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Mucormycosis: The Black Fungus medical comic

This comic explains mucormycosis, the 'black fungus', from the soil and rotting matter where its spores live to the people it attacks. It covers risk factors, how the fungus invades blood vessels and kills tissue, the clinical forms, how it is diagnosed and treated, and practical steps to lower the risk.

For MBBS, NEET-PG, FMGE, NEXT and USMLE revision.

Mucormycosis: what the comic covers

High-yield points

  • Mucormycetes live in soil and decaying organic matter such as leaves, compost and dung; people breathe in their spores every day.
  • Disease strikes mainly people with uncontrolled diabetes (especially ketoacidosis), cancer, neutropenia, transplants or high-dose steroids, and after trauma such as burns or natural disasters.
  • The fungus invades blood vessels, causing thrombosis and tissue death — hence black, necrotic eschars.
  • Rhinocerebral (sinus, orbit and brain) disease is the commonest form in diabetes; pulmonary, cutaneous, gastrointestinal and disseminated forms also occur.
  • Diagnosis needs tissue: KOH mounts and histology show wide, ribbon-like, mostly aseptate hyphae with right-angle branching; culture identifies the genus (Rhizopus, Mucor, Lichtheimia and others).
  • Treatment combines urgent surgical removal of dead tissue with amphotericin B; posaconazole or isavuconazole are alternatives or step-down drugs.
  • There is no vaccine; people at risk can lower exposure by avoiding dusty and soil-contact activities and covering skin.

Quick questions

Who gets mucormycosis?

Mainly people with uncontrolled diabetes, especially diabetic ketoacidosis, and those with cancer, neutropenia, organ or stem-cell transplants, or on high-dose steroids. Skin infection can follow burns or wounds.

Why is mucormycosis called black fungus?

Because the fungus invades blood vessels, cutting off blood supply and leaving black, dead tissue (eschar) in the nose, palate or skin.

How is mucormycosis treated?

With urgent surgery to remove dead tissue, amphotericin B (usually a lipid formulation), and correction of the underlying problem such as ketoacidosis. Posaconazole or isavuconazole are alternatives.

Is this comic free to read?

The first pages are free to preview. Members read the full comic, and you can sign up free to read one comic in full.

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High-yield flash cards (34 cards)

Where do Mucorales live?
In soil and decaying organic matter — leaves, compost, dung, rotting fruit and bread; people inhale the spores every day
Commonest genera causing mucormycosis
Rhizopus (most common, especially R. arrhizus), Mucor, Lichtheimia, Rhizomucor, Cunninghamella and Apophysomyces (A. variabilis causes skin disease after trauma)
Main risk factors for mucormycosis
Uncontrolled diabetes (especially ketoacidosis), haematological malignancy and neutropenia, stem-cell and organ transplant, high-dose corticosteroids, iron overload or deferoxamine therapy, injecting drug use, burns and major trauma

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