Review Article
IntroductIonCOVID-19 has created a vast impact on general population and health-care sector, since it was declared as pandemic by the WHO on March 11, 2020. [1] With emergence of second wave, there is increasing number of cases each day leading to scarcity of health-care resources affecting the outcome of the treatment. With all these consequences, COVID-19 has become India's fastest growing epidemic. [2] Among this crisis, there is increased incidence of mucormycosis, which is considered highly fatal. Mucormycosis is an angioinvasive opportunistic fungal infection caused by the ubiquitous filamentous fungi of the Mucorales order of the class of Zygomycetes. It was first described by Paultauf in 1889. [3] Mucormycosis, also referred to as Zygomycosis, is third most common invasive mycosis after candidiasis and aspergillosis in patients with compromised immunity, underlying debilitating systemic diseases, and hematological abnormalities. [4] The common Mucorales species involved are Rhizopus, Lichtheimia, and Mucor. Other species such as Rhizomucor, Saksenaea, Cunninghamella, and Apophysomyces are rare. Mucorales are ubiquitous, present mainly in bread molds, decaying foods, soil, and in putrefying organisms. The major route of infection is through inhalations of the airborne fungal spores, which can then spread to the paranasal sinuses (PNS), lungs, and extensive tissue involvement. [5] Six well recognized clinical forms of mucormycosis are the pulmonary, cutaneous, gastrointestinal, rhinocerebral, central nervous system, and disseminated. Rhinocerebral form followed by pulmonary is the most common type of this invasive infection. [6] Mucormycosis, commonly regarded as black fungus, is one of the most tissue destructing and devastating complications in uncontrolled diabetics with high fatality rates ranging between 60 and 80%. It is well established that there is direct association between diabetes and the severity of SARS-CoV-2 infection and thus diabetics are at higher risk of contracting the secondary opportunistic mucormycosis during COVID-19 infection. [7] However, it is offlate affecting individuals below 40 years without any comorbidities. Stress along with usage of corticosteroids could probably being the cause. Infection with mucormycosis is considered highly fatal due to its fulminating spread, disseminated infection, cavernous sinus thrombosis, carotid artery involvement, osteomyelitis, and death. [8] Emergence of "Black fungus" in this Covid-19 pandemic has created an situation of medical emergency. Black fungus, scientifically known as mucormycosis, is an rare opportunistic invasive fungal infection caused by Mucorales affecting uncontrolled diabetics, immunocompromised patients, patients with stem cell transplant, prolonged intensive care unit stay and in those with hematological abnormalities. Offlate, there has been upsurge of this potentially fatal infection in COVID patients and in post-COVID scenario due to the mutant strain and treatment protocol followed in COVID patients. Elev...
