BROUGHT TO YOU BY

s
MR. PIYUSH WAGH

MUCURMYCOSIS ASSISTANT PROFESSOR

GCON JALAGAON
 About Mucor mycosis

 Mucor mycosis (previously called zygomycosis , Black Fungus) is a serious but rare fungal
infection caused by a group of molds called mucor mycetes. 
 These molds live throughout the environment.
 Mucor mycosis mainly affects people who have health problems or take medicines that
lower the body’s ability to fight germs and sickness.
 It most commonly affects the sinuses or the lungs after inhaling fungal spores from the
air.
 It can also occur on the skin after a cut, burn, or other type of skin injury

 s
 What is mucor mycosis?
 Mucor mycosis (sometimes called zygo mycosis) is a serious but rare fungal
infection caused by a group of molds called mucor mycetes.  

 These fungi live throughout the environment, particularly in soil and in decaying
organic matter, such as leaves, compost piles, or rotten wood. 
 CONT.

 People get mucor mycosis by coming in contact with the fungal spores in the
environment.
 For example, the lung or sinus forms of the infection can occur after
someone breathes in spores. These forms of mucor mycosis usually occur in
people who have health problems or take medicines that lower the body’s
ability to fight germs and sickness.
 Mucor mycosis can also develop on the skin after the fungus enters the skin
through a cut, scrape, burn, or other type of skin trauma.
 Types of mucor mycosis
 Rhino cerebral (sinus and brain) mucor mycosis is an infection in the sinuses that
can spread to the brain.
 This form of mucor mycosis is most common in people with uncontrolled diabetes
and in people who have had a kidney transplant.

 Pulmonary (lung) mucor mycosis is the most common type of mucor mycosis in
people with cancer and in people who have had an organ transplant or a stem cell
transplant.
 Gastrointestinal mucor mycosis is more common among young children than
adults, especially premature and low birth weight infants less than 1 month of age,
who have had antibiotics, surgery, or medications that lower the body’s ability to
fight germs and sickness.
 CONT.
 Cutaneous (skin) mucor mycosis: occurs after the fungi enter the body through a
break in the skin (for example, after surgery, a burn, or other type of skin trauma).
This is the most common form of mucor mycosis among people who do not have
weakened immune systems.

 Disseminated mucor mycosis occurs when the infection spreads through the

bloodstream to affect another part of the body. The infection most commonly affects
the brain, but also can affect other organs such as the spleen, heart, and skin.
 Symptoms of Mucor mycosis
 The symptoms of mucor mycosis depend on where in the body the fungus is growing.

 Symptoms of rhino cerebral (sinus and brain) mucor mycosis include:

• One-sided facial swelling
• Headache
• Nasal or sinus congestion
• Black lesions on nasal bridge or upper inside of mouth that quickly become more severe
• Fever
Symptoms of pulmonary (lung) mucor mycosis include:

• Fever
• Cough
• Chest pain
• Shortness of breath

• Cutaneous (skin) mucor mycosis can look like blisters or ulcers, and the
infected area may turn black.
• Other symptoms include pain, warmth, excessive redness, or swelling around a
wound.
Symptoms of gastrointestinal mucor mycosis include:

• Abdominal pain

• Nausea and vomiting

• Gastrointestinal bleeding
 CONT.
 Disseminated mucor mycosis typically occurs in people who are already sick from other
medical conditions, so it can be difficult to know which symptoms are related to mucor
mycosis.

 Patients with disseminated infection in the brain can develop mental status changes or
coma.
 People at Risk & Prevention
 Who gets mucor mycosis?

• Diabetes, especially with diabetic ketoacidosis

• Cancer

• Organ transplant

• Stem cell transplant

• Neutropenia -LOWER white blood cell

 CONT.
• Long-term corticosteroid use

• Injection drug use

• Too much iron in the body (iron overload or hemochromatosis)

• Skin injury due to surgery, burns, or wounds

• Prematurity and low birthweight (for neonatal gastrointestinal mucormycosis)

 How does someone get mucor mycosis?
 People get mucor mycosis through contact with fungal spores in the environment.

 For example, the lung or sinus forms of the infection can occur after someone inhales
the spores from the air.

 A skin infection can occur after the fungus enters the skin through a scrape, burn, or
other type of skin injury.
 How can lower the risk of mucor mycosis?
 There is no vaccine to prevent mucor mycosis.

