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What is Mucormycosis?

 

Mucormycosis Disease Caused by Mucor Fungus

Mucormycosis is caused by a naturally occurring "mucor" fungus in the environment. It is a rare but potentially serious disease. It is characterized by mycelium invading blood vessels, causing thrombosis and necrosis, causing lesions in the nose, brain, digestive tract, and respiratory tract, and the prognosis is serious. "Mucormycosis" may cause redness and pain in the eyes and nose, accompanied by symptoms such as fever, headache, cough, and shortness of breath. In severe cases, it may also cause damage to the upper jaw and even blindness.

Image showing disease of Mucormycosis


When did Mucormycosis wave start in India?

On May 11, 2021, the Indian media reported that at least 8 people in the Surat area of ​​Gujarat had been blinded by the fungus after recovering from the new coronary pneumonia. In the past two weeks, at least 40 cases of Mucor have been reported in Surat.

According to Tataralao, at least 200 people in Maharashtra were infected with mucormycosis, of which 8 people survived the new crown virus but died after being infected with mucor. This germ attacked the patient's fragile immune system and proved to be a deadly fungus.

 

Table of Contents

1. Overview

2. Causes

3. Pathogenesis and pathology

4. symptoms

5. Diagnosis

6. treatment

7. Status

8. Prevention advice


Overview

Mucormycosis (mucormycosis) is a fungal disease caused by conditional pathogens in the order Mucorales. 

It is characterized by mycelium invading blood vessels, causing thrombosis and necrosis, causing lesions in the nose, brain, digestive tract and respiratory tract, and the prognosis is serious.

Structure of Mucormycosis Disease


What is the Causeof Mormycosis?

The pathogens are Rhizopus and Mucor in the order Mucorales. The former can invade the nose, sinuses, brain and digestive tract, and the latter can invade the lungs. 

Pathogenic bacteria of these conditions are all over nature, especially in food and fruits, and are spread through air dust and diet. 

The hyphae of this type of fungus are thick (10-20 μm), are not divided, and branch at right angles; the wall thickness is uneven, and the cross section resembles spores.


Mucormycosis Pathogenesis and Pathology

Decreased immunity of the body is an important cause of disease. For example, patients with leukemia, lymphoma, malnutrition, diabetes, uremia, and long-term use of cytotoxic drugs and corticosteroids are susceptible to this disease. 

It enters the human body mainly through skin and mucous membrane junctions, respiratory tract, digestive tract, surgery, interventional treatment or through damaged skin.

The most prominent histopathological changes are due to fungus invading blood vessels, especially large and small arteries, causing thrombus and adjacent tissue ischemia, infarction and necrosis. 

It can be purulent, but rarely shows granulomatous changes. Hyphae can be seen in the blood vessel wall.

Fungal disease of Mucormycosis


What are the symptoms of Mucormycosis?

Rhinocerebral mucormycosis is the most common type, but sometimes primary skin, lung or gastrointestinal lesions can also occur, and it can also occur when it spreads to other parts through the bloodstream. 

Nasal brain infections are usually fulminant and often fatal. Tissue necrotizing lesions often occur in the nasal mucosa and sometimes in the palate. 

Mycelium invades blood vessels and can cause progressive tissue necrosis of the nasal septum, palate and bones around the orbit or sinuses.

The clinical manifestations are pain, fever, orbital cellulitis, prominent eyes, purulent nasal discharge, and mucosal necrosis. 

The progressive expansion of necrosis can affect the brain, causing signs of ethmoid sinus embolism, convulsions, aphasia, or hemiplegia.

Patients with diabetic ketoacidosis are most susceptible to infection. However, opportunistic infections can also occur in patients with chronic kidney disease treated with renal deferoxamine, or patients with immunosuppression, especially patients with neutropenia or receiving high-dose corticosteroids. 

Lung infection is similar to invasive aspergillosis. In the case of occlusive dressings, skin Rhizopus infection can occur.

On May 9, 2021, experts from India’s “national Covid-19 task force” (the national Covid-19 task force) issued medical advice on “mucormycosis”.

 Experts say that "mucormycosis" is a rare but potentially serious disease caused by the naturally occurring "mucormycosis" fungus in the environment. "Mormycosis" may cause redness and pain in the eyes and nose, accompanied by symptoms such as fever, headache, cough, and shortness of breath. 

In severe cases, it may also cause damage to the upper jaw and even blindness.

 

Mucormycosis Diagnosis

What is Hospital treatment of Mucormycosis?

Because many necrotic fragments do not contain fungi, diagnosis requires a high suspicion index and laborious examination of tissue specimens, looking for large and undivided branched hyphae with irregular diameters. 

Culture is often negative, even if hyphae are clearly visible in the tissue, the culture is still negative, but the reason is unknown. 

CT scans and X-rays often underestimate or miss bone destruction with diagnostic significance.


What is the effective treatment for Mucormycosis?

Effective antifungal treatment should first control diabetes or, if indeed possible, reverse immunosuppression or stop using deferoxamine. Because azole drugs are ineffective, amphotericin B must be injected intravenously. 

It may be necessary to use surgical debridement to remove the necrotic tissue, because amphotericin B cannot penetrate into the avascular area to kill the remaining fungus.


What is the status quo of Mucormycosis?

On May 11, 2021, according to overseas news, Indian doctors recently reported that a small number of recovered and recovered patients with new coronary pneumonia were infected with the rare mucormycosis, and many people have gone blind or even died. 

The head of the Indian Medical Education and Research Council (DMER), Tataralau Lane, said that the number of infections with mucor in India is increasing. 

According to Indian media sources, at least eight people in Surat, Gujarat, have been blinded by the fungus after recovering from the new coronary pneumonia. 

Although this fungus exists in the environment, people with weakened immunity or patients receiving treatment for new coronary pneumonia are prone to infection. 

Experts believe that the chance of contracting this fungus after getting on a ventilator has increased significantly.

According to Indian media sources, at least eight people in Surat, Gujarat, have been blinded by the fungus after recovering from the new coronary pneumonia. 

In the past two weeks, at least 40 cases of Mucor have been reported in Surat. 

According to Tataralao, at least 200 people in Maharashtra were infected with mucormycosis, of which 8 people survived the new crown virus but died after being infected with mucor. This germ attacked the patient's fragile immune system and proved to be a deadly fungus.

Doctors in some Indian states have noticed that among hospitalized or recovered patients with new coronary pneumonia, the incidence of "mucormycosis" has increased, and some people need urgent surgical treatment. 

However, experts also said that although "mucormycosis" cases have increased, they have not reached the level of "major outbreak".


What is Prevention Advice for Mucormycosis?

On May 9, 2021, experts from India’s “national Covid-19 task force” (the national Covid-19 task force) issued medical advice on “mucormycosis”. Experts point out that "mucormycosis" is a relatively rare disease and usually "not a major threat" to people with a normal immune system. 

Image showing Mucormycosis


Conclusion

Experts suggest that when going to dusty construction sites, you should wear a mask, and when handling soil, moss, fertilizer and other items for gardening, you should wear long trousers, gloves, and pay attention to personal hygiene.



Author's Bio


Name: Gwynneth May

Educational Qualification: MBBS, MD (Medicine) Gold Medalist

Profession: Doctor

Experience: 16 Years of Work Experience as a Medical Practitioner

About Me


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