Mucormycosis – Nepal

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The southwestern Dang district of Nepal reported the death of 2 people due to Mucormycosis also called Black Fungus.

The disease is often observed in immunocompromised patients. In this case, the patients had comorbidities (one was diabetic and another was a dialysis patient; however both were corona positive).

The symptoms of mucormycosis are one-sided facial swelling, headache, nasal or sinus congestion, blurred vision and pain in eye, black lesions on nasal bridge or upper inside of mouth.

Indiscriminate use of steroids to treat Covid-19 is linked to mucormycosis. Around 11 people are undergoing treatment. There is a shortage of drugs, Amphotericin B and Deoxycholate used for the treatment which is addressed by the health authorities.

The health authorities are preparing to buy an extra 10,000 vials of the drugs from WHO and the international market for mucormycosis treatment.

Photo: Mucor fungus species.

Mucormycosis is a fungal infection. Generally, species in the Mucor, Rhizopus, Absidia, and Cunninghamella genera are most often implicated.

Common sources of infections are from soil and damp walls on old buildings.

It can infect the sinuses and brain, lungs, skin and digestive tract. The infection in some cases also spreads through the bloodstream where it can result in the formation of blood clots and tissue death in the surrounding areas. Patients with this disease frequently need amputations due to necrotized tissue when blood clots form.

Mostly mucormycosis occurs with underlying conditions such as diabetes, HIV, lymphomas kidney failure and immunosuppressive therapy. However, in some cases infection is reported without any predisposing factors present.

It has been reported in association with COVID-19 and may be caused by treatment with corticosteroids.

It is a very rare infection. Hospital outbreaks are a risk where infection can spread through contaminated hospital linen.

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