 Protect yourself from the environment.

 Try to avoid areas with a lot of dust like construction or excavation sites. If you can’t
avoid these areas, wear an N95 respirator (a type of face mask) while you’re there.

 Avoid direct contact with water-damaged buildings and flood water after hurricanes and
natural disasters. 
 CONT.
Avoid activities that involve close contact to soil or dust, such as yard work or gardening. If
this isn’t possible,

• Wear shoes, long pants, and a long-sleeved shirt when doing outdoor activities such as gardening,
yard work, or visiting wooded areas.

• Wear gloves when handling materials such as soil, moss, or manure.

• To reduce the chances of developing a skin infection, clean skin injuries well with soap and water,
especially if they have been exposed to soil or dust.
 Where Mucor mycosis Comes From

 Mucor mycetes, the group of fungi that cause mucormycosis, are present throughout the
environment, particularly in soil and in association with decaying organic matter, such as
leaves, compost piles, and animal dung.
Diagnosis and testing for Mucor mycosis
 medical history
 symptoms,
 physical examinations,
 and laboratory tests when diagnosing mucor mycosis.
  in lungs or sinuses might collect a sample of fluid from your respiratory system to
send to a laboratory
  perform a tissue biopsy, in which a small sample of affected tissue is analyzed in a
laboratory
 also need imaging tests such as a CT scan of your lungs, sinuses, or other parts of your
body, depending on the location of the suspected infection.
 MEDICAL MANAGMENT

 Amphotericin B and isavuconazole are the two agents currently Food and Drug
Administration (FDA) approved for the primary therapy of mucor mycosis.
COST –
1)Amphotericin B - ₹ 3,500
2)isavuconazole - ₹ 1,000/ Box 

Amphotericin B isavuconazole
Phosome Liposomal Amphotericin B Injection

₹ 3,500/ Vial Get Latest Price

Brand Phosome

Form Injection

Packaging Type Box

Dose 50 mg

Manufacture By Cipla

Usage Hospital
Isavuconazonium Sulfate 372 Mg Cresemba Injection

₹ 1,000/ Box Get Latest Price

Strength 372 mg
Packaging Size 10 vials/carton

Brand Cresemba

Composition Isavuconazonium Sulfate

Treatment Infections caused by fungus

Prescription/Non Prescription
prescription
BLACK MARKET VALUE SED
DUE TO HIGH DEMAND AND
MEDICINAL DEFICIENCY
 Deaths due to mucor mycosis
 Mucor mycosis is frequently a life-threatening infection.

 A review of published mucor mycosis cases found an overall all-cause mortality rate
of 54%. 
 
 The mortality rate varied depending on underlying patient condition, type of fungus,
and body site affected (for example, the mortality rate was 46% among people with
sinus infections, 76% for pulmonary infections, and 96% for disseminated mucor
mycosis)
Maharashtra may have over 2,000 cases of
'Black fungus'
 REFERENCES
1. Richardson M. The ecology of the Zygomycetes and its impact on environmental exposureexternal
icon. Clin Microbiol Infect. 2009 Oct;15 Suppl 5:2-9.
2. Al-Ajam, MR, Bizri, AR, Mokhbat, J, Weedon, J, Lutwick, L. Mucormycosis
in the Eastern Mediterranean: a seasonal diseaseexternal icon. Epidemiol Infect. 2006 Apr
134(2):341-6.
3. Talmi, YP, Goldschmied-Reouven, A, Bakon, M, Barshack, I, Wolf, M, Horowitz, Z, et al. 
Rhino-orbital and rhino-orbito-cerebral mucormycosisexternal icon. Otolaryngology-Head and Neck
Surgery, 2002 July 1;127(1):22–31.
4. Sivagnanam, S, Sengupta, DJ, Hoogestraat, D, Jain, R, Stednick, Z, Fredricks, DN, et al. 
Seasonal clustering of sinopulmonary mucormycosis
in patients with hematologic malignancies at a large comprehensive cancer centerexternal icon.
Antimicrob Resist Infect Control. 2017 November;6(1)
5. Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele RL, et al. 
Epidemiology and outcome of zygomycosis: a review of 929 reported casesexternal icon. Clin Infect
Dis. 2005 Sep 1;41(5):634-53.