MUCORMYCOSIS (BLACK FUNGUS): INTERPLAY BETWEEN IMMUNOSUPPRESSION, DIABETES MELLITUS, AND GENETIC SUSCEPTIBILITY: A REVIEW

Rand Manaf Abd Al-Rhman; Marwa Shaker Mahmood; Hala Ali Turky

doi:10.61796/jmgcb.v2i10.1421

Authors

Rand Manaf Abd Al-Rhman
rand.manaf@sc.uobaghdad.edu.iq
University of Baghdad, Iraq
Marwa Shaker Mahmood University of Baghdad, Iraq
Hala Ali Turky University of Baghdad, Iraq

Vol. 2 No. 10 (2025): Journal of Medical Genetics and Clinical Biology

Articles

August 30, 2025

Downloads

VIEW ARTICLE

Abstract
How to Cite
Metrics
References
License

Objective: Moulds called mucormycetes are the source of the uncommon but dangerous fungal infection known as mucormycosis, or zygomycosis. Method: Immunocompromised people, such as those with untreated diabetes, haematologic malignancies, and immunological dysregulation brought on by COVID-19, are the main victims. Results: Rapid progression, angioinvasion, tissue necrosis, and a high death rate if left untreated are the disease's hallmarks. Novelty: This study highlights the emerging association of mucormycosis with COVID-19-induced immunological dysregulation, emphasizing its significance in recent patient populations and the urgent need for clinical awareness.

Al-Rhman, R. M. A., Mahmood, M. S., & Turky, H. A. (2025). MUCORMYCOSIS (BLACK FUNGUS): INTERPLAY BETWEEN IMMUNOSUPPRESSION, DIABETES MELLITUS, AND GENETIC SUSCEPTIBILITY: A REVIEW . Journal of Medical Genetics and Clinical Biology, 2(10), 460–468. https://doi.org/10.61796/jmgcb.v2i10.1421

Download Citation

P. Pradnya and K. P. Kunal, "A Review On Mucormycosis (Black Fungus)," Int. J. of Pharm. Sci., vol. 2, no. 6, pp. 1020–1037, 2024.

B. Mousavi, M. T. Hedayati, N. Hedayati, M. Ilkit, and S. Syedmousavi, "Aspergillus species in indoor environments and their possible occupational and public health hazards," Curr Med Mycol., vol. 2, no. 1, pp. 36–42, 2016.

O. A. Barbosa, E. S. do Amaral, G. Pinheiro Furtado, V. C. Filomeno da Silva, M. de Alencar Isabele, and K. Aguiar de Freitas, "Fungal Necrotizing Fasciitis Due to Mucormycosis Following Contaminated Substance Inoculation: A Report of Two Cases," Eur J Case Rep Intern Med., vol. 11, no. 11, p. 004914, 2024.

M. Kottarathil, P. Thayanidhi, P. S., and A. Jyoti Kindo, "Rise of mucormycosis during the COVID-19 pandemic and the challenges faced," Curr Med Mycol., vol. 9, no. 1, pp. 44–55, 2023.

M. Sen, S. G. Honavar, N. Sharma, and M. S. Sachdev, "COVID-19 and eye: a review of ophthalmic manifestations of COVID-19," Indian J Ophthalmol, vol. 69, no. 3, p. 488, 2021.

J. L. Hernández and C. J. Buckley, "Mucormycosis," StatPearls [Internet], Treasure Island (FL): StatPearls Publishing, 2025.

C. R. Thornton, "Detection of the 'Big Five' mold killers of humans: Aspergillus, Fusarium, Lomentospora, Scedosporium and Mucormycetes," Adv Appl Microbiol., vol. 110, pp. 1–61, 2020.

B. Vasudevan, N. Hazra, K. P. Shijith, S. Neema, and S. Vendhan, "Mucormycosis: The Scathing Invader," Indian J Dermatol., vol. 66, no. 4, pp. 393–400, 2021.

A. S. Ibrahim, B. Spellberg, T. J. Walsh, and D. P. Kontoyiannis, "Pathogenesis of mucormycosis," Clin Infect Dis., vol. 54, Suppl 1, pp. S16–22, 2012.

C. H. Yin, C. Wang, Z. Tang, S. W. Zhang, and B. S. Wang, "Clinical analysis of 146 patients with critical severe acute respiratory syndrome in Beijing areas," Clin J Emerg Med., vol. 1, pp. 12–14, 2004.

G. Reid, J. P. Lynch 3rd, M. C. Fishbein, and N. M. Clark, "Mucormycosis," Semin Respir Crit Care Med., vol. 41, pp. 99–114, 2020.

L. Millon et al., "Early diagnosis and monitoring of mucormycosis by detection of circulating DNA in serum: Retrospective analysis of 44 cases collected through the French surveillance network of invasive fungal infections (RESSIF)," Clin Microbiol Infect., vol. 22, pp. 810.e1–8, 2016.

A. Weissferdt, Infectious Lung Disease, Diagnostic Thoracic Pathology, pp. 3–71, 2019.

B. D. Nam, T. J. Kim, K. S. Lee, T. S. Kim, J. Han, and M. J. Chung, "Pulmonary mucormycosis: Serial morphologic changes on computed tomography correlate with clinical and pathologic findings," Eur Radiol., vol. 28, pp. 788–795, 2018.

Y. Addasi, A. H. Nguyen, A. Sabri, F. Ahmad, R. Rangray, and M. Velagapudi, "Gastrointestinal Mucormycosis: A Clinical Review," Gastroenterology Res., vol. 16, no. 5, pp. 249–253, 2023.

A. H. Sarrami et al., "Fatal disseminated mucormycosis in an immunocompotent patient: a case report and literature review," Int J Prev Med., vol. 4, no. 12, pp. 1468–1471, 2013.

