Black Fungus: Pandemic Devastating India?
DOI:
https://doi.org/10.37285/ijpsn.2022.15.2.9Abstract
Black fungus is the latest threat to the patients who just recovered from the covid-19. Black fungus is a type of mucormycosis infection, predominantly seen in patients with co-morbidities, mainly diabetes, cancer, immunocompromised infections, and organ transplant. Rising black fungus cases are not only a major aesthetic problem disrupting the medical and socioeconomic system, but it also senses another upcoming pandemic in India. Black fungus has a clinical appearance that is indistinguishable from other common illnesses at first, and it is invariably deadly unless diagnosed early or untreated vigorously. Rapid and precise diagnostic procedures, as well as the availability of less toxic, more effective antifungal drugs like posaconazole and isavuconazole, should be pursued as targets for improved black fungus care. The liposomal Amphotericin B had brought new rays of hope for treating black fungus by providing better efficacy amongst people. Since there is a dearth of literature regarding the management of black fungus patients, the article focused on the incidences, prevalence, diagnosis, and treatment protocol, to gain insight into the extent of this epidemic in India in 2021.
Downloads
Metrics
Keywords:
Anti-fungal drugs, Black fungus, Co-morbidities, Diabetes mellitus, Mucormycosis, Pandemic at IndiaDownloads
Published
How to Cite
Issue
Section
References
Abdalla A, Adelmann D, Fahal A, Verbrugh H, Van Belkum A, et al (2002) De Hoog S. Environmental occurrence of Madurellamycetomatis, the major agent of human eumycetoma in Sudan. J Clin Microbiol 40: 1031–1036.
Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, et al (2020) Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. N Engl J Med. 383:120-8.
Alanio A, Garcia-Hermoso D, Mercier-Delarue S, Lanternier F, Gits-Muselli M, Menotti J, Denis B, Bergeron A, Legrand M, Lortholary O, et al (2015) Molecular identification of Mucor in human tissues: Contribution of PCR electrospray-ionization mass spectrometry. Clin. Microbiol. Infect. 21: 594-599.
Almyroudis N.G, Sutton D.A, Linden P, Rinaldi M.G, Fung J, Kusne S, et al (2006) Zygomycosis in Solid Organ Transplant Recipients in a Tertiary Transplant Center and Review of the Literature. Am. J. Transplant. 6:2365–2374.
Aribandi M, McCoy VA, Bazan C 3rd (2007) Imaging features of invasive and noninvasive fungal sinusitis: A review. Radiograph. 27:1283–96.
Artis WM, Fountain JA, Delcher HK, Jones HE, et al (1982) A mechanism of susceptibility to mucormycosis in diabetic ketoacidosis: transferrin and iron availability. Diabet. 31:1109–14.
Apicella M, Campopiano MC, Mantuano M, Mazoni L, Coppelli A, Del Prato S (2020) COVID-19 in people with diabetes: understanding the reasons for worse outcomes. Lancet Diabetes Endocrinol. 8:782–792.
Bala K., Chander J., Handa U (2015) A prospective study of mucormycosis in north India: experience from a tertiary care hospital. Med Mycol. 53:248–257.
Baldin C, Soliman S.S.M, Jeon, H.H, Alkhazraji S, Gebremariam T, Gu Y, Bruno V.M, Cornely O.A, Leather H.L, Sugrue M.W, et al (2018) PCR-Based Approach Targeting Mucorales-Specific Gene Family for diagnosis of Mucormycosis. J. Clin. Microbiol. 56:00746-18.
Bayram N, Ozsaygılı C, Sav H, et al. (2021) Susceptibility of severe COVID-19 patients to rhino-orbital mucormycosis fungal infection in different clinical manifestations. Jpn J Ophthalmol. 65:515-525.
Bernal-Martínez, L, Buitrago M.J, Castelli M.V, Rodriguez-Tudela J.L, Cuenca-Estrella M, et al (2013) Developmentof a single tube multiplex real-time PCR to detect the most clinically relevant Mucormycetes species. Clin. Microbiol. Infect.19:E1–E7.
