This refers to moulds of a particularly microbial genus commonly found in the digestive system, decaying vegetable matter, plant surfaces, and soil. Depending on the route of infection, mucor can result in two types of infection (Ibrahim, Spellberg, Walsh, & Kontoyiannis, 2012). In the case of pulmonary exposure, the victim inhales fungal spores found in the environment which may cause an infection to develop in the sinuses, face, eyes and lungs. During