Black fungus symptoms, causes, and treatment explained. Learn about early signs, risk factors, and medical care for mucormycosis with guidance from GetWellGo.
Black fungus generally refers to a severe fungal infection known as mucormycosis. The infection is caused by a family of molds named mucormycetes that are present in the environment, particularly in soil, rotting organic matter, and compost.
Important Facts regarding Black Fungus (Mucormycosis):
Etiologic agents: Mucormycetes fungi, particularly from genera such as Rhizopus, Mucor, and Lichtheimia.
Appearance: Refers to as "black fungus" due to the black discoloration that may occur in infected tissues, particularly on the face or nasal cavity.
Mode of Infection: Most often infects individuals who breathe in the fungal spores. It may also penetrate through wounds or skin trauma.
Types of Mucormycosis:
Rhinocerebral (sinus and brain) – most frequently occurring form, particularly among diabetic or immunocompromised individuals.
Pulmonary (lungs) – prevalent among cancer patients or organ transplant recipients.
Gastrointestinal – typically occurs in young children.
Cutaneous (skin) – follows skin injury or surgery.
Disseminated – spreads via the blood and affects several organs.
Black Fungus Symptoms
Black fungus (mucormycosis) can have varying symptoms depending on where in the body the infection lies, but the most frequent and life-threatening is rhinocerebral mucormycosis (sinuses, brain, and face).
Following are the key symptoms based on the type of mucormycosis:
General Symptoms of Black Fungus (Rhinocerebral Mucormycosis):
Swelling or pain in the face, one-sided
Black or discolored nasal, mouth, or palate patches
Nasal discharge or congestion, blackish
Headache
Fever
Eye swelling, redness, or bulging of the eye
Blurred or double vision
Loss of vision
Facial numbness or paralysis
Toothache or loosening of teeth
Difficulty chewing or opening the mouth
Mental confusion or drowsiness (if brain is involved)
Pulmonary (Lung) Mucormycosis:
Fever
Cough
Chest pain
Shortness of breath
Blood-tinged sputum
Cutaneous (Skin) Mucormycosis:
Blisters, ulcers, or blackened skin
Redness, swelling, and tenderness
Localized pain or warmth at the site
Gastrointestinal Mucormycosis (Rare):
Abdominal pain
Nausea or vomiting
Gastrointestinal bleeding
Swelling in the abdomen
Disseminated Mucormycosis (Spreads in the body):
Mental status changes
Coma
Multiple organ failure (in severe cases)
Black Fungus Treatment
Mucormycosis is an emergency condition, and treatment should be prompt and aggressive. Early diagnosis and treatment are better for survival.
Antifungal Medication
Treatment of choice is intravenous antifungal therapy:
Primary Antifungal Drugs:
Liposomal Amphotericin B
Most widely used and effective
High doses (5–10 mg/kg/day) intravenously
Posaconazole or Isavuconazole
As alternatives or oral follow-up therapy after Amphotericin B
Used also if Amphotericin B cannot be tolerated
Duration: Therapy is usually continued for 4–6 weeks or longer, based on severity and response of the patient.
Surgical Debridement
Such infected tissue must be urgently removed.
May include:
Removal of dead tissue from sinuses, eyes, or brain
In severe cases, removal of an eye (orbital exenteration) to prevent further spread
This reduces the chance of spread of the fungus and increases the efficacy of antifungal therapy.
Control of Underlying Conditions
Tight control of blood sugar in diabetic patients
Discontinue or taper corticosteroids or immunosuppressive medications (with medical supervision)
Enhance immunocompetence, if feasible (e.g., in patients with cancer or transplant recipients)
Supportive Care
Oxygen therapy (if needed)
Nutritional management
Kidney and liver function monitoring during antifungal therapy (particularly with Amphotericin B)
Black Fungus Causes
Black fungus is caused by a family of molds known as mucormycetes, which are present naturally in the environment (soil, rotting leaves, compost, and animal manure). When these fungi infect the body of an immunocompromised individual, they produce a severe, frequently fatal infection named mucormycosis.
How It Enters the Body?
Inhalation of fungal spores (most common)
Spores are inhaled into the sinuses or lungs by breathing.
Ingestion (rare)
Food or water containing the contamination.
Skin exposure
By cuts, burns, wounds, or operative wounds.
Black Fungus in Humans
Human black fungus is a term for an uncommon but life-threatening fungal infection known as mucormycosis, which results from contact with mucormycetes, a collection of molds that occur naturally in the environment.
Why It's Dangerous?
Quickly advancing and possibly lethal if not treated promptly.
Especially targets individuals with compromised immune systems.