Bhadauria D, Etta P, Chelappan A, GurjarM, Kaul A, Sharma R.K, Gupta A, Prasad, N, Marak R.S, Jain M, et al (2018) Isolated bilateral renal mucormycosis in apparently immunocompetent patients—A case series from India and review of the literature. Clin. Kidney J. 34:1–8.
Bhansali A (2004) Presentation and outcome of rhino-orbital-cerebral mucormycosis in patients with diabetes. Postgrad. Med. J. 80:670–674.
Binder U, Maurer E, Lass-Flörl C (2014) Mucormycosis--from the pathogens to the disease. Clin Microbiol Infect 20:60-6.
Burnham-Marusich A.R, Hubbard B, Kvam A.J, Gates-Hollingsworth M, Green H.R, Soukup E, Limper A.H, Kozel T.R, et al (2018) Conservation of Mannan Synthesis in Fungi of the Zygomycota and Ascomycota Reveals a Broad Diagnostic Target. mSphere;3:94-18.
Cain DW, Cidlowski JA (2017) Immune regulation by glucocorticoids. Nat Rev Immunol. 17:233-47.
Caramalho R, Madl L, Rosam K, Rambach G, Speth C, Pallua J, Larentis T, Araujo R, Alastruey-Izquierdo, Lass-Flörl, et al (2019) Evaluation of a Novel Mitochondrial Pan-Mucorales Marker for the Detection, Identification, Quantification, and Growth Stage Determination of Mucormycetes. J. Fungi. 5: 98-104.
Cassagne C, Ranque S, Normand A.C, Fourquet P, Thiebault S, Planard C, Hendrickx M, Piarroux R, et al (2011) Mould Routine Identification in the Clinical Laboratory by Matrix-Assisted Laser Desorption Ionization. Time-Of-Flight Mass Spectrometry 6: e284-25.
Chakrabarti A, Singh R (2014) Mucormycosis in India: unique features . Mycoses 57: 85–90.
Chakrabarti A, Das A, Sharma A, Panda N, Das S, Gupta K.L., Sakhuja V, et al (2001) Ten Years Experience in Zygomycosis at a Tertiary Care Centre in India. J. Infect. 42: 261–266.
Chakrabarti A, Das A, Mandal J, Shivaprakash M.R, George, V.K, Tarai B, Rao P, Panda, N Verma, S.C Sakhuja, et al (2006) The rising trend of invasive zygomycosis in patients with uncontrolled diabetes mellitus. Med. Mycol. 44: 335–342.
Chakrabarti A., Kaur H, Savio J, Rudramurthy S.M, Patel A, Shastri, P, Pamidimukkala, U, Karthik R., Bhattacharya S, Kindo A.J, et al (2019) Epidemiology and clinical outcomes of invasive mold infections in Indian intensive care units (FISF study). J. Crit. Care. 51:64–70.
Chakrabarti A, Chatterjee S.S., Das A, Panda N, Shivaprakash M.R, Kaur A, Varma S.C, Singhi S, Bhansali A, SakhujaV, et al (2009) Invasive zygomycosis in India: Experience in a tertiary care hospital. Postgrad. Med. J. 85:573–581.
Chakrabarti, A.; Sood, P.; Denning, D. Estimating Fungal Infection Burden in India: Mucormycosis Burden as a Case Study.Available online: https://www.gaffi.org/wp-content/uploads/P1044.pdf (accessed on 1 December 2020).
Chander J, Kaur M, Singla N, Punia R, Singhal S, Attri A,. Alastruey-Izquierdo A., Stchigel A, Cano-Lira J, Guarro J,et al (2018) Mucormycosis: Battle with the Deadly Enemy over a Five-Year Period in India. J. Fungi. 4:46-49.
Chan-Tack K.M, Nemoy L.L, Perencevich E.N, et al (2005) Central venous catheter-associated fungemia secondary to mucormycosis. Scand. J. Infect. Dis.37:925–927.
Chen N, Zhou M, Dong X, et al (2020) Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 395:507-13.
