Mucormycosis In Patient With Uncontrolled Diabetes Nursing Discussion

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Mucor or Mucormycosis is a fungal infection caused by a group of molds called mucormycetes, usually found in soil or decaying yard waste (CDC, 2015). This patient likely a fungal spore and it developed into pneumonia in the lungs. People with weakened immune systems are more likely to develop the infection such as cancer patients, patients with a low WBC count and chronic disease, and premature infants (CDC, 2015). Signs and symptoms of a Mucor infection in the lungs are chest pain, dyspnea, cough, and fever (CDC, 2015). Fungi cause infections by multiplying in the area if the immune system is weakened and there are not enough white blood cells to attack the fungi (Copstead & Banasik, 2013).

Nursing interventions include sitting the patient upright, monitoring the patient’s oxygen saturation, vital signs, I&O’s, breath sounds, apical and peripheral pulses, and mental status. Medical intervention for treatment is beginning antifungal medications as soon as possible (CDC, 2015). Early recognition and intervention is critical for the best outcome in patients. Managing the symptoms and the underlying condition that is making the patient immunocompromised is important (CDC, 2015).

Based on the lab workup, the patient’s ABG values are abnormal and reveal they are in respiratory alkalosis. This is the direct cause of the pneumonia and warrants immediate treatment of the underlying condition. The fasting glucose in a little higher than normal values and indicates stress to the body and hormone fluctuations during infection. The hemoglobin and hematocrit are slightly lower than normal, indicating the infection or underlying condition is causing trouble transporting oxygen to the body. The increased white blood cell value indicates infection. The lymphocyte percentage is low (normal range is 18-45%) indicating immunosuppression from something like HIV/AIDS or previous chemotherapy treatment (CBC explained, n.d.). This would explain the patient’s inability to fight off the infection.

Medications most likely prescribed will be antifungals such as Amphotericin B, posaconazole, and isavuconazole, as these are first line treatments proven to be successful (CDC, 2015). Hyperbaric oxygen is sometimes used for treatment, but the therapy has not always proved to be successful (CDC, 2015). Giving oxygen, fluids and nutritional support will assist the patient in addressing the symptoms and begin the healing process. Addressing the underlying condition is important. If this patient is immunocompromised, it would behoove the healthcare provider to initiate isolation precautions and strict hand washing before caring for the patient so that the patient does not acquire another infection while hospitalized for treatment.

Centers for Disease Control and Prevention. (2015). Information for Healthcare Professionals about Mucormycosis. Retrieved from https://www.cdc.gov/fungal/diseases/mucormycosis/h...

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