Mucor is a fungus. It can be found in the house on bread and bread like products. It can also be in the heating and air ducts and soiled carpets. Outside it can be found in soil, hay and manure. Especially in leaves, compost and rotten wood piles. It can sometimes be in stored seeds. It can be inhaled or ingested. It affects the respiratory system. It can lead to a brain infection, paralysis, pneumonia, seizures, even death. It can also affect the digestive tract as well. The colonies if the fungus is fast growing and spread quickly. Because we are all probably exposed at times to these conditions, it is most likely for patients with weakened immune systems have a high chance to become affected. There is a lot of complications from fungal pneumonia.

The disease dissemination to other areas, like the brain, heart, eyes, adrenals, meninges, kidneys, spleen, liver and skin is one complication. Another is that the blood vessel invasion, leading to hemoptysis, pulmonary infraction, myocardial infarction, cerebral septic emboli, cerebral infarction, or even blindness. People can experience bronchopleural fistulas, chronic pulmonary symptoms, histoplasmosis, and pericarditis (Web MD, 2017). As a nurse, it is important to watch for effective airways clearance and breathing pattern, Provide oxygen if necessary. It is important to watch for fluid deficit and encourage fluids, watching for fluid overload. As a nurse always be aware of any pain and treat as needed. Give ordered antibiotics as prescribed by the doctor. It is always important to help maintain adequate nutrition.

The laboratory tests are all within normal limits except the following. The glucose fasting was 138 which is higher than the normal range. This may indicate that the patient may have diabetes. The WBC are elevated suggesting infection or inflammation. The ph is elevated meaning the blood is alkaline, low levels of concentrated carbon dioxide. The lymphocytes are low, meaning the body’s ability to fight infection is low. The PaO2 is low and this means low oxygen saturation in the blood. The PaCO2 is also low, this means low carbon dioxide in the blood.  The HCO3 is high, meaning the bicarbonate which helps determine body’s ph. These all point to respiratory alkalosis. The numbers represent an infection or inflammation. The patient has a disturbance in the acid and base exchange from alveolar hyperventilation. This decreases carbon dioxide and increases the bicarbonate which increases the ph which is the bases for respiratory alkalosis.

Treatment would include antibiotics to get rid of infection. Cough medication to give your lungs a rest and allow them to clear. Pain relief because you need to have pain under control so that you can rest. Possible steroids to reduce inflammation. The doctor would order intravenous antifungal medications and consider having surgical debridement. This involves cutting away all infected tissue. By doing the surgery it prevents infection from spreading. These antibiotics of choice are:

  • amphotericin B (given through an IV)- Concerns of nephrotoxity. Must monitor renal functions closely, as well as electrolytes
  • Posaconazole- (given through an IV or orally)- triazole antibiotic and can be used as the step down antibotic from amphotericin B.
  • isavuconazole (given through an IV or orally)- wide spectrum triazole fungal antibiotic

 

 

 

 

Centers for Disease Control and Prevention.(2015). Fungal Diseases. Retrieved August 19, 2017, from https://www.cdc.gov/fungal/diseases/mucormycosis/treatment.html

 

Medscape. (2017). Mucormycosis (Zygomycosis). Retrieved August 19, 2017, from

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