N. Rais, R. Ahmad, A. Ved, K. Parveen, D. G. Bari, and O. Prakash, "Diabetic Ketoacidosis (DKA), a Leading Risk Factor for Mucormycosis (Black Fungus), during the Era of Coronavirus Disease-2019 (COVID-19): An Overview," Curr Diabetes Rev., vol. 19, no. 1, p. e150322202260, 2023.

Z. Soleimani et al., "Mucormycosis in patients infected with the delta strain of COVID-19 virus, effective of some factors in the prevalence and patient prognosis in Shahid Beheshti Hospital, Kashan, central Iran," Caspian J Intern Med., vol. 16, no. 2, pp. 239–245, 2025.

I. Mahalaxmi et al., "Mucormycosis: An opportunistic pathogen during COVID-19," Environ Res., vol. 201, p. 111643, 2021.

P. Dam et al., "Surge of mucormycosis during the COVID-19 pandemic," Travel Med Infect Dis., vol. 52, p. 102557, 2023.

K. Takemura et al., "Iron acquisition strategies in pathogenic fungi," mBio, vol. 16, p. e01211-25, 2025.

A. D. Castrejón-Pérez, E. C. Welsh, I. Miranda, J. Ocampo-Candiani, and O. Welsh, "Cutaneous mucormycosis," An Bras Dermatol., vol. 92, no. 3, pp. 304–311, 2017.

M. S. Lionakis, R. A. Drummond, and T. M. Hohl, "Immune responses to human fungal pathogens and therapeutic prospects," Nat Rev Immunol., vol. 23, no. 7, pp. 433–452, 2023.

F. E. Nicolás, L. Murcia, E. Navarro, M. I. Navarro-Mendoza, C. Pérez-Arques, and V. Garre, "Mucorales Species and Macrophages," J. Fungi, vol. 6, p. 94, 2020.

A. A. Al-Qahtani, F. S. Alhamlan, and A. A. Al-Qahtani, "Pro-Inflammatory and Anti-Inflammatory Interleukins in Infectious Diseases: A Comprehensive Review," Trop. Med. Infect. Dis., vol. 9, p. 13, 2024.

M. J. Marakalala, A. M. Kerrigan, and G. D. Brown, "Dectin-1: a role in antifungal defense and consequences of genetic polymorphisms in humans," Mamm Genome., vol. 22, pp. 55–65, 2011.

M. A. Langarizadeh et al., "A review on function and side effects of systemic corticosteroids used in high-grade COVID-19 to prevent cytokine storms," EXCLI J., vol. 20, pp. 339–365, 2021.

D. T. DiPalma, K. Lumbreras, and M. L. Shinohara, "Interplay between fungal infections and autoimmunity: mechanisms and therapeutic perspectives," EMBO Mol Med, vol. 17, pp. 1501–1518, 2025.

K. A. Mohammad et al., "Role of TLR2 rs5743708 and dectin-1 rs16910526 polymorphisms in susceptibility to fungal infections in COVID-19 patients," Cent Eur J Immunol., vol. 50, no. 1, pp. 77–86, 2025.

D. Li et al., "Hereditary hemochromatosis caused by a C282Y/H63D mutation in the HFE gene: A case report," Heliyon, vol. 10, p. e28046, 2024.

M. T. Martínez-Pastora and S. Puig, "Adaptation to iron deficiency in human pathogenic fungi," BBA - Molecular Cell Research, vol. 1867, no. 10, p. 118797, 2020.

Y. Kang, Y. Yu, and L. Lu, "The Role of Pentraxin 3 in Aspergillosis: Reality and Prospects," Mycobiology, vol. 48, no. 1, pp. 1–8, 2020.

J. A. Ribes, C. L. Vanover-Sams, and D. J. Baker, "Zygomycetes in human disease," Clin Microbiol Rev., vol. 13, no. 2, pp. 236–301, 2000.

S. M. Heaton et al., "Histopathological techniques for the diagnosis of combat-related invasive fungal wound infections," BMC Clin Pathol., vol. 16, p. 11, 2016.

R. Gudisa, R. Harchand, and S. M. Rudramurthy, "Nucleic-Acid-Based Molecular Fungal Diagnostics: A Way to a Better Future," Diagnostics (Basel), vol. 14, no. 5, p. 520, 2024.

M. Kumar and M. Mugunthan, "β-d-Glucan and Aspergillus Galactomannan assays in the diagnosis of invasive fungal infections," Med J Armed Forces India., vol. 75, no. 4, pp. 357–360, 2019.

N. R. Stone, T. Bicanic, R. Salim, and W. Hope, "Liposomal Amphotericin B (AmBisome(®)): A Review of the Pharmacokinetics, Pharmacodynamics, Clinical Experience and Future Directions," Drugs, vol. 76, no. 4, pp. 485–500, 2016.

S. Boqaaiya, Y. Cohen, K. Beiruti Wiegler, and O. Chassid, "Treatment and Survival Outcomes in Rhino-Orbital Mucormycosis with and without Orbital Exenteration: A Retrospective Case Series and Literature Review," Int Med Case Rep J., vol. 18, pp. 747–762, 2025.

R. Ahmad, M. Narwaria, A. Singh, S. Kumar, and M. Haque, "Detecting Diabetic Ketoacidosis with Infection: Combating a Life-Threatening Emergency with Practical Diagnostic Tools," Diagnostics, vol. 13, p. 2441, 2023.

A. S. Ibrahim et al., "The iron chelator deferasirox protects mice from mucormycosis through iron starvation," J Clin Invest., vol. 117, no. 9, pp. 2649–2657, 2007.