Cornely O.A, Alastruey-Izquierdo A, Arenz D, Chen S.C.A, Dannaoui E, Hochhegger B, Hoenigl M, Jensen H.E, Lagrou K, Lewis R.E., et al (2019) Global guideline for the diagnosis and management of mucormycosis: An initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect. Dis.19:e405–e421
Dadwal S.S, Kontoyiannis D.P (2018) Recent advances in the molecular diagnosis of mucormycosis. Expert Rev.Mol. Diagn. 18:845–854.
Das A, Oberoi S, Trehan A, Chakrabarti, A, Bansal D, Saxena A.K, Sodhi K.S, Kakkar, N Srinivasan, et al (2018)Invasive Fungal Disease in Pediatric Acute Leukemia in the Nontransplant Setting: 8 Years’ Experience From a Tertiary Care Center in North India. J. Pediatr. Hematol. Oncol 40:462–467.
Dayal D, Jain P, Kumar R, Bakshi J, Menon P, Das A, Singhi S, Singh M, et al (2015) Clinical spectrum and outcome of invasive filamentous fungal infections in children with Type 1 diabetes: North Indian experience. Clin. Pediatr. Endocrinol. 24:51–57.
Dimitrios P Kontoyiannis, Hongbo Yang, Jinlin Song, Rachel Harrington (2016) Prevalence, the clinical and economic burden of mucormycosis-related hospitalizations in the United States: a retrospective study, BMC Infect Dis. 16:730-746.
Dizbay M, Adisen E, Kustimur S, Sari N, Cengiz B, Yalcin B, Kalkanci A, Gonul I, Sugita T, et al (2009) Fungemia and cutaneous zygomycosis due to Mucorcircinelloides in an intensive care unit patient: Case report and review of the literature. Jpn. J. Infect. Dis. 62:146–148.
Dzieciatkowski T., Szarpak L., Filipiak K.J., Jaguszewski M., Ladny J.R.,Smereka J et al (2020) COVID-19 challenge for modern medicine. Cardiol 27: 175-183.
Etrikkos G, Skiada A, Lortholary O (2012) Epidemiology and clinical manifestations of mucormycosis. Clin Infect Dis 54: S23–S34.
Francis JR, Villanueva P, Bryant P, Blyth CC, et al (2018) Mucormycosis in children: review and recommendations for management. J Pediatric Infect Dis Soc. 7:159-164.
Fürbringer, P (1876) Beobachtun-genüberLungenmycosebeim Menschen. Virchows Arch 66:330–365.
Gangneux JP, Bougnoux ME, Dannaoui E, Cornet M, Zahar JR Invasive fungal diseases during COVID-19: we should be prepared. J Mycol Med. 2020;30:100971.
Garg J, Sujatha S, Garg A, Parija S.C, et al (2009) Nosocomial cutaneous zygomycosis in a patient with diabetic ketoacidosis. Int. J. Infect. Dis. 13:508–510.
Godara S.M, Kute V.B, Goplani K.R, Gumber M.R, Gera D.N, Shah P.R., Vanikar A.V, Trivedi H.L, et al (2011) Mucormycosis in renal transplant recipients: Predictors and outcome. Saudi J. Kidney Dis. Transpl; 22:751–756.
Guarner J, Brandt M.E (2011) Histopathologic Diagnosis of Fungal Infections in the 21st Century. Clin. Microbiol. Rev. 24:247–280.
Guegan H, Iriart X, Bougnoux M.E, Berry A, Robert-Gangneux F, Gangneux J.P et al (2020) Evaluation ofMucorGenius® mucorales PCR assay for the diagnosis of pulmonary mucormycosis. J. Infect.81:311–317.
Gupta K.L, Bagai S, Ramachandran R, Kumar V, Rathi M, Kohli H.S, Sharma A Chakrabarti A, et al (2020) Fungal infection in postrenal transplant patient: center single-center experience. Indian J. Pathol. Microbiol. 63:587–592.
Gupta N, Kumar A, Singh G, Ratnakar G, Vinod K.S, Wig N, et al (2017) Breakthrough mucormycosis after voriconazole use in a case of invasive fungal rhinosinusitis due to Curvularialunata. Drug Discov. Ther. 11:349–352.
