce inflammation but weaken the immune response to stop it from attacking healthy cells. These lead to the decreased immune surveillance making patients susceptible to mucormycete.[3]

Black Fungus Symptoms:

The symptoms of black fungus differ based on where the infection develops in the body. Studies show that black fungus symptoms occur two to three days after a person recovers from the Covid-19. It generally starts in the sinus and progresses to the eyes in two to four days. By the end of the next twenty-four hours, it reaches the brain.

Symptoms of black fungus infection in sinuses and brain include:

• Nasal or sinus congestion
• One-sided facial swelling
• Headache
• Black lesions on nasal bridge or upper inside of mouth that quickly become more severe
• Fever
• If not treated in time, the black fungus in the eyes can lead to blindness.[4]

Symptoms when lungs get involved are:

• Fever
• Cough
• Chest pain
• Shortness of breath

Symptoms when the skin is involved are:

• Blisters or ulcers
• Pain and warmth
• Excessive redness or swelling around a wound.

Black Fungus Treatment:

Antifungal medications like Liposomal Amphotericin B or LAmB are the main line of treatment in black fungal infections. In advanced stages, surgery is required to remove all dead and infected tissues. It is very crucial to control blood sugar levels, use steroids and immunosuppressive medications cautiously.

Black Fungus Treatment In Ayurved:

Description of black fungus as a disease is not available in Ayurvedic texts. But symptoms of sinus and brain fungal infection are like those of Raktaja Pratishyaya and Krimija Shirorogaa described in Ayurved.  Similarly, black fungal skin infection features can be co-related with Kushtha and Visarpa. Ayurved can be an add-on to the contemporary line of mucormycosis management.

Black Fungus Prevention:

It is always better to take precautions to avoid infections. Here are a few precautionary measures that can help to avoid black fungus infection:

• Use N-95 face mask and face shields when going out. Wash the mask every day or use a disposable one. Ensure personal hygiene by bathing and scrubbing the body thoroughly. These should be followed rigorously after returning home from work, working out, or visiting neighbours, relatives, friends.   
• Controlling blood sugar levels is one of the foremost prevention methods suggested by health authorities. One should use steroids in the doctor-recommended dosages only to avoid the risk of infection. Closely monitor the warning signs and symptoms mentioned above.  Immediately consult a health care professional to initiate treatment.
• Maintaining proper nasal and oral hygiene is of utmost importance as black fungus enters through these routes. Use lukewarm water with a pinch of Turmeric, Triphala, or Allum powder for gargling. Daily tongue scraping helps to eliminate micro-organisms preventing their growth within the oral cavity. 
• Instil 2-3 drops of medicated oil like Anu tail or cow ghee once or twice a day in each nostril before going out and after coming back home. It can help prevent the entry of spores into the respiratory tract. Steam inhalation: Inhaling steam for 10-15 minutes twice a day eases congestion. Add 1-5 drops of Eucalyptus oil or Camphor or Ajwain or Pudina in small quantity.
• Dhupana Karma or fumigation is a unique Ayurvedic measure to purify the environment and prevent the spread of airborne infections. Use antimicrobial and antifungal herbs like Guggulu, Vacha, Neem, Karanja, Turmeric, Kushtha, and Jatamansi for fumigation.
• Ayurvedic immuno-modulatory supplements coupled with the COVID-19 management regimen can help to prevent black fugus infection. Amla, Giloy, and Ashwagandha are well-known for their rejuvenating properties. They are beneficial in preventing the associated complications. Take these herbs or Ayurvedic formulations containing them after consulting a doctor.
• Avoid excess sour, salt, and spicy food. Also avoid going out in polluted areas or farm work or gardening for 2-3 months post-covid recovery. Fungal spores are richly present in the soil.

Final Word On Black Fungus:

We are witnessing a surge in the cases of the deadly Black fungus infection in COVID-recovered patients. It is crucial to take precautionary steps to prevent it.

Seek immediate medical advice if any of the signs are manifesting. Following Ayurvedic preventive measures can help stay protected. 

References:

1. S. Kameshwaran et al, Int. J. of Pharmacology and Clin. Research Vol-5(2) 2021 [24-27] https://ijpcr.net/ijpcr/issue/view/12
2. Moorthy A, Gaikwad R, Krishna S, et al. SARS-CoV-2, Uncontrolled Diabetes and Corticosteroids-An Unholy Trinity in Invasive Fungal Infections of the Maxillofacial Region? A Retrospective, Multi-centric Analysis [published online ahead of print, 2021 Mar 6]. J Maxillofac Oral Surg. 2021;1-8. doi:10.1007/s12663-021-01532-1 https://pubmed.ncbi.nlm.nih.gov/33716414/
3. Ibrahim AS, Spellberg B, Walsh TJ, et al. Pathogenesis of mucormycosis. Clin Infect Dis. 2012;54 Suppl 1(Suppl 1): S16–S22 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3286196/
4. Bhat I, Beg MA, Athar F. A contemporary intimidation for COVID-19 patients coinfected with mucormycosis in India. J Bacteriol Mycol Open Access. 2021;9(2):69‒71. DOI: 10.15406/jbmoa.2021.09.00298 https://medcraveonline.com/JBMOA/JBMOA-09-00298.pdf