Mucormycosis, also known as black fungus, is a rare but serious fungal infection caused by a group of molds called mucormycetes. It has been occurring in COVID-19 patients in India treated with steroids, which can reduce immunity and increase blood sugar levels. Symptoms vary depending on the infected organ but may include sinus congestion, black lesions, fever and loss of vision. Those at highest risk include diabetics, severely immunocompromised individuals, and those with prolonged hospital stays. The fungus enters through inhalation or skin and spreads rapidly if not treated promptly with antifungal drugs and possibly surgery to remove infected tissue.

1. Genes and Cancer
Sushil Kumar
Cancer Biology and MSB Division
CSIR-CDRI Lucknow, India
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2. CSIR-CDRI
What is mucormycosis/Black fungus?
• Mucormycosis is a rare but serious infection that is caused by mucor
mould(mucormycete)
• Mucormycosis some times also called as zygomycosis
• According to the US Centre for Diseases Control and Prevention (CDC),
mucormycosis or "black fungus" infection is caused by a group of molds
called mucormycetes that are widely found in the environment.
• In India most of the patients infected with black fungus in between 12 to
15 days after recovery from Covid-19
• In European countries the symptoms of mucormycosis usually
appear two-three days after a person has recovered from the Covid-
19 infection
• From the sinus, the infection takes about two to four days to invade the
eyes, In the next 24 hours, the black fungus can travel up to the brain
• Black fungus is also known as Mucormycosis
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3. CSIR-CDRI
Is black fungus contagious?
Mucormycosis/Black fungus is not contagious
Human to Human
No transmission
Human to Animals
No transmission
Environment to Human
Transmission occur
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4. CSIR-CDRI
Common habitats of Black fungus
Mucormycetes generally found in the following habitats:-
-Soil
-Plants
-Manure
-Decaying fruits
-Vegetables
-Air
-Human body
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5. CSIR-CDRI
Organs in the human body which affects by Black Fungus
- Sinuses
-Brain
-Lungs
Note: Mortality rate of black fungal infected patients is approx. 50%
-Eyes
-Skin
These are the following organs of human body that affects by black fungal
infection :-
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6. CSIR-CDRI
Who is more prone to Black fungal infection
-Diabetic pateints especially with diabetic ketoacidosis
-Cancer patients
-HIV/AIDS patients
-Viral infected patients
• Severe immunocompromised patients are more susceptible to black fungal infections
• Excessive use of steroids for therapy also trigger black fungal infection
These patients are more sensitive to black fungal infection:
-Prolonged ICU stay
-Stem cell transplant
-Organ transplant
-Neutropenia(lower neutrophils)
-Too much iron in the body
-Skin injury due to surgery, burns, or wounds
-Prematurity and low birthweight
-kidney or heart failure patients
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7. CSIR-CDRI
Interrelation between Covid 19 infection & Black fungal infection
Covid 19 patient
Steroids therapy to the Covid 19 patient
Steroids reduce
inflammation in the
lungs
It reduce immunity and push up
blood sugar levels in both
diabetics and non-diabetic Covid-
19 patients
Patient may become immunocompromised
Body sensitive to black fungal infection
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8. CSIR-CDRI
Symptoms of mucormycosis
According to CDC symptoms depend on where in the body the fungus is growing for e.g.
Sinus and brain mucormycosis
-One-sided facial swelling
-Headache
-Nasal or sinus congestion
-Black lesions on nasal bridge
-Fever
-Black lesions on upper inside of the mouth
Lung mucormycosis
-Fever
-Cough
-Chest pain
-Shortness of
breath
Skin mucormycosis
-blisters or ulcers
-Pain
-Warmth (sensation of
being warm)
-Excessive redness
-Swelling around the
wound
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9. CSIR-CDRI
Other common Symptoms of black fungal infection
-Stuffy nose
-Bleeding nose
-Swelling of eyes
-Pain in the eye
-Drooping of eyelids
-Blurred vision
-Loss of vision
-Black patches of skin around the nose
-Redness around the eyes or nose
-Headache
-Coughing
-Shortness of breath
-Bloody vomits
-Altered mental status
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10. CSIR-CDRI
Infection path of Black fungus in the human
Black fungal spores in the surrounding environment
Spores enter in the human body through nose, eyes, skin & mouth
Germination of spore to form mature Mold body
Infection spread in the near by tissues
Finally it reaches in the brain
Death of the patients
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11. CSIR-CDRI
How to diagnose black fungal infection
Respiratory fluid sample for laboratory testing
Tissue biopsy of infected organ
CT scan of your lungs
CT scan of sinuses
MRI scans of brain
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12. CSIR-CDRI
How to save the life of black fungal infected patients
-By antifungal drugs therapy (amphotericin B )up to eight weeks
-Surgery of local infected organs(for example eyes, jaw bones etc.)
-Reduce steroid use in the therapy
-Discontinue immunomodulating drugs
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13. CSIR-CDRI
Life after surgery for mucormycosis
• Loss of the upper jaw
• Loss of eye
• Difficulty with chewing, swallowing, facial aesthetics and loss
of self-esteem
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14. CSIR-CDRI
Precautionary measures to protect yourself from black fungus
-Wear masks
-Wear shoes
-Wear long trousers
-Wear long-sleeved shirts
-Wear gloves when handle soil, manure
-Regular scrub bath for maintaining personal hygiene
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15. CSIR-CDRI
Government advisory for infection with mucormycetes
Mucormycetes should be suspected when there is:
• Sinusitis:- nasal blockade or congestion, nasal discharge
(blackish/bloody).
• Local pain on the cheek bone, one-sided facial pain, numbness or
swelling.
• Blackish discoloration over bridge of nose/palate.
• Loosening of teeth, jaw involvement.
• Blurred or double vision with pain.
• Thrombosis, necrosis, skin lesion.
• Chest pain, pleural effusion, worsening of respiratory symptoms.
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