Hanley B, Naresh KN, Roufosse C, et al (2020) Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study. Lancet Microbe. 1:e245-e253.
Hata D.J, Buckwalter S.P, Pritt B.S, Roberts G.D, Wengenack N.L, et al (2008) Real-time PCR method for detection of zygomycetes. J. Clin. Microbiol. 46:2353–2358.
Hemashettar B.M, Patil R.N, O Donnell K, Chaturvedi V, Ren P, Padhye A.A, et al (2011) Chronic rhinofacialmucormycosis caused by Mucorirregularis (Rhizomucorvariabilis) in India. J. Clin. Microbiol. 49:2372–2375.
Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, Linsell L, et al (2021) Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med. 384:693-704.
Ibrahim AS, Spellberg B, Walsh TJ, Kontoyiannis DP (2012) Pathogenesis of mucormycosis. Clin Infect Dis.54:S16–22.
Ino, K, Nakase K, Nakamura A, Nakamori Y, Sugawara Y, Miyazaki K, Monma F, Fujieda A, Sugimoto Y, Ohishi K, et al (2017). Management of Pulmonary Mucormycosis Based on a Polymerase chain reaction (PCR) Diagnosis in Patients with Hematologic Malignancies: A Report of Four Cases. Intern. Med. 56: 707–711.
Ibrahim AS, Spellberg B, Avanessian V, Fu Y, Edwards JE, et al (2005) Jr Rhizopusoryzae adheres to, is phagocytosed by, and damages endothelial cells in vitro. Infect Immun. 73:778–83.
Jayakumar M, Gopalakrishnan N, Vijayakumar R, Rajendran S, Muthusethupathi M.A, et al (1998) Systemic fungal infections in renal transplant recipients at Chennai, India. Transplant. Proc 30:3135-3139.
Jensen H.E, Salonen J, Ekfors T.O, et al (1997). The use of immunohistochemistry to improve sensitivity and specificity in the diagnosis of systemic mycoses in patients with hematologicalhematological malignancies. J. Patho.181:100–105.
Jeong W, Keighley C, Wolfe R, Lee W.L, Slavin M.A, Kong D.C.M, Chen S.C.A, et al (2019) The epidemiology and clinical manifestations of mucormycosis: A systematic review and meta-analysis of case reports. Clin. Microbiol. Infect. 25:26–34.
John T.M., Jacob C.N., Kontoyiannis D.P (2021) When uncontrolled diabetes mellitus and severe COVID-19 converge: the perfect storm for mucormycosis. J Fungi (Basel). 7:298-317.
Jung, J, Park, Y.S, Sung H, Son J.S, Lee S.O, Choi S.H, Kim Y.S, Woo J.H, Kim S.H, et al (2015) Using immunohistochemistry to assess the accuracy of histomorphologic diagnosis of aspergillosis and mucormycosis. Clin. Infect. Dis. 61:1664–1670.
Kang JW (2016) Kim JH Dark necrotic mucosa in sinonasal mucormycosis. Br J Hosp Med (Lond) 77:51-57.
Katragkou A, Walsh TJ, Roilides E, et al (2014) Why is mucormycosis more difficult to cure than more common mycoses? Clin Microbiol Infect. 20:74-81.
Kasai M, Harrington S.M, Francesconi A, Petraitis V, Petraitiene R, Beveridge M.G, Knudsen T, Milanovich J, Cotton M.P, Hughes J, et al (2008) Detection of a Molecular Biomarker for Zygomycetes by Quantitative PCR Assays of Plasma, Bronchoalveolar Lavage, and Lung Tissue in a Rabbit Model of experimental Pulmonary Zygomycosis. J. Clin. Microbiol. 46: 3690–3702.
Koshy S, Ismail N, Astudillo C.L, Haeger C.M, Aloum, O, Acharige M.T, Farmakiotis D, Baden L.R, Marty F.M, Kontoyiannis D.P, et al (2017) Breath-Based Diagnosis of Invasive Mucormycosis (IM). Open Forum Infect. Dis.4:S53–S54.
