Black fungus
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  • Some hospitals in India have seen a rise in mucormycosis, a life-threatening infection known as "black fungus."
  • Experts say steroids used to treat COVID-19 may be linked fueling the uptick by dampening patients' immune systems.
  • One doctor in Mumbai said 11 of his patients have required life-saving eye removal surgery.
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In the wake of India's second wave of COVID-19, hospitals are reporting an uptick in cases of mucormycosis or "black fungus" – a serious but rare fungal infection.

Dr. Akshay Nair, an eye surgeon who works at three hospitals in Mumbai, India, told the BBC he saw at least 40 patients with the fungal infection in April alone.

That's a huge uptick from the average amount: he had only seen 10 cases of mucormycosis in the past two years, Nair said.

The majority of patients had diabetes and developed symptoms two weeks after recovering from COVID-19. Eleven of the patients had to have surgery to remove an eye to stop the spread of the infection, which is lethal in 50% of cases.

Nair told the BBC doctors believe that steroids, a treatment that has proven effective in treating those severely ill with COVID-19, may play a role in fueling the infections. While steroids reduce inflammation and prevent lung damage in those with COVID-19, it also suppresses the immune system.

"Diabetes lowers the body's immune defenses, coronavirus exacerbates it, and then steroids which help fight Covid-19 act like fuel to the fire," Nair told the BBC.

There is no data counting mucormycosis cases across the world, and Indian officials have said there is no major outbreak, according to Reuters.

However, one expert said the numbers appear to be higher in India, which has a high rate of diabetes, than in other countries.

"There have been cases reported in several other countries - including the UK, US, France, Austria, Brazil and Mexico, but the volume is much bigger in India," David Denning, a professor at Manchester University, told Reuters. "And one of the reasons is lots and lots of diabetes, and lots of poorly controlled diabetes."

Black fungus symptoms

Indian government officials have told doctors to be on the lookout for symptoms of mucormycosis.

It is caused by coming into contact with fungal spores, which can be found in soil, plants, and manure.

According to the Centers for Disease Control and Prevention, early symptoms include:

  • One-sided facial swelling
  • Headache
  • Nasal or sinus congestion
  • Fever

Symptoms can escalate to:

  • Blackening of the nose
  • Blurred or double vision
  • Chest pain
  • Breathing difficulties
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