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Mucor belongs to the mold genus, together with yeasts and mushrooms. Mucor comprises of several species which have been identified across the globe. They are eukaryotic organisms living in soil, plants, rotting matter, digestive systems and are capable of causing fatal infections among patients whose immune systems are compromised. Infections from these forms of fungi result in what is commonly known as mucormycosis. Typically, mucormycosis attacks the lungs and sinuses, but may at times affect any part of the body in immunocompromised persons (Rajagopalan, Tachamo, Pathak & Hingorani, 2016). The symptoms of the illness manifest depending on the route of exposure.
Currently, research has identified cutaneous as well as pulmonary exposure (Spellberg & Ibrahim, 2010). Individuals who are at an increased risk of developing mucormycosis include all cases of immune suppression, including those with organ transplants. Patients with ketoacidosis also have a higher chance of
developing the disease. Prompt management of the symptoms is essential, bearing in mind the rapidity upon which the infection spreads. The disease attacks the alveoli mucor, which is the first line of defense. A weak defense will allow spores to penetrate within the spaces in the alveoli, an occurrence that triggers a person’s body to trigger an immune reaction in response. A result will be an increase in the number of leucocytes in the alveoli. Similarly, the increase in reactions will cause excess fluid to leak from the blood vessels to the alveoli, causing pneumonia.
Place the patient on oxygen if they are not receiving hyperbaric treatment. In the meantime, the nurse should monitor the patient’s vital signs and pain frequently. Pneumonia impairs the oxygen transport system; necessitating the need for initiating an incentive spirometer aimed at expelling excess fluids from the lungs (Spellberg, 2017).
The abnormal laboratory values include a pH of 7.5, partial pressure of oxygen=59, bicarbonate level of 29, partial pressure of 25. All these values show that the patient’s body is compensated partially. The patient has lymphocytes level of 10%, indicating that their immune system is compromised. Similarly, the increased white blood cell count of 15,200/mm means that presence of infection cannot be ruled out in this particular patient.
The most important aspect of this patient’s plan of care would be to address the underlying cause of their current state. Neutropenia should be managed by use of colony stimulating factors whereas insulin should be given to patients with diabetic ketoacidosis. Whichever the case, immunosuppressive drugs need to be avoided since they would only worsen the patient’s case. According to Spellberg & Ibrahim, (2010), the lipid formulations of Amphotericin B deoxycholate would safely be
administered to patients with mucormycosis. Their significantly reduced nephrotoxicity nature allows practitioners to deliver high doses for long. The drug remains highly preferred since they are more affordable and result in fewer effects. Amphotericin B deoxycholate is administered in the same manner as the lipid formulations of Amphotericin B deoxycholate. The only difference is that the latter cannot be used patients with cardiac conditions (Spellberg, 2017).
Posaconazole and, or isavuconazole medications should be considered in cases where patients do not respond to Amphotericin B treatment. These drugs may be used conjunctively, or when an initial treatment of Amphotericin B has been done (Spellberg, 2017). Of the drugs discussed, Amphotericin B can only be administered intravenously, while the rest can be given by mouth or through the vein. Sometimes, a doctor may request for surgery to cut away the tissue, or tissues (Spellberg, 2017).
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