Korula A, Abraham A, Abubacker F.N, Viswabandya A, Lakshmi K.M, Abraham O.C, Rupali P, Varghese G.M, Michael J.S, Srivastava A, et al (2017) Invasive fungal infection following chemotherapy for acute myeloid leukaemia-Experience from a developing country. Mycoses. 60:686–691.
Kumar C, Jain P, Wadhwa N, Diwaker P, Khan N, et al (2017) Nosocomial JejunalMucormycosis—An Unusual Cause of Perforation Peritonitis. Iran. J. Pathol 12: 295–300.
Kumar G, Adams A, Hererra M, Rojas ER, Singh V, Sakhuja A, et al (2020) Predictors and outcomes of hais in COVID-19 patients. Int J Infect Dis. 104:287–92.
Kursun, E, Turunc, T, Demiroglu Y.Z, Aliskan H.E, Arslan A.H, et al (2015) Evaluation of 28 cases of mucormycosis. Mycoses; 58:82–87.
Lackner M, Caramalho R, Lass-FlörlC, et al (2014) Laboratory diagnosis of mucormycosis: Current status and future perspective future perspectives. Future Microbiol. 9:683–695.
Lin E, Moua T, Limper AH (2017) Pulmonary mucormycosis: clinical features and outcomes. Infect. 45:443-448.
Liu Y, Wu H, Huang F, Fan Z, Xu B, et al (2013) Utility OFF- FDG PET/CT in diagnosis and management of mucormycosis. Clin Nucl Med 38: e370–e371.
Lengerova M, Racil Z, Hrncirova K, Kocmanova I, Volfova P, Ricna D, Bejdak P, Moulis M, Pavlovsky Z, Winbergerova B, et al (2014) Rapid detection and identification of Mucormycetes and bronchoalveolar lavage samples from immunocompromised patients with pulmonary infiltrates by use of high-resolution melt analysis. J. Clin. Microbiol. 52:2824–2828.
Legrand M, Gits-Muselli M, Boutin, L, Garcia-Hermoso D, Maurel V, Soussi S, Benyamina M, Ferry A, Chaussard M, Hamane S, et al (2016) Detection of Circulating Mucorales DNA in Critically Ill Burn Patients: Preliminary Report of a Screening Strategy for Early Diagnosis and Treatment. Clin. Infect. Dis. 63:1312–1317.
Long B, Koyfman A (2015) Mucormycosis: what emergency physicians need to know? Am J Emerg Med 33:1823-5.
Lu XL, Najafzadeh MJ, Dolatabadi S (2013) Taxonomy and epidemiology of Mucorirregularis, agent of chronic cutaneous mucormycosis. Persoonia 30: 48–56.
Mandhaniya S, Swaroop C, Thulkar S, Vishnubhatla S, Kabra S.K, Xess I, Bakhshi S, et al (2017) Oral Voriconazole Versus Intravenous Low Dose Amphotericin B for Primary Antifungal Prophylaxis in Pediatric Acute Leukemia Induction. J. Pediatr. Hematol. Oncol. 33:e333–e341.
Manesh A, Rupali, P, Sullivan M.O, Mohanraj P, Rupa V, George, B, Michael J.S. et al (2019)Mucormycosis-A clinicoepidemiological review of cases over 10 years. Mycoses.62:391–398.
Manesh A, John A.O, Mathew B, Varghese L, Rupa V, Zachariah A, Varghese G.M, et al (2016) Posaconazole: An emerging therapeutic option for invasive rhino-orbit orbit-cerebral mucormycosis. Mycoses. 59: 765–772.
Marty F.M, Ostrosky-Zeichner L, Cornely O.A, Mullane K.M, Perfect J.R, Thompson G.R, Alangaden G.J, Brown J.M, Fredricks D.N, Heinz, W.J, et al (2016) Isavuconazole treatment for mucormycosis: A single-arm open-label trial and case-control analysis. Lancet Infect. Dis. 16:828–837.
