Coronavirus: a case of “black fungus” raises alarms in Uruguay

MONTEVIDEO.- Mucormycosis, or “black fungus”, a rare infection that began to be reported in India as a coronavirus-associated disease, has arrived in Uruguay, with the first case reported in an academic assembly of medicine in Montevideo.

In the chair of infectious diseases at the University of the Republic, infectologist Henry Albornoz indicated that I was treating a man under the age of 50 with diabetes who, about ten days after infection with Covid-19, began to have necrosis (tissue death) in the mucous membrane area. and that, through a laboratory test, it was confirmed that he had also been infected with the “Black mushroom”.

Although mucormycosis is known by this name, the adjective does not refer to the color of the fungus but to what it causes, death of body tissue. In India, where more than 26 million people have confirmed they have tested positive for SARS-CoV-2, In recent weeks, around 9,000 cases of patients who later suffered from mucormycosis have been reported.

It is not known if the reported case is the first in Uruguay because the mucormycosis it is not reported as an exclusive event. As Albornoz explains, “the important thing is not the identification of a case, butIno warning that immune wear and tear caused by Covid-19 may leave fertile ground for other infections“.

Mushrooms are one of the kingdoms of nature. Zygomycetes – the family of fungi that cause this infection called mucormycosis – they are abundant in the environment. They are the cause, for example, of black mold on bread or that greenish coloration of cheeses that have been left uncovered in the refrigerator for several days. But as infectologists say, For infection to occur in a human being, the presence of the fungus alone is not enough – there must be conditions.

Mucormycosis, although rare, has been reported in patients with uncontrolled diabetes, in those who are immunocompromised, who have had leukemia or a bone marrow transplant. The fungus finds a lesion in the tissue – which is why it sometimes invades the body of a person with burns or in a traffic accident – and begins to move forward, killing the tissue.

“These are the most opportunistic fungi: they need previous damage in order to be able to develop”, explained infectologist Zaida Arteta, one of the references of mycology in Uruguay. In the case of patients passing through Covid-19: “The lesions are generally located in the paranasal sinuses, mucous membranes, lungs …”.

Why, if the infection was already known, did what happened in India attract attention? Arteta argued that India is the second most populous country in the world and the cases are observed on a large scale, but, in addition, it is a country with areas where a lot of dust is concentrated or where pollution. is high and this makes these fungi are more prevalent.

It is also striking because the infection caused by this “black fungus” it considerably increases mortality: between 50% and 80% in those who suffer from it.

This virulence means that, given the advance of the fungus, doctors need to act quickly: early diagnosis, surgery (the damaged part is removed, if possible) and the use of fungicidal drugs (amphotericin B).

This drug, Albornoz said, is available in Uruguay. The problem, compared to what happens with viral and bacterial infections, is that the variety of drugs is much more limited. But high mortality is not just a question of treatment, but “usually occurs in patients who are already vulnerable and which greatly affects their ability to recover.”

In the case of the Uruguayan patient, he had previous comorbidities, but his Covid-19 infection was not serious and did not even require hospitalization. “But about ten days later, the symptoms of the fungal infection started and this is now their main battle.”

The Country / GDA

The country (Uruguay)