Invasive Mold Infections: A Rare but Deadly Fungal Disease

WORDS DR LOW LEE LEE

FEATURED EXPERT
DR LOW LEE LEE
Infectious Disease Physician
Sultanah Bahiyah Hospital
FUNGI: OUR FRIENDS & FOES (IT’S COMPLICATED)

Fungi are found naturally in our environment. There are many different types of fungi, over 2 million species however about 600 fungi have caused diseases.

Invasive fungal infections typically manifest as a severe and aggressive form of the disease, leading to corresponding to high prevalence and death rates if left untreated.

These infections include invasive mold infections.

INVASIVE MOLD INFECTIONS AT A GLANCE
  • Usually caused by Aspergillus (giving rise to invasive aspergillosis) but can also be caused by other rarer molds such as Mucormycetes (giving rise to mucormycosis).
  • These molds produce spores; most of us encounter these spores every day without getting ill, but people with compromised immune systems may develop complications as a result of these spores.
  • Despite invasive aspergillosis and mucormycosis being relatively uncommon, invasive mold infections are often life threatening. If left untreated, the mortality rates can reach 100%!
  • Various parts of the world reported superinfections of invasive aspergillosis and mucormycosis in patients with COVID-19, which are associated with increased risk of death. COVID-19 likely increases the risk for fungal infections because it weakens the immune system or due to certain therapies used for treatment such as steroids.
  • There are no specific symptoms, as symptoms can vary depending on the type of infection. This makes diagnosis an infection a challenging and sometimes complicated task!
Invasive Aspergillosis
Aspergillosis and how it affects our lungs. Click on the image for a larger, more detailed version.
  • Invasive aspergillosis is uncommon and occurs primarily in immunocompromised people.
  • Commonly seen in people that have undergone stem cell and other organ transplants (especially lung transplant), as well as in patients with blood-related cancers such as acute leukemia.
  • Typically affects the lungs, but it can also spread to other parts of the body.
Mucormycosis
  • Mucormycosis is rare and estimated to affect approximately 10,000 cases worldwide, barring India. If India is included the numbers rise to 910,000 cases annually!
  • Typically occurs in the sinuses of the nose or lungs; however it can spread to the brain and other organs as well.
COMMON SYMPTOMS OF A POSSIBLE INVASIVE MOLD INFECTION
  • Typical pneumonia symptoms including fever, chest pain, cough, coughing up blood, and shortness of breath
  • Sinus infection, which may be painful
  • Pain, tenderness, swelling and pressure around the eyes, cheeks, nose or forehead
  • One-sided facial swelling
  • Headaches
  • Nasal or sinus congestion
  • Black lesions on nasal bridge
HOW TO REDUCE YOUR RISK OF AN INVASIVE MOLD INFECTION
  • When performing activities that involve close contact with soil and dust, such as yard work or gardening, take care to wear shoes, long pants, and long-sleeved shirts
  • Whenever possible, avoid dusty areas like construction or excavation sites; wear a N95 mask when you have to visit these areas
  • Keep your house dry and mold-free
  • Avoid staying in a moldy home (even while it is being cleaned)

GETTING REAL ABOUT RABIES

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GETTING REAL ABOUT RABIES

October 22, 2020   Return

WORDS LIM TECK CHOO

Facts about Rabies

  • It can come from a bite. The rabies virus is spread through infected saliva. When an infected creature bites through your skin, the virus can enter the body through infected saliva.
  • It’s bad for the brain—really bad. Once it enters the body, the rabies virus can quickly move via the bloodstream to the brain, where it can cause swelling and inflammation. If left untreated, this can be fatal. Most deaths from rabies occur among children.


Does Your Dog Have Rabies?
In popular media, a dog with rabies is often portrayed as foaming excessively around the mouth, but things are a little more complicated in real life. It may not be easy to tell from a glance whether a dog has rabies. There is a window of time after infection when an infected creature will not show any symptoms of illness, but could still infect other mammals in the meantime.

We can get a clue that something is wrong with our canine pet, though, if it begins to behave in a strange manner. For example, they may become more timid and move more slowly. In fact, it is more common for dogs with rabies to behave this way, compared to the stereotypical aggressive, barking behaviour shown in popular media!

The rule of thumb here is to bring our pet to a veterinary physician for a check-up if we suspect that it may be infected by rabies.

Alternatively, vaccinate our pet every year with the rabies

vaccine, and we’ll have nothing to worry about!

If we spot any stray dogs behaving strangely, especially during a rabies outbreak, we should report them to the city council. In our report, we should include description (colour, species, etc) as well as location of the stray.

 

How to Protect Your Dog from Rabies during an Outbreak

  • Vaccinate your dog.
  • Keep your dog isolated in your house compound (no going out!), so that it will not come into contact with potentially infected dogs. Isolation is necessary even after receiving a vaccination, as a dog still needs some time after a jab to build up the necessary immunity against rabies.

What If Your Dog Has Rabies?
Unfortunately, at this time there is no effective cure or treatment for rabies. Rabies is almost always fatal; infected dogs will succumb to the disease less than a week after showing signs of infection.

Prevention is the only way to protect our dogs. The vaccine offers protection for about a year, so the rabies vaccine should be given to our dogs once every year.

 

What to Do If You Had Been Bitten by a Rabies-Infected Dog
Don’t panic. Health experts say that the most important

thing to do is to clean the wound with soap and running water for 10 to 15 minutes.

Then, visit the hospital right away, and inform the doctor that you have been bitten by a dog.

Children may not voluntarily inform adults that they have been bitten by a dog, so if you suspect that their injury is a dog bite, ask them for confirmation first. Wash the wound as described above and send them to the hospital immediately after.