Palanisamy Priyadharsini R, Elango Dhivya
Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Karaikal, Puducherry, India.
J Family Med Prim Care. 2022 Feb;11(2):418-423. doi: 10.4103/jfmpc.jfmpc_1186_21. Epub 2022 Feb 16.
Mucormycosis, a rare fungal disease has emerged as a new epidemic in India, during the CoronaVirus Disease 2019 (COVID-19) pandemic. Mucormycosis is caused by the mucormycetes group of molds. Immunocompromised states such as diabetes, chronic steroid use, and patients receiving immunosuppressant drugs are the risk factors for mucormycosis. The second wave of the COVID-19 pandemic has also invited the notorious mucormycosis in the current scenario. India has announced mucormycosis as a notifiable disease in May 2021, as the number of COVID-19-associated mucormycosis cases has increased swiftly. There are different opinions and evidence for the emergence of mucormycosis or the so-called 'black fungus'. It is proposed that the use of steroids, monoclonal antibodies, and prolonged hospitalization in the treatment of COVID-19 has substantially decreased the immunity in COVID-19-affected patients and maybe the reason for the emergence of fungal infections. The other hypothesis is that improper disinfection procedures such as using non-sterile water for humidification of oxygen can be the reason. Or, the COVID-19 infection itself produces an immunocompromised and diabetic-like state is again a question. This review mainly focuses on the discussion and identification of the most common risk factor for mucormycosis, investigations, and management of mucormycosis.
毛霉病是一种罕见的真菌疾病,在2019年冠状病毒病(COVID-19)大流行期间,已在印度成为一种新的流行病。毛霉病由毛霉菌类霉菌引起。免疫功能低下的状态,如糖尿病、长期使用类固醇以及接受免疫抑制药物治疗的患者,是毛霉病的危险因素。在当前情况下,COVID-19大流行的第二波也引发了臭名昭著的毛霉病。由于与COVID-19相关的毛霉病病例迅速增加,印度于2021年5月宣布毛霉病为应报告疾病。对于毛霉病或所谓“黑真菌”的出现,存在不同的观点和证据。有人提出,在治疗COVID-19时使用类固醇、单克隆抗体以及延长住院时间,已大幅降低了受COVID-19影响患者的免疫力,这可能是真菌感染出现的原因。另一种假设是,诸如使用非无菌水进行氧气加湿等不当消毒程序可能是原因。或者,COVID-19感染本身会产生免疫功能低下和类似糖尿病的状态,这再次成为一个问题。本综述主要侧重于讨论和确定毛霉病最常见的危险因素、毛霉病的调查与管理。