Comment 1: Mucor is a mold that causes a serious fungal infection. Mucormycosis most commonly affects the sinuses or lungs and affects people with weakened immune systems. It infects the sinuses or lungs after inhaling fungal spores from the air, or can enter the skin through a cut, scrape, burn, or other skin injury. This group of fungi lives in most soil, especially decaying leaves, composite piles, or rotten wood. People come in contact with this frequently but may do not often develop mucormycosis unless they are immune compromised, then the fungi gets into their sinuses or lungs, develops an infection and spreads to other areas of the body and they are unable to fight it off (Cdcgov. (2015)). The infection starts with signs of a fever, cough sometimes with dark or bloody sputum, and shortness of breath, it then progresses and rapidly multiplies in blood vessel walls. When the fungus reaches the alveoli in the lungs, it travels into the spaces between the cells and the connecting pores. The immune system is then triggered to send the white blood cells (neutrophils) to try and fight off the invasion of the fungus. The neutrophils then try to do their job while at the same time are releasing cytokines which activate the immune system. This is when the pneumonia sets in and just continues to take over as the alveoli fill with fluid leaking from the surrounding blood vessels which results in impaired oxygen transportation (Wikipediaorg. (2018)).
Medical/Nursing interventions:
1) Educate the patient on the importance of taking their medication as prescribed and to finish the entire dose.
2) Apply Oxygen as needed to help ease the symptoms of dyspnea
3) Control any underlying immune compromised condition if possible
Comment 2: The attending physician will prescribe an antifungal treatment for mucormycosis. Prescription antifungals will be used such as amphotericin B, posaconazole or isavulcaonazole (CDC, 2015). Antifungal therapies can be administered IV and oral depending on the medication. Treatment can also involve surgical debridement of the infected area. The chest X-ray in the case study shows areas in the lungs that are infected and potentially necrotic, requiring surgical intervention. Lastly, appropriate treatment of any other debilitating diseases should be addressed, such as diabetes and infections, other than mucormycosis.