Black fungus disease: Mucormycosis, Introduction, Epidemiology and Symptoms

Black fungus disease: Mucormycosis, Introduction, Epidemiology and Symptoms


Black fungus disease also known as mucormycosis is an angioinvasive fungal infection, It is an infection caused by a group of filamentous molds of the order Mucorales and of class Zygomycetes. Depending on the clinical presentation it is classified as rhinocerebral, pulmonary, cutaneous, gastrointestinal, and disseminated or other, which includes uncommon rare forms, such as endocarditis, osteomyelitis, peritonitis, renal, etc Infections may result from ingestion of contaminated food, inhalation of spores into the nares or lungs, or inoculation into disrupted skin or wounds. In many countries it occurs in patients who are immunocompromised. It is classically defined as an opportunistic infection, preferentially affecting patients with diabetes mellitus (DM), neutropenia, malignancy, chronic renal failure, and acquired immunodeficiency syndrome and those who have received organ or hematopoietic stem cell transplants, it can affect immunocompetent hosts as well (such as trauma patients)


The disease was first described in 1876 when Furbinger described in Germany a patient who died of cancer and in whom the right lung showed a hemorrhagic infract with fungal hypae and a few sporangia. In 1885, Arnold Paltauf published the first case of disseminated mucormycosis, which he named “Mycosis mucorina”. A change in the epidemiology of mucormycosis has been observed in recent years with the rise in incidence, new causative agents and susceptible population. The rise has been perceived globally, but it is very high in the Asian continent. Though diabetes mellitus overshadow all other risk factors in Asia, post-tuberculosis and chronic renal failure have emerged as new risk groups.

Causative agent

Rhizopus arrhizus is the most common agent causing mucormycosis across the globe, followed by Lichtheimia, Apophysomyces, Rhizomucor, Mucor and Cunninghamella species. The incidence of mucormycosis is rising globally, but the rise is very high in India and China among patient with uncontrolled diabetes mellitus.


The symptoms of this disease depends upon which part of the body the fungus us growing.
Symptoms of rhinocerebral mucormycosis (sinus and brain) include:
• One sided facial swelling
• Nasal or sinus congestion
• Headache
• Fever
• Black lesions on nasal bridge or upper inside of mouth that quicly becomes more severe

Symptoms of gastrointestinal mucormycosis include
• Abdominal pain
• Nausea and vomiting
• Gastrointestinal bleeding
Symptoms of pulmonary mucormycosis include
• Fever
• Cough
• Chest pain
• Shortness of breath
Mucormycosis alo occers in Skin. Cutaneous mucormycosis look like blisters or ulers, and the infected area may turn black. Some other symptoms include pain, warmth, excessive redness, or swelling around a wound.


  1. Reid G, Lynch JP 3rd, Fishbein MC, Clark NM. Mucormycosis. Semin Respir Crit Care Med. 2020 Feb;41(1):99-114. doi: 10.1055/s-0039-3401992. Epub 2020 Jan 30. PMID: 32000287.
    2. Ibrahim AS, Spellberg B, Walsh TJ, Kontoyiannis DP. Pathogenesis of mucormycosis. Clin Infect Dis. 2012;54 Suppl 1(Suppl 1):S16-S22. doi:10.1093/cid/cir865
    3. Fürbringer P. Beobachtungen über Lungenmycose beim Menschen. Virchows Arch. 1876;66:330–365. doi: 10.1007/BF01878266.
    4. Camara-Lemarroy CR, González-Moreno EI, Rodríguez-Gutiérrez R, et al. Clinical features and outcome of mucormycosis. Interdiscip Perspect Infect Dis. 2014;2014:562610.
    5. Prakash H, Chakrabarti A. Global Epidemiology of Mucormycosis. J Fungi (Basel). 2019;5(1):26. Published 2019 Mar 21. doi:10.3390/jof5010026