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Black Fungus and Oral Care

You must have heard about black fungus that’s why you are reading this article.

There is so much hype about black fungus. There is so much fear around this word ”Black Fungus”

Amidst Corona virus Pandemic – Second Wave – India is hit by black Fungus disease  which is declared as epidemic in various states like Gujarat, Maharashtra, Kerala, Tamil Nadu.

Black fungus has become a serious threat to people and created burden on our healthcare system. As a healthcare worker I have seen people struggling with this disease and some people have really lost one or more organs of the body like eyes ,upper jaw and lower jaw .

So its better to learn about this disease and be alert so that you can save your near and dear ones

 

Statistics

Let’s have a look at some statistics

 

  • It was a rare occurence before Covid

 

  • 3 in 10,000 Covid cases

 

  • 50 % mortality rate that is if 100 people get infected by black fungus then 50 persons survive and 50 persons die

 

 

What is Black Fungus?

Black Fungus also called Mucormycosis is is a disease caused by fungi belonging to the fungal family ‘Mucorales’,a rare but dangerous infection caused by group of moulds mucormycetes -fungus already present in the environment.It affects sinuses,lungs,skin and brain. It can affect humans through soil,compost and bread.These fungi generally infect people with an impaired immune system.The species of black fungus are Rhizopus,Mucor,Rhizomucor species.It is an opportunistic infection that means it gets the opportunity to infect people if the immunity is very low

Black Fungus – Misnomer

Wrong term given as black fungus

As the fungus is not black in colour it is white but it creates crusting on your tissues which is black in colour so termed as black fungus.The fungus is angioinvasive that means the fungus enters and blocks the blood vessel due to lack of blood supply tissue dies and turns black

 

Can Black Fungus spread from one person to another?

No black fungus cannot spread from one person to another.Unlike Covid – Mucormycosis is not contagious disease.

 

Types of disease:

Disease can be named according to the site affected:

  1. Rhino cerebral Mucormycosis- It involves Sinus and brain Symptoms could be toothache,headache,nasal or sinus congestion,black lesions on nasal bridge and fever
  2. Pulmonary-It involves lungs .The symptoms could be fever,cough,chest pain and shortness of breath
  3. Gastrointestinal-abdominal pain, nausea,vomitting and gastrointestinal bleeding
  4. Cutaneous – It involves skin and the symptoms are blackness around wound
  5. Disseminated-

 

 

How do you know if you are suffering from black fungus?

You have to alert and really look for the following changes,if any

 

  1. Pain and redness around eyes and nose
  2. Fever,Headache and coughing
  3. Any Black discolouration in your mouth,tongue,cheeks and gums
  4. Swelling over any part of your face
  5. Tooth mobility (loosening of teeth
  6. Toothache or pain in areas of face

 

 

 

High risk factors (Who can get the infection??)

Diabetic patients(Uncontrolled diabetes)

Covid 19 Patients

Excessive use of steroids

Prolonged ICU Stay

Co-morbidities- Post transplant/Malignancy

Weak immunity system

Zinc supplements

 

Diagnosis:

  1. Nasal swab
  2. Nasal endoscopy
  3. MRI
  4. Biopsy
  5. CT Scan

 

 

 

 

 

Interdisciplinary Team required for treatment

  1. Microbiologist
  2. Internal Medicine specialist
  3. Intensivist
  4. ENT Specialist
  5. Ophthalmologist
  6. Dentist
  7. Surgeon

 

 

Treatment

1.Anti fungal medicines- Posaconazole and Amphotericin B are the most preferred anti fungal drugs for treatment.The drugs are advised for atleast 3 to 6 weeks along with other medications

2.Surgery- Debridement surgery is performed on the affected areas like eyes and sinus.The debridement of the infected area is done

3.Exenteration Surgery-Sometimes the infected part has to be removed in order to restore life and the surgery done to remove the infected part is called as Exenteration surgery.

 

What is white fungus and Yellow fungus ?

Aspergillus is called as white fungus and the mould which is grown on bread is aspergillus and the symptoms are white patches on tongue and

Ears and eyes may also be affected

No need for names like white fungus and yellow fungus

The name is given based on symptoms and not on the colour of the fungus.

 

 

Oral Care Tips

  • Maintain proper oral hygiene-Make sure to check bad smell from your mouth,loose tooth,discolouration in gums or any other oral area.
  • Visit your dentist regularly as it will help to detect any dental problem easily as well as black fungus symptoms can be detected at an early stage.
  • Toothbrushing- Brushing twice a day for 2 minutes is recommended for maintaining proper oral hygiene
  • Flossing & Interdental brushing-It can keep clean tooth and healthy gums.They both effectively removes food particles in between the two teeth.
  • Oral Rinsing- It reduces the microbial load and helps to reduce infection through saliva.It can be done by Chlorhexidine mouthwash

 

  • Disinfecting toothbrush and tongue cleaner-Keep separate oral hygiene kit for each family member as it will prevent infection spreading from 1 person to another.

 

  • Discard toothbrush and tongue cleaner after Covid infection- Mouth is the home for microorganisms and toothbrush carries the virus and other microorganisms present in the mouth so it is better to discard toothbrush after Covid infection.

 

 

 

 

 

PREVENTION IS BETTER THAN CURE

 

 

  • Regularly monitor blood glucose after Covid in diabetic patients

 

  • Maintain oral hygiene and overall hygiene

 

  • Don’t stop wearing masks even after recovery from Covid

 

  • Wear clean mask everyday- A mask can harbour microorganisms and can cause black fungus .So wear a clean surgical mask everyday.

 

  • Wash your mask regularly ,if cloth masks re used

 

  • Vaccination– It is the most proactive step you can take to save yourself from the coronavirus and also black fungus.As a wise citizen of the country you should go for vaccination.

 

 

 

Conclusion:

Black Fungus is a dangerous disease amidst Covid pandemic but we all can defeat it by being alert towards any of the symptoms mentioned in the above article.

If you suffer from any of the symptoms do visit your physician on a urgent basis so that they can cure mucormycosis at the right time and prevent fatality.

You have also learned through this article how you can maintain proper oral hygiene as the mouth is the primary area of infection.Another important point to be noted is vaccination .

 

I request all the citizens to get vaccinated as soon as possible so that we can create a safe place for everyone .

In last I want to give you a message —–

“When we are living a sustainable life we should be grateful for every breathe we take and we should not take our life for granted”

If you like this blog also refer to my webinar on black fungus and oral care as I have answered publicly and bursted some myths around it

https://youtu.be/_5KKqCeb4Fg

Please find the attached link and get what you are looking for about black fungus.