McDermott N.E, Barrett J, Hipp J, Merino M.J, Lee C.C.R, Waterman P, Domingo D.L, Walsh T.J, et al (2010).Successful treatment of periodontal mucormycosis: Report of a case and literature review. Oral Surg. Orland. Oral Pathol. Oral Radiol. Endodontol 109:e64–e69.
Mehta S, Pandey A (2020) Rhino-orbital mucormycosis associated with COVID-19. Cureus. 12:e10726.
Meis JF, Chakrabarti A (2009) Changing epidemiology of an emerging infection: zygomycosis. Clin Microbiol Infect.15:10–14.
Mekonnen Z.K., Ashraf D.C., Jankowski T., Grob S.R., Vagefi M.R., Kersten R.C., Simko J.P., Winn B.J (2021) Acute invasive rhino-orbital mucormycosis in a patient with COVID-19-associated acute respiratory distress syndrome. Ophthalmic. Plast. Reconstr. Surg. 37:e40–e80.
Mercier T, ReyndersM.B, Beuselinck K, Guldentops E, Maertens J, Lagrou K, et al (2019)Serial Detection of circulating Mucorales DNA in Invasive Mucormycosis: A Retrospective Multicenter Evaluation. J. Fungi.5:113-120.
Mercier T, Reynders M.B, Beuselinck K, Guldentops E, Maertens, J, LagrouK, et al (2019) . Serial Detection of Circulating Mucorales DNA in Invasive Mucormycosis: A Retrospective Multicenter Evaluation. J. Fungi 5:113-118.
Millon L, LaRosa F, Lepiller Q, Legrand F, Rocchi S, Daguindau E, Scherer E, Bellanger A.P, Leroy J, Grenouillet F, et al (2013) Quantitative Polymerase Chain Reaction Detection of Circulating DNA in Serum formerly Diagnosis of Mucormycosis in Immunocompromised Patients. Clin. Infect. Dis.56: e95–e101.
Millon L, Herbrecht R, Grenouillet F, Morio F, Alanio A, Letscher-Bru V, Cassaing S, Chouaki T, Kaumann-Lacroix C, Poirier P, et al (2016) Early diagnosis and monitoring of mucormycosis by detection of circulating DNA in serum: Retrospective analysis of 44 cases collected through the French Surveillance, Network of Invasive Fungal Infections (REIF). Clin. Microbiol. Infect.22: 810-819.
Millon L, Scherer E, Rocchi S, Bellanger A.P, et al (2019) Molecular Strategies to Diagnose Mucormycosis. J. Fungi. 5: 24-30.
Monte ESD, Junior, Santos MELD, Ribeiro IB, et al (2020) Rare and Fatal Gastrointestinal Mucormycosis (Zygomycosis) in a COVID-19 Patient: A Case Report. Clin Endosc. 53:746-749.
Nasir N, Farooqi J, Mahmood SF, Jabeen K (2020) COVID-19 associated pulmonary aspergillosis (CAPA) in patients admitted with severe COVID-19 pneumonia: an observational study from Pakistan. Mycoses. 63:766–770.
Neetu Chandra Sharma (2021) India reports 40,854 cases of black fungus so far.livemint.com. https://www.livemint.com/news/india-records-over-40k-cases-of-mucormycosis-11624875874985.html. accessed 28 Jun 2021.
Orne C, Burnham-Marusich A, Baldin C, Gebremariam T, Ibrahim A, Kvam A, Kozel T, et al. Cell wallfucomannan is a biomarker for diagnosis of invasive murine mucormycosis. In Proceedings of the 28thECCMID, Madrid, Spain, 21–24 April 2018.
Orr Y, Taylor JM, Bannon PG, Geczy C, Kritharides L (2005) Circulating CD10-/CD16low neutrophils provide a quantitative index of active bone marrow neutrophil release. Br J Haematol. 131:508-19.
Parackova Z, Zentsova I, Bloomfield M, Vrabcova P, Smetanova J, Klocperk A, et al (2020) Disharmonic inflammatory signatures in COVID-19:Augmented neutrophils’ but impaired monocytes’ and dendritic cells’ responsiveness. Cells. 9:2206.
