The resurgence of black fungus in the context of Covid -19 second wave epidemic in India
Formar faculty member, Department of internal Medicine, G.I.T.A.M. Dental college, G.I.T.A.M. University campus, Rushikonda, Visakhapatnam, Andhra Pradesh, India.
Review Article
World Journal of Advanced Research and Reviews, 2021, 11(02), 173–183
Article DOI: 10.30574/wjarr.2021.11.2.0382
Publication history:
Received on 12 July 2021; revised on 14 August 2021; accepted on 16 August 2021
Abstract:
There is a sudden surge of the cases of the black fungus infection ((mucormycosis / Zygomycosis), at a time when India is reeling under a catastrophe created by the second wave of Covid -19. it is like a 'medical tsunami, ' that ravaged the health care system and the administration alike, both being caught unaware. In the beginning, there is an acute shortage of hospital beds earmarked for this infection, and the lifesaving drug, the liposomal Amphotersin B, coupled with the appalling morbidity, mortality, not to speak of the financial burden and the resource crunch, that is inflicted by it.This article briefly reviews the black fungus infection in India, in the pre and post Covid -19 eras. The risk factors for the black fungus, both Covid associated (CAR) as well as non-Covid -19 associated, are discussed. The host as well as pathogen related factors, in the pathogenesis of the black fungus infection, are explored. An alternative explanation to diabetic ketoacidosis, (DKA) in providing the acidic pH required by the fungus, is hypothesized, as the occurrence of the infection, in the absence of DKA, remained inexplicable. It may be noted that the acidic pH is responsible for making available, the free iron from the host ‘s serum, that is needed for the sustenance, grouth and multiplication of the fungus, as well as causing phagocytic dysfunction in the host. The different clinical presentations of mucormycosis, their salient clinical features and the management are outlined in the present article.
Keywords:
Black fungus; Mucormycosis; Covid 19; Amphotericin B; Diabetes Mellitus Type 2; Immunosuppression, Rhino-Orbito-cerebral mucormycosis
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Copyright © 2021 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0