INTRODUCTION:

Black fungus, also known as Mucormycosis, it rare but dangerous infection. Black fungus is caused by gettimh into contact with fungus spores in tje environment. It can also form in the skin after the fungus enters through a cut, scrape, burn, or another type of skin trauma.

Fungi live in the environment, perticularly in soil and decaying organic matter such as leaves, compost piles, rotten wood, and so on. The fungul infection is caused by a type of mould known as ‘mucromcetes’. It should be noted that this rare fungal infection affects person who have health issues such as deabetes, asthama, or anyu chronic disease OR person eho has a les immunity power

Where does black fungus come from?

Black fungus (mucormycosis) is a complication caused by a fungai infection. People catch mucormycosis by coming in contact with the fungal spores in the envornment.

It can also occure in the skin once the fungus enters through a cut, scrape, burn, or another sort of skin damage.

Why it is occuring in covid-19 patients?

· Mucormycosis can occure after covid -19 infection, wheather during the hospital stay or a few weeks after discharge.

· The COVID-19 generates a sudden change in the interior enviornment of the hos for the fungus, and the medical treatment administered unknowing promotes fungul development. Covid-19 causes harm to the airway mucosa and blood vessels. It also causes a rise in serum iron, which is required to the fingus to grow. Long-term use of ventilator decrease imunity, and thereis conjecture that the humidifier water that is delivered along with the oxygen transfers the fungus.

· The mucormycosis also generates by steroids which is given to the covid-19 patients, because steroids directly affect to the body’s immune system.

How Black fungus affects non-covid people?

· Mucormycosis is a fungul infection that primarily affects patients with compromised immune system, but it can also affect non-covid people. Experts warn if left untreated, this can become dangerous.

Sign And Symptoms of Mucormycosis:^3,4,11

· The sign to watch out for are a stuffy nose, Bloody, blackish or brown discharge from the nose, blackish discolouration of the skin, swelling or numbness around the cheek, one side facial pain, thoothache or jaw pain droping of eyelids or eyelid swelling, double vision, redness of eyes and sudden decrease vision

· Mucormycosis is present itself as either a respiratory or skin infection

· Mucormycosis can develop within any part of your body

· If may initially occure at the site of skin trauma but it can quickly spread to another area

· Black fungus symptoms mainly show some symptoms including running nose

· You may feel swelling and pain your eyes

· black fungal infection covid, eyelid loss and blurred vision

· Darkspot can also be seen around the nose of the infected patient

· Sign and symptoms fever

· Headache

· Nasal congestion

· Sinus pain

· Visual problem

· Blister

· Ulcer

· Facial pain

· Redness

· Dark scabbing in the nose by eyes

· Bloody and dark vomits

· Swelling

· Blocked skin tissue

· Shortness of breath

· Symptoms of sinus and brain (rhinocerebral) mucormycosis

· One sided facial swelling

· Headache

· Nasal or sinus congestion

· Blank lession on nasal Bridge or upper inside of mouth quickly

· Symptoms of Lung (pulmonary) mucormycosis

· Fever

· Cough

· Check pain

· Shortness of breath skin (cutaneous) mucormycosis blister and ulcer excessive

· Redness

· Warmth

· Swelling around wound Symptoms of (gastrointestinal) mucormycosis

· Abdominal pain

· nausea and vomiting

· gastrointestinal bleeding

Mucormycosis causes:^5,6,12

Several different types of fungi can cause mucormycosis. These fungi are present throughout the environment, particularly in soil and in association with decompose organic matter, such as leaves, compost piles, and animal dung. They are more common in soil than in air, and in summer and fall than in spring.

These fungi aren’t harmful to most people. However, for people who have weakened immune systems, breathing in mucormycete spores can cause an infection in the sinuses which can spread to other parts of the body. Most people come in contact with microscopic fungal spores every day, so it’s probably impossible to completely avoid coming in contact with mucormycetes.

Types of fungi that cause mucormycosis The most common types that cause mucormycosis are

· Rhizopus species

· Mucor species.

Other examples include; Rhizomucor species, syncephalastrum species, Cunninghamela bertholletiae, Apophysomyces lichtheimia, saksenaea and rhizomucor. You can contract mucormycosis by breathing in affected mold spores in the air.

This is referred to as a pulmonary exhibition. In turn, you may develop the infection in your:

· Central nervous system (rarer)

· Eyes

· Face

· Lungs • sinuses.

These fungus can also infect your skin via a cut or burn (cutaneous exposure). In such cases, the wound or burn ends up becoming the area of infection.While these types of molds can naturally occur in the environment, not everyone exposed will get the fungal infection. You may be at an increased risk of contracting this type of infection if you have a weakened immune system.

Conditions that may increase your risk include:

· Burns

· Cuts and scrapes

· Cancer

· Recent organ transplant

· HIV or AIDS

· Diabetes (especially if it’s not being treated properly).

Treatment of mucormycosis:^7,8,9,10

Mucormycosis is a life threatning infection caused by fungi of the order mucorales.

Mucormycosis typically occurs in patients with diabetes mallitus, organ or hematopoitic stem cell transplantation, neutropenia or hematopoitic.

