Death by fungus is gruesome one. I recall telling a friend in college that he want to look up some pictures as test to see if he might be able withstand a transit through med school. I didn't read about it coming up during the huge surges in western countries. But seeing lots of
cases of mucor infections being reported in the current wave in the desh. In America I have seen reports of it arising from infections of injuries in war or during hurricanes but didn't read of it as sequel of SARS-CoV-2 infection. But standard references state explicitly that
majority of cases arise in patients with diabetes with high ketone concentration in blood. This could explain the high incidence in the current wave due to the high incidence of diabetes in India which might be exacerbated by the steroid treatment & perhaps pushing some to
ketoacidosis. Mucors are more basal fungi (i.e. outside of the "crown fungi" composed of ascomycetes, e.g. the alcohol yeast & basidiomycetes, e.g. mushrooms). They are commonly seen as molds on decaying food and their spores are abundant in any place with a little decay,
especially in desh. We inhale their spores all the time but normal humans are quite resistant to it. It appears that cold blooded animals are way more susceptible to fungal infections. Warm blooded animals like mammals and dinosaurs are less so. One of the selective advantages
that might have led to the fixation of warm bloodedness is probably a high degree of natural resistance to systemic mycosis. My own investigations suggest that cold-blooded animals might have a special defense against such fungal pathogens that we have lost as endothermy takes
care. Thus, we see frogs being decimated by systemic fungal infection but rare to see mammalian (except probably bats) or bird species being similar attacked. So there has to be a special condition for systemic mycosis& probably the diabetes prevalence in desh is the big factor
in this. I don't know how well physicians in desh are conversant with mycology -- while it might not immediately affect treatment it would be good for them to keep an eye on: 1) what are the prevalent species in this wave? 2) Are ascomycetes also involved like aspergillosis?
3) Is there a difference in pathology between the different species? This might be important for prevention especially if some species tend to be more common 1 could keep an eye on the common sources of decaying matter where they are growing in the vicinity of healthcare settings
It might also help more rapid detection because these mycosis are super-destructive. Hence, it is important the molecular biologists develop & standardize the primers for detecting these. The most widely reported mucors include: Mucor, Rhizopus, Lichtheimia Cunninghamella,
Rhizomucor, Apophysomyces & Phycomyces. Primers for these could be easily developed. In addition to the ascomycosis by Aspergillus, physicians would also want to keep an eye to see if Basidiobolus or Conidiobolus might be active. Further, their response to different antifungals
should also be carefully monitored. Wonder if small molecules or odor tests could also allow a detection like Basidiobolus having that geosmin smell. But if it has come to that it might be too advanced.

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