Introduction
Mucor is a type of fungi that is pathogenic to human beings. When mucor causes infection, it is called mucormycosis. Mucormycosis can occur in different parts of the body; six distinct areas of the body are susceptible to infection by mucor. These parts include the following: pulmonary, cutaneous, bones, breast, kidneys and mediastinum (Fernandez, Maselli, Simpson, &Restrepo, 2012). In this paper, however, the focus will be pulmonary mucormycosis, the first ever case of pulmonary mucormycosis was observed in 1876 by Furbringer.
Pulmonary mucormycosis is caused when an individual inhales fungi spores into the bronchioles then into the alveoli. After inhalation, there is rapid progress to pneumonia. Rhizopusoryzae is the main causative agent for pulmonary mucormycosis. Immunosuppressive conditions are the main factors that predispose people to pulmonary mucormycosis (Panigrahi, Manju, Vinod Kumar, &Toi, 2014). Patients with poorly managed diabetes mellitus in DKA, patients on long-term corticosteroid therapy, cancer patients, and neutropenic patients are some examples of patients whose immunity is compromised.
Mucoracercae is ubiquitous fungi that are often found in soil or in a matter that is decaying. Rhizopus can be found on decaying bread; as such, human beings are exposed to these agents on a daily basis. They however rarely cause infection and only attack immuno-compromised individuals. The major avenue for infection is via inhalation of conidia. The infected tissues undergo substantial necrosis. The recommended medical treatment for the infection is liposomal amphotericin B. Studies also advocate for surgical debridement of the patients. Similar studies indicate that a combination of amphotericin B and surgical debridement significantly improves survival rates (Panigrahi, Manju, Vinod Kumar, &Toi, 2014).
There are a couple of abnormalities in the blood work up of the patient. Primarily the patient has leukocytosis; his white blood cell count is elevated at 15,200 per microliter of blood. Normally it ranges between 4500 and 10,000 white blood cells per microliter of blood. The leukocytosis is indicative of infection and in this case the infection of the pulmonary tissues by mucor. The body is producing more WBCs to fight the infection. The patient has low partial pressures of carbon IV oxide due to hypoventilation because of the shortness of breath caused by the fungal infection (Wang, Guo, Xue, & Chen, 2016). The mild alkalosis is due to the hypoventilation that reduces the CO2 in the blood.
According to Wang, Guo, Xue, & Chen (2016) treatment should focus on eliminating the cause of the patient’s immunosuppressed state. For patients in diabetic ketoacidosis, insulin should be administered to correct the condition. Sodium bicarbonate should also be given to reduce the acidosis. Neutropenia that is associated with hematologic malignancy or its treatment be reversed. The alternative could be withdrawing the cytotoxic chemotherapeutic agents. The patients that have been on long-term corticosteroid therapy should be weaned off them and stop the other immunosuppressive drugs.
The medications that could be prescribed include antifungal agents such as liposomal and lipid complex amphotericin B. Fernandez, Maselli, Simpson, &Restrepo (2012) suggest that the drug is efficacious against pulmonary mucormycosis. In higher doses, it is nephrotoxic. In such instances posaconazole, a second line drug that is a triazole can be administered to the patient. Another necessary form of treatment includes surgical debridement of the necrotic tissue. The surgeries will remove the dead tissues that can cause a blockage at the bronchioles; lobectomy is indicated.
In summary, mucor is a fungal pathogen that causes mucormycosis when it infects body tissues. It is an opportunistic infection that only takes advantage of people in immunocompromised states such as cancer patients. The infection can cause pulmonary mucormycosis among other types of mycoses. The paper has analyzed the pathology of the infection, the abnormal blood works and the likely treatments and prescription drugs.
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References
Fernandez, J., Maselli, D., Simpson, T., & Restrepo, M. (2012). Pulmonary Mucormycosis: What Is the Best Strategy for Therapy?. Respiratory Care. http://dx.doi.org/10.4187/respcare.02106
Panigrahi, M., Manju, R., Vinod Kumar, S., & Toi, P. (2014). Pulmonary Mucormycosis Presenting as Nonresolving Pneumonia in a Patient With Diabetes Mellitus. Respiratory Care, 59(12), e201-e205. http://dx.doi.org/10.4187/respcare.03205
Wang, X., Guo, L., Xue, S., & Chen, Y. (2016). Pulmonary mucormycosis: A case report and review of the literature. Oncology Letters. http://dx.doi.org/10.3892/ol.2016.4370