Can penetrate blood vessels, leading to cell death, resulting in the blackened appearance in infected areas.
How It Affects Humans
It usually infects:
Sinuses
Lungs
Brain
Eyes
Skin
Gastrointestinal tract (rare)
Black Fungus Disease
Black fungus disease, also referred to as mucormycosis, is a rare but serious fungal infection produced by molds termed as mucormycetes. It mainly attacks individuals with compromised immune systems, and if not treated immediately, can result in serious complications or even cause death.
Infected medical devices (e.g., humidifiers, oxygen tubing)
How to prevent black fungus?
Preventing black fungus (mucormycosis) is most critical for individuals with compromised immunity, including those recovering from COVID-19, diabetes, or those undergoing steroids or oxygen therapy.
Control Underlying Health Conditions
Maintain blood sugar in check, particularly if diabetic.
Monitor blood glucose frequently, even post-COVID-19 recovery.
Avoid steroids, or restrict their use, unless absolutely essential and under medical guidance.
If immunocompromised (e.g., cancer, transplant recipient), observe strict infection control measures.
Maintain Personal Hygiene
Bathe every day and maintain skin, hair, and nails clean and dry.
Wash face and hands often.
Wash wounds well and cover with sterile dressings.
Maintain Clean Medical Equipment (Particularly in COVID Care)
Use oxygen humidifiers with sterile water.
Disinfect and clean nebulizers, masks, and oxygen tubes daily.
ICU and ventilator equipment should be sanitized strenuously by hospitals.
Minimize High-Risk Environments
Avoid dusty or moldy sites such as construction, old structures, and compost piles.
If you have to visit such sites:
Wear N95 masks
Wear gloves, shoes, long sleeves, and pants
Boost Immunity Naturally
Eat a balanced and healthy diet that is full of vitamins and minerals.
Rest well and take care of your stress.
Don't smoke and drink.
Watch for Early Symptoms
Be aware of:
Nasal congestion or black discharge
Swelling or pain in the face, eyes, or nose
Eye or vision issues
Fever or headache that does not change
Black Fungus Diagnosis
Diagnosis of black fungus (mucormycosis) mandates immediate medical examination since prompt diagnosis is essential to avoid severe complications or death.
Step-by-Step Diagnosis Process
Clinical Evaluation
History check:
Recent COVID-19 infection
Diabetes, steroid use, immunosuppression
Symptom review:
Facial swelling, black nasal discharge, eye pain, loss of vision, high fever persisting, chest pain, or wound infection
Physical Examination
ENT inspection (nasal cavity, sinuses)
Eye examination for swelling or visual impairment
Oral cavity examination for black ulcers or lesions
Imaging Tests
Used to check how extensive the infection has become.
CT scan (of sinuses/chest/brain): To check for tissue damage, bone loss, or involvement of the lungs
MRI scan: Is superior for brain or orbital (eye) involvement
Laboratory Tests
These are used to confirm the diagnosis of the fungus:
Nasal endoscopy with tissue biopsy:
Sample from infected tissue (sinuses, nose, or lung)
Most definitive test
KOH mount or fungal staining:
Identifies fungal elements under a microscope
Culture test:
Specifically identifies the fungus from tissue or fluid
Histopathology:
Demos tissue invasion by fungi
Blood tests:
Screen for immune function, kidney function, blood sugar
Black Fungus Risk Factors
Black fungus, or mucormycosis, is an aggressive fungal infection that mainly influences human beings with compromised immunity. The risk of infection will increase drastically while one or extra of the subsequent risk factors are present:
Uncontrolled Diabetes
COVID-19 Infection
Excessive or Prolonged Steroid Use
Immunosuppression
Long ICU Stay or Hospitalization
Iron Overload
Skin Trauma or Wounds
Malnutrition
Environmental Exposure
Black Fungus in India
Black fungus (mucormycosis) became a serious public health difficulty in India, mainly throughout and after the second wave of COVID-19 in 2021. India saw one of the maximum international surges of mucormycosis cases at that point.
Why India Was Severely Affected?
High Prevalence of Diabetes
Steroid Misuse During COVID-19
Prolonged Oxygen Therapy
Poor Infection Control in Some Settings
Is black fungus contagious?
No, black fungus (mucormycosis) is not contagious.
It Does Not Spread:
Person to person
By touch, coughing, sneezing, or talking
By eating, drinking, or using food and water, utensils
How It Spreads:
Black fungus is due to fungal spores (mucormycetes) found in the environment, particularly:
Soil
Rotting leaves or compost
Animal feces
Air (dusty, damp conditions)
People breathe in the spores, or the fungus gets in through wounds, cuts, or operating wounds, particularly when the immune system is compromised.
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