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Black Fungus

Facts about black Fungus, Types and Treatment ..

Black Fungus / SECONDARY OR OPPORTUNISTIC INFECTIONS-A LEAKAGE FROM PANDORA’S BOX

With the ferocious 2nd wave of covid 19 which has hit the country like a tsunami which is now settling, the focus of the entire country has shifted to the post covid complications like a chain of fungal infections known as mycosis to the doctors.

 we are attracted more towards “Negativity

It is very painful that social media and a chunk of electronic media are flooded with half-baked truths about these infections which cause much confusion and anxiety amongst the semiliterate and illiterate fellow citizens

who are glued to the social or electronic media to update their knowledge on the covid related developments. It is human psychology that we are attracted more towards “Negativity” than any positive developments,

it is one of our “Evolutionary survival extinct” the so-called “3Fresponse” i.e., “Fight, Fright and Flight” response.

Black Fungus / Such terminology has no medical or scientific basis.

The medical profession is a profession of High Dignity. So it is very sad even some medical professionals are going overboard on the electronic and social media by coining Pseudo nomenclature or false classification of the secondary infections to be more precise in this case “Fungal Infections” like Black, White, Yellow fungus.

This has no medical or scientific basis. In the standard medical text, no such terminology exists. As correctly pointed out by respected Dr. Randeep Guleria Director of A.I.I.M.S and a renowned specialist, this color coding of disease is not only wrong but dangerous.

CANDIADIASIS

My experience as an E.N.T. specialist attending to a variety of patients has shown that many times same fungus can turn its color from white in the initial stages where there are only “Hyphae” to black color when sporangia arise.

“White Fungus” a term which has been loosely used for “CANDIDIASIS” is in fact caused by yeast-like organisms which may arrange in tissues as blastospores, pseudohyphae; and hyphae.

Black Fungus /Cheap publicity stunt.

Infections like Mucormycosis, Candidiasis, Aspergillosis are not new to ENT specialists, Respiratory physicians, and other doctors although there has been a surge of these infections in post covid cases. This ‘MISNOMENCLATURE’ based on the color of the disease is a cheap publicity stunt that leaves the general public confused and anxious.

I always used to teach that when Pandora opened her box the Primary Infections that are infections that cause disease in healthy individuals came out. The secondary or opportunistic just leaked out through the back door to infect and cause disease in individuals with primary infections or immunocompromised hosts.

The secondary infections

The fungal infections in post covid 19 patients belong to the second category. The secondary infections strike in patients who are:
1. Diabetic
2. Steroid depended
3. Cancer patients on chemotherapy
4. Organ transplant patients on immune suppressants
5. HIV patients with AIDS and lower CD 4 counts
6. Terminally ill patients on life support.

Atypical pneumonia

Such infections include atypical pneumonia caused by a fungus Pneumocystis jirovecci which is common in HIV patients with AIDS and lower CD 4 counts. In Post covid 19 most common fungal infections include
1. Mucormycosis being sarcastically labeled Black fungus.
2. Candidiasis mislabeled White fungus
3. Aspergillosis

Mucormycosis:-

It has attracted a lot of attention because of its destructive potential because it literally “eats through” the infected tissue. It is caused by fungi of order Mucorales most commonly Rhizopus oryzae.

These are ubiquitous environmental fungi that effect

1. Diabetics on steroids
2. Cancer patients on chemotherapy
3. Organ transplant patients on immune suppressants
4. Terminally ill patients on life support
5. Patients with Iron overload syndrome.

Types:-

1. Rhinoculo cerebral commonest involving nose, sinuses. Eye, brain in that order.
2. Pulmonary involving lungs
3. Cutaneous involving skin
4. Disseminated involving multiple organs.

Treatment:-

Includes radical surgery and Amphotericin-B.

Candidiasis:-

These are yeast-like ubiquitous in nature inhabiting GI Tract, Female Genital Tract, Skin. Causes infections only in the immunocompromised host, patients with indwelling catheters. Patients on life support systems and with poor hygiene.

Types:-

1. Mucocutaneous
2. Deeply Invasive
3. Candidemia or disseminated candidiasis

Treatment:

– Azoles, nystatin in topical applications. In mucocutaneous
In Candidemia or disseminated candidiasis Amphotericin-B.
The rule of thumb is prevention is better than cure. In all opportunistic infections. Let these infections not be Nosocomial i.e., Hospital Acquired or Iatrogenic i.e., Acquired during various Invasive procedures.

In the end, I will like to quote the wisdom of great physician Sir Robert Hutchison.
“ From the inability to let an alone: from too much zeal for the new and contempt for what is old: from putting knowledge before wisdom and science before art and cleverness before common sense

from treating patients as cases: and for making the cure of the disease more grievous than the endurance of the same, Good Lord, deliver us.”
Dr.Amandeep Kapila
M.S ENT, ENT Specialist
Kapurthala.(PB)
Mb-9815333105

 

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