Pathophysiologic Progression of Mucor Infections to Pneumonia and Nursing Interventions

in Treatment

Mucor infections in the pulmonary system result from inhalation of fungal spores or conidia resulting in mucormycosis (Mohammed et al., 2012). In susceptible persons, the introduction of spores or conidia to the pulmonary system causes symptoms such as chest pains and coughs. Pneumonia-like symptoms are produced as mucus production is increased as well as inflammatory responses by the body’s immunity are initiated. The symptoms worsen with further angio-invasion which could result in parenchymal tissue necrosis and hemoptysis.

Early nursing interventions are necessary to prevent the progression of pulmonary mucormycosis. With early diagnosis and treatment, damage on pulmonary tissues is avoided hence improving patient outcomes. The proper nursing interventions in case of pneumonia infections in ensuring the airway are open, proper breathing and oxygenation. This can be assessed using arterial blood gas levels which determines whether gaseous exchange through the lungs is effective (Mohammed et al., 2012).

Abnormal Laboratory and Blood Gasses Results and their Probable Pathophysiologic Causes

From the presented lab values, pH and HCO3 levels are slightly elevated. This indicates hypoventilation due to compromised lung function (Lin, Moua, & Limper, 2017). Pulmonary mucormycosis affects gaseous exchange in the lungs which consequently reduce oxygen levels in the blood (Lin et al., 2017). This can also result in metabolic alkalosis. The lymphocytes levels are below their normal range indicating that the patient is possibly immunocompromised. Also, his fasting blood glucose levels are elevated showing that the patient possibly has diabetes.

Pulmonary mucormycosis commonly affects patients with low immunity and poorly controlled diabetes hence explaining its occurrence in this case (Mohammed et al., 2012). The x-ray shows a left sided blunting due to pneumonia. The left side is opacified with the presence of pleural effusions suggestive of lung destruction.

Medications and Treatments Likely to Be Prescribed

Antifungal therapy is used in the treatment of mucormycosis. The recommended first line drug is liposomal amphotericin B. Other antifungal drugs that could be used include posaconazole and itraconazole (Fernandez et al., 2013). The effectiveness of these drugs is dependent on several factors including early diagnosis and treatment, host response to medications and the extent of the infection. Treating mucormycosis is also affected by the few antifungal agents available for its treatment.

In cases where mucormycosis is advanced and has invaded lung tissue, drug treatment is often futile as they cannot penetrate the affected tissues. Mucormycosis can result in parenchymal tissue necrosis which is irreversible. In such instances, surgery is required to remove the damaged tissues (Fernandez et al., 2013).

References

Fernandez, J. F., Maselli, D. J., Simpson, T., & Restrepo, M. I. (2013). Pulmonary Mucormycosis: What is the best strategy for therapy? Respiratory Care, 58(5), e60–e63. http://doi.org/10.4187/respcare.02106.

Lin, E., Moua, T., & Limper, A. (2017). Pulmonary mucormycosis: Clinical features and outcomes. Infection, 1-6.

Mohammed M., Rahman A., Amer S., Nusrat S., Hassan S., & Hashmi S. (2012). Pulmonary doi:10.1155/2012/120809.

Mucormycosis: An emerging infection. Case Reports in Pulmonology, 2012.