Journal of Gastrointestinal Infections

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VOLUME 11 , ISSUE 1 ( January-December, 2021 ) > List of Articles


Gastrointestinal Mucormycosis: A Challenge during COVID-19 Pandemic

Jagdish Chander

Keywords : Amphotericin B, CAM, COVID-19, Gastrointestinal mucormycosis, Pandemic

Citation Information : Chander J. Gastrointestinal Mucormycosis: A Challenge during COVID-19 Pandemic. J Gastrointest Infect 2021; 11 (1):30-35.

DOI: 10.5005/jp-journals-10068-3052

License: CC BY-NC 4.0

Published Online: 18-01-2022

Copyright Statement:  Copyright © 2021; The Author(s).


In India, the second wave of COVID-19 pandemic came with unprecedented number of patients in the months of April, May, and June, 2021. This time correspondingly there was a record number (~50,000) of mucormycosis, which was popularized by the mainstream media as “black fungus.” The most common presentation was rhino-orbital mucormycosis followed by pulmonary and gastrointestinal mucormycosis. Scientifically this disease should be termed as COVID-19-associated mucormycosis (CAM). The Government of India had to declare it as an emergency situation under the Epidemic Diseases Act, 1897, on May 20, 2021. A large number of professional bodies in medical sciences, particularly in the field of microbiology, came out with various guidelines to tackle the challenging issue. The most common species involved is Rhizopus arrhizus, which is found in our surroundings, food material, and different places. Sometimes it is taken as a contaminant or “bread-mold” in houses or “lid-lifter” in the laboratory. But when there is an underlying background of any disease like diabetic mellitus, the same very fungus also becomes life-threatening. During this intervening period of second and looming third wave, patients are presenting with recurrence of the disease. The diagnosis is not very difficult when the index of suspicion is high. The direct finding of nonseptate hyphae with right-angle branching followed by cultural confirmation on Sabouraud Dextrose Agar clinch the final diagnosis. As far as the treatment is concerned, it is mainly surgical intervention of the necrotic tissue followed by antifungals like amphotericin B (conventional/liposomal), posaconazole, isavuconazole, apart from taking care simultaneously of the underlying risk factors like diabetes mellitus. With timely management the patient can be saved easily otherwise it can prove fatal.

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