Unmasking Mucormycosis: A Post-Covid-19 Public Health Emergency In India

Abstract

Mucormycosis, often dubbed the "black fungus," rose to national and international attention during India’s second wave of COVID-19. What was once a rare, opportunistic fungal infection suddenly turned into a parallel crisis, affecting thousands of patients recovering from COVID-19-many of whom had diabetes and had received corticosteroids. This review takes a closer look at how mucormycosis evolved into a post-pandemic emergency, exploring its causes, risk factors, clinical manifestations, diagnostic hurdles, and treatment strategies. The disease is caused by fungi of the Mucorales order, which normally exist harmlessly in the environment but can become lethal when the immune system is compromised. Rhino-orbito-cerebral mucormycosis (ROCM) emerged as the most common and destructive form, often leading to facial disfigurement, vision loss, or worse, death. With timely diagnosis, surgical intervention, and antifungal therapy-especially liposomal amphotericin B-patients can be saved, but delays in diagnosis often mean grim outcomes. India’s public health response included declaring the disease notifiable, launching awareness campaigns, and improving drug access, though challenges in rural healthcare access, drug shortages, and lack of early warning systems persist. This review aims not only to map the medical landscape of mucormycosis during the COVID era but also to underscore the importance of preparedness, multidisciplinary collaboration, and public education in tackling such emerging threats. Understanding this deadly yet preventable fungal disease is a crucial step in strengthening our healthcare response for future pandemics and opportunistic infections.