It is difficult to have robust data for the treatment of mucormycosis, because it is a rare disease, characterised by heterogeneity of hosts and sites of infection, as well as the multitude of offending. Mucorales; therefore, no prospective, randomised clinical studies exist. Information regarding the current approach to treatment is based on single-institution, retrospective studies including a limited number of patients with significant variability in their presentation and risk factors, registries with methodological flaws, and “expert opinions.

There is some stratergies for treatment of mucormycosis (black fungus) such as:

1. Early diagnosis

2. Surgical Debriment (if applicable)

3. Promot Antifungal Therapy

1. Early Dignosis:

Many people don’t know that they have mucormycosis, that’s why they are not capable to take a proper treatment, because of lack of time.

There are some methods to dignose mucormycosis such as:

CT Scan

MRI Scan’s

The most commom finding by CT scanning of patients with rhino-orbital-cerebral disease is simply sinusitis, so absence of deeper infection by CT scan does not rule out mucormycosis.

CT scan are usefull for early detection pf pulmonary mucormycosis.

MRI’s are more sensetive than CT scan’s for detecting orbital and CNS involvment.

Surgical Debriment:

Surgical debridement is the key to controlling and eliminating mucormycosis,but anti-fungal treatment is also typically used in combination.⁹ Studies confirm amphotericin-B. liposomal 3.0mg/kg accompanied by aggressive surgical debridement, up to and including amputation, is reasonably effective.

Promote Antifungal Therapy:

In antifungal therapy the primarily stge is dispence of antifungal medicines to the patient Such as;

Amphotericine B (Trough an IV)

Posaconazole (through IV and salline)

Isavucanazole (through IV and salline)

Amphotericine B

Molecular Formula of Amphotericine B:

· Amphotericin B is an antifungal medication used for serious fungal infections and leishmaniasis .

· Amphotericin B was isolated from Streptomyces nodosus in 1955 at the Squibb For Medical Research Institute from cultures isolated from the streptomycete obtained from the river bed of Orinoco in that region of Venezuela Posaconazole:

Molecular formula of Posaconazole:

Posaconazole is a novel lipophilic antifungal triazole that inhibits cytochrome P450-dependent 14alpha demethylase in the biosynthetic pathway of ergosterol.

Isavuconazole:

Molecular Formula of Isavuconazole:

Isavuconazole has broad-spectrum antifungal activity against Candida spp., Aspergillus spp., Fusarium spp. and several species of the Mucorales.^136-139 Isavuconazole is approved for primary treatment of invasive aspergillosis and mucormycosis in adult patients.

Isavuconazole is active against experimental murine disseminated mucormycosis by Rhizopus oryzae.

Isavuconazole was as effective as liposomal amphotericin B in improving survival and decreasing residual fungal burden in cyclophosphamide/cortisone acetate immunosuppressed mice.

CONCLUSION:

Here by we conclude our study by giving in detail infection regarding fungal infection occurring in post COVID-19 patients. The above information has been gathered with the help of various information on internet, books, newspaper and other source. We also conclude by stating that the fungal infection occurring in post COVID-19 patients is one of the sever and hazardous infection till death.

ACKNOWLEDGEMENT:

We are thankful to google scholler & ahinsa Institute of pharmacy for providing us Guidance of proff. Suraj K. Ishikar and the available facilities of college library to do work.

REFERENCE:

1. https://www.cdc.gov/fungal/diseases/mucormycosis/treatment. html

2. https://www.cdc.gov/fungal/diseases/mucormycosis/treatment. html

3. https://www.healthline.com/health/mucormycosis#diagnosis

4. https://www.cdc.gov/fungal/disease/mucormycosis/sympto ms.html

5. https://www.cdc.gov/fungal/diseases/mucormycosis/causes.ht ml

6. https://www.healthline.com/health/mucormycosis

7. https://www.sciencedirect.com/topics/pharmacologytoxicology-and-pharmaceuticalscience/isavuconazole

8. https://www.healthline.com/health/mucormycosis

9. .https://www.cdc.gov/fungal/diseases/mucormycosis/treatment. html#:~:text=Mucormycosis%20is%20a%20serious%20infectio n,mouth%20(posaconazole%2C%20isavuconazole)

10. https://www.cdc.gov/fungal/diseases/mucormycosis/causes.ht ml

11. https://www.google.com/search?q=mucormycosis&client=m s-android- oppo&prmd=nibv&sxsrf=ALeKk01jrzm7puQvkiicyCFtyRwg2t 9ZsA:1624425694311&source=lnms&tbm=isch&sa=X&ved=2 ahUKEwiCmuSjga3xAhX2zjgGHZiQA18Q_AUoAnoECAIQA g&biw=360&bih=692&dpr=3#imgrc=gE8o_JSsO_gG5M&img dii=yw_BvxENBwMdvM

12. https://www.google.com/search?q=mucormycosis&client=m s-android-oppo&prmd=nibv&sxsrf=ALeKk01jrzm7puQvkiicyCFtyRwg2t 9ZsA:1624425694311&source=lnms&tbm=isch&sa=X&ved=2 ahUKEwiCmuSjga3xAhX2zjgGHZiQA18Q_AUoAnoECAIQA g&biw=360&bih=692&dpr=3#imgrc=KM5S86JW8TcoXM&i mgdii=gE8o_JSsO_gG5M

Received on 03.04.2022 Modified on 02.05.2022

Res. J. Pharmacognosy and Phytochem. 2022; 14(3):204-207.

DOI: 10.52711/0975-4385.2022.00036