MUCORMYCOSIS (THE BLACK FUNGUS) ASSOCIATED WITH COVID-19 PATIENTS- EPIDEMIOLOGY, PATHOGENESIS, DIAGNOSIS AND TREATMENT REGIMES

Mucormycosis is an opportunistic fungal infection caused by a member of the order Mucorales. It is an angio-invasive fungal infection because of its propensity to invade blood vessel walls, resulting in catastrophic tissue ischemia (restriction in blood supply to tissues, causing a shortage of oxygen that is needed for cellular metabolism), infarct (tissue death that is necrosis) due to inadequate blood supply to the affected area. Mucorales fungi are distributed worldwide and found in soil and decaying organic substrates. The most common microbiologically confirmed infecting members of the order Mucorales are Rhizopus, Mucor, Cunninghamella bertholletiae, Apophysomyces elegans, Absidia, Saksenaea and Rhizomucor pusillus. The incidence of mucormycosis has increased significantly in patients with diabetes which is the commonest underlying risk factor globally. Recently, COVID-19 caused by SARS CoV-2 has further worsened the incidence of this disease. Diagnosis of mucormycosis remains challenging. The clinical approach to diagnosis has a low sensitivity and specificity; however, it helps raise suspicion and prompt the initiation of laboratory testing. Histopathology, direct examination, and culture remain essential tools, although the molecular methods are improving. The review highlights the current status on epidemiology, pathogenesis diagnosis and treatment regime available for mucormycosis.