“Black fungus” surges in India—thousands blinded, maimed, dead

So-called “black fungus” infections are surging in India in the wake of a devastating wave of COVID-19. The rare but devastating infection can destroy the eyes and spread to the brain.

Cases now top 31,000, rising from an estimate of dozens to a few hundred cases just last month. Media reports have tallied over 2,100 deaths, but federal health authorities have not released an official death count.

Past medical reviews have estimated that the fungal infection—mucormycosis—has an overall fatality rate of around 50 percent. However, mortality rates vary by patients’ underlying condition and what part of the body the mucormycetes fungi invade. Infection can take hold in the gastrointestinal tract, skin breaks, lungs, and the blood.

In India, the fungi appear to be mainly taking root in the nose and sinuses, where they can spread to facial bones, eyes, and even the brain. Once an infection is established, it can quickly become aggressive and lead to tissue death. If it spreads to the eye, many patients end up permanently losing vision and, in some cases, need to have their eye entirely removed to keep the infection from spreading.

Mucormycetes are a ubiquitous group of molds, and they typically only strike immunocompromised patients, such as those with diabetes. The soil-lurking molds love acidic conditions, making patients with diabetic ketoacidosis—a complication in which the blood becomes acidic—particularly vulnerable.

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