in india the prevalence of covid 19 in black fungus infections has increased
what's the black fungus why is it associated with covid why is it occurring in india how is
it diagnosed and treated and how do you prevent it that's what this video is about so welcome to
another video if you're new here my name is mike hanson i'm a board-certified physician
specializing in internal medicine pulmonary disease and critical care medicine and if you
like learning about health and medicine this is the channel to click on that subscribe button
and bell notification okay what is the black fungus among us black fungus is mucor mucormicosis
a rare but dangerous infection it's caused by a group of molds known as mucor miceites these fungi
can be found in decaying leaves compost piles and rotten wood molds require moisture in decaying
organic material in order to thrive mucormicities release large numbers of spores that can go into
the air infections occur more frequently in the summer and fall compared to the winter and spring
people can inhale these fungal spores when they're near moist dead vegetation
small hair-like structures called cilia can catch these spores in your airways
and get into your lungs they can also get trapped in your mouth nose and sinuses you can
also swallow them in which case these spores are harmless and pass through your digestive system
the immune system cleans up any leftover spores now for most people the vast majority of people
getting these spores in their body is no big deal but black fungus has an advantage
in people who have a weak immune system if your immune system is weak or your cilia for some
reason don't work well for example with certain genetic conditions it's easier for the spores to
get deep into the sinuses and other body tissues once this happens it's harder for your immune
system to dispose of them besides entering your body through your mouth nose and sinuses
the fungus can also enter through a break in your skin such as a cut or a scrape
the types of mucourmycosis infections depend on where they enter your body so rhino cerebral
mucour mycosis is an infection of the sinuses that can occur when a person with a weakened immune
system breathes in those fungal spores air enters the nose and may go into the sinuses which are air
chambers found in the facial bones sinuses are air pockets that serve to lighten the skull provide
resonance for speech and moisturize and warm the air that we breathe the infection can spread from
the sinuses to the brain or the eyes people with diabetes who have poorly controlled blood
sugar are more likely to develop a black fungal infection of the sinuses same for those who've
had a kidney transplant lung mucormicosis is most common in those with a very weakened immune system
after having cancer treatment or an organ transplant skin mucour mycosis develops when the
fungus enters the skin through a scrape or cut in the skin and this is the most common type of black
fungus infection in people who have a healthy immune system disseminated mucomicosis occurs when
the infection spreads throughout the body via the bloodstream the fungus invades the blood vessels
reducing blood flow to organs and tissues supplied by these damaged blood vessels now when that blood
flow is decreased the tissues can't get enough oxygen and nutrients and then they start to die
dyeing tissue turns black black fungus grows well on dying tissue after passing through the
blood the fungus usually affects the brain but it can also affect the spleen heart and skin
an opportunistic infection takes advantage of you when your immune system is weak
we use steroids like dexamethasone aka decadron to treat sicker people with covid 19. when covid 19
gets into the lungs meaning covid pneumonia the immune system is stirring up this crazy amount of
inflammation there which can do a lot of damage so we try to minimize that inflammation with steroids
sometimes for very severe covid pneumonia we also give a drug called tosolyzymab which also
makes the immune system weaker unfortunately this can lead to black fungus infection
not just because it suppresses the immune system but also because steroids
increase blood sugar levels and fungal infections love sugar sugar is their go-to for nutrition
people with uncontrolled diabetes have higher blood sugar levels which helps the fungus grow
and flourish diabetes is extremely common in india it's actually estimated that 15% of adults
in india's urban areas have it so why is this black fungus outbreak mainly happening in india
well one reason is related to the swelling number of covid cases in addition to the liberal use of
steroids there but there are likely other factors as well sometimes there are
mucormycosis outbreaks in hospital settings these outbreaks have been linked to adhesive bandages
wooden tongue depressors hospital linens negative pressure rooms water leaks
poor air filtration non-sterile medical devices building construction but also oxygen face masks
and humidifiers help people with covid 19 breathe easier and they deliver oxygen to their lungs
these devices can make it easier for the black fungus to invade the sinuses and cause infection
the majority of infected people have diabetes and have recently recovered from covid 19
so according to recent reports 85 percent of people with mucormycosis also have diabetes of the
222 initially diagnosed 212 were covid 19 positive 29 were not given steroids
12 were considered to be immunocompromised and 21 had another medical condition
the symptoms of mucormicosis depend on where the fungus is growing in your body
the most common sight of infection in patients recovering from covid is the sinuses in the
brain the symptoms would then be similar to those of a sinus infection so facial swelling on one
side of the face headache nose or sinus congestion black sores on the bridge of the nose or the roof
of the mouth and fever so the black sores are a feature of black fungus and are not usually found
in more typical bacterial and viral sinus infections as the infection gets worse these
symptoms can progress to blood-tinged runny nose bulging eye difficulty fully closing
the eyelid difficulty moving the eye visual problems and black pus draining from the eyes
when the infection involves the skin there are blisters or ulcers that may eventually turn black
you may also experience pain warmth redness and swelling around that area of infection these are
signs of inflammation which indicate that your immune system is fighting the infection as a skin
infection worsens and progresses the affected area swells and becomes hard and painful to the
touch it may begin draining pus form a walled off infection known as an abscess or develop
blackened areas from dying skin tissue symptoms of a lung infection this would include fever
cough chest pain shortness of breath and since mucormycosis is caused by fungal spores in the
environment it's not contagious it does not spread from person to person or from animal to person
if you have typical black fungus symptoms your doctor may take a sample of fluid
from your nose or your throat and then send it to a lab to be tested
they may also do a tissue biopsy which means taking a small piece of tissue
and then looking at it underneath the microscope if your infection is in your nose or your sinuses
a doctor may use a tube with a light and a camera to look inside your nose and sinuses
blackened or dead looking tissue makes it more likely that the black fungus is the culprit
so your doctor may also do a cat scan or an mri or both to take pictures of your head and sinuses
cte or mri scans can help find out whether the infection has spread to your brain or other organs
although rare black fungus is a serious infection the sooner you detect it and treat it the better
the outcome anti-fungal medication can stop the fungus from dividing and spreading
in india doctors are treating the infection with an iv drug called amphotericin b now this medication
has lots of potential for side effects and there's an inside joke in the medical community that it's
called amphoterible treatment can take several weeks so black fungus thrives on dead and dying
tissue in severe cases as the infection worsens and the tissue dies it will become black and
necrotic in this case doctors will surgically remove this tissue to keep the infection from
spreading some people with severe infections have had parts of their face jaw or eyes removed
untreated the death rate from mucormycosis is estimated to be 54%
the death rate from the fungus will depend on how healthy the person is but also whether
they have other medical conditions the type of fungus and the area of the body that's infected
also if their blood sugars are controlled or not so if you have covid what can you do to
prevent getting mucormycosis for one make sure your blood sugars are well controlled
two only take steroid medications if properly recommended by a doctor
three if you're wearing a mask make sure it's a fresh clean mask and four this includes cpap masks
or bipap masks make sure that you clean them properly and frequently so that's all for this
video thank you for watching and i'll be coming out with another one it's gonna be a big one and
it's gonna be a controversial one on the origin of covid so make sure you stay tuned for that you