Paltauf A (1885) Mycosis mucorina: EinBeitragzurKenntnis der menschilchenFadenpiltzer-krankungen. Virchows Arch. Pathol. Anat 102:543–564.
Patel A., Kaur, H., Xess I., Michael J.S., Savio J., Rudramurthy S, Singh R, Shastri P, Umabala P, Sardana R, et al (2020) A centre multi-center observational study on the epidemiology, risk factors, management and outcomes of mucormycosis in India. Clin. Microbiol. Infect. 26:e9–944.
Patel A, Kaur H, Xess I, Michael JS, Savio J, Rudramurthy S, et al (2020) A multicentre observational study on the epidemiology, risk factors, management and outcomes of mucormycosis in India. Clin Microbiol Infect. 26:9–15.
Prakash H, Ghosh A.K, Rudramurthy S.M, Singh P, Xess I, Savio J, Pamidimukkala U., Jillwin J, Varma, S, Das, A, et al (2019) A prospective multicenter study on mucormycosis in India: Epidemiology, diagnosis, and treatment. Med. Mycol. 57:395–402.
Patel A., Kaur, H., Xess I., Michael J.S., Savio J., Rudramurthy S, Singh R, Shastri P, Umabala P, Sardana R, et al (2020) A centre multi-center observational study on the epidemiology, risk factors, management and outcomes of mucormycosis in India. Clin. Microbiol. Infect. 26:e9–944.
Patel A.K, Patel K.K, Patel K, Gohel S, Chakrabarti A, et al (2017)Mucormycosis at a tertiary care centre centerin Gujarat, India. Mycoses 60:407–411.
Petrillo MG, Fettucciari K, Montuschi P, Ronchetti S, Cari L, Migliorati G, et al (2014) Transcriptional regulation of kinases downstream of the T cell receptor: Another immunomodulatory mechanism of glucocorticoids. BMC Pharmacol Toxicol. 15:35-49.
Prakash H, Chakrabarti A (2019) Global Epidemiology of Mucormycosis. J. Fungi. 5:26-29.
Rammaert B, Lanternier F, Zahar J.-R, Dannaoui E, Bougnoux M.-E, Lecuit M, Lortholary O, et al (2012) Healthcare-associated mucormycosis. Clin. Infect. Dis 54:S44–S54.
Ravani S.A., Agrawal G.A., Leuva P.A., et al (2021) Rise of the phoenix: mucormycosis in COVID-19 times. Indian J Ophthalmol. 69:1563–1568
Ribes J.A, Vanover-Sams C.L, Baker D.J, et al (2000) Zygomycetes in human disease. Clin. Microbiol. Rev. 13:236–301.
Roden M.M, Zaoutis T.E, Buchanan W.L, Knudsen T.A, Sarkisova T.A, Schaufele R.L., Sein, M, Sein T, Chiou C.C, Chu J.H, et al (2005) Epidemiology and outcome of zygomycosis: A review of 929 reported cases. Clin. Infect. Dis 41:634–653.
Sahota R, Gambhir R, Anand S, Dixit Aet al (2017) . RhinocerebralMucormycosis: Report of a Rare Case. Ethiop J Health Sci. 27:85-90.
Sargin F., Akbulut M., Karaduman S., Sungurtekin H (2021) Severe rhinocerebral mucormycosis case developed after COVID 19. J Bacteriol Parasitol.12:386
Schleimer RP (2004) Glucocorticoids suppress inflammation but spare innate immune responses in airway epithelium. Proc Am Thorac Soc. 1:222-30.
Scherer E, Iriart X, Bellanger A.P, Dupont D, Guitard J, Gabriel F, Cassaing S, Charpentier E,Guenounou S, Cornet M, et al (2018) Quantitative PCR (qPCR) Detection of Mucorales DNA in Bronchoalveolar Lavage Fluid to Diagnose Pulmonary Mucormycosis. J. Clin. Microbiol.56:289-18.
Shekar M, Elumalai R, Elayaperumal I, Yelahanka R.P, Anandkumar D.G, Bandi V.K, Matcha J, et al ()Prevalence and outcome of systemic fungal infections in renal transplant recipients—A tertiary care experience. Saudi J. Kidney Dis. Transpl. 2019; 30:1137–1143.
Springer J, Goldenberger D, Schmidt F, Weisser M, Wehrle-Wieland E, Einsele H, Frei, R, Loe J, et al (2016) .Development and application of two independent real-time PCR assays to detect clinically relevant Mucoralesspecies. J. Med. Microbiol. 65: 227–234.
Schulte-Schrepping J, Reusch N, Paclik D, Baßler K, Schlickeiser S, Zhang B, et al (2020) Severe COVID-19 is marked by a dysregulated myeloid cell compartment. Cell;182:1419-40.
Singh A.K., Singh R., Joshi S.R., Misra A (2021) Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India. Diabetes Metab. Syndr. 15:102-146.
Skiada A, Pavleas I, Drogari-Apiranthitou, et al (2020) M. Epidemiology and Diagnosis of Mucormycosis: An Update. J. Fungi 6: 265-269.
Sindhu D, Jorwal P, Gupta N, Xess I., Singh G, Soneja M, Nischal N, Sethi P, Ray A, Biswas A, et al (2019) Clinical spectrum and outcome of hospitalizedhospitalized patients with invasive fungal infections: A prospective study from a medical ward/intensive care unit of a teaching hospital in North India. Le Inez. Med. 27:398–402.
Song Y, Qiao J, Giovanni G, Liu G, Yang H, Wu J, et al (2017) Mucormycosis in renal transplant recipients: a review of 174 reported cases. BMC Infect Dis 17: 283-287.
Spellberg B, Edwards J, Ibrahim A (2005) Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev.18:556‐569.
Springer J, Lackner M, Ensinger C, Risslegger B, Morton C.O, Nachbaur D, Lass-Flörl, C, Einsele H, Heinz W.J, et al (2016) Clinical evaluation of a Mucorales-specific real-time PCR assay in tissue and serum samples. J. Med. Microbiol. 65:1414–1421.
Szarpak L., Chirico F., Pruc M., et al (2021) Mucormycosis — a serious threat in the COVID-19 pandemic? J Infect. 83:237–239
Szarpak L., Chirico F., Pruc M., et al (2021) Mucormycosis — a serious threat in the COVID-19 pandemic? J Infect. 83:237–239.
Son H.J, Song J.S, Choi S, Jung J, Kim M.J, Chong Y.P, Lee S.O, Choi S.H, Kim Y.S, Woo J.H, et al (2020). A comparison of histomorphologic diagnosis with culture- and immunohistochemistry-based diagnosis of invasive aspergillosis and mucormycosis. Infect. Dis. 52:279–283.
Vaidyanathan G (2021) Coronavirus variants are spreading in India — what scientists know so far. Nature. 593:321–322.
Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, et al (2020) Endothelial cell infection and endothelins in COVID-19. Lancet. 395:1417-8.
Walsh T.J, GamaletsouM.N, McGinnis M.R, Hayden R.T, Kontoyiannis D.P, et al (2012) Early Clinical and LaboratoryDiagnosis of Invasive Pulmonary, Extrapulmonary, and Disseminated Mucormycosis (Zygomycosis).Clin. Infect. Dis. 54: S55–S60.
Williams R, Colagiuri S, Almutairi R, Montoya P.A, Basit A, Beran D, Besançon S, Bommer C, Borgnakke W, Boyko E, et al. International Diabetes Federation Diabetes Atlas. Ninth Edition. 2019. Available online: https://diabetesatlas.org/en/ sections/worldwide-toll-of-diabetes.html (accessed on 5 December 2020).
Zaman K, Rudramurthy S.M, Das A, Panda N, Honnavar, P, Kaur H, Chakrabarti A, et al(2017) Molecular diagnosis of rhino-orbit-cerebral mucormycosis from fresh tissue samples. J. Med. Microbiol. 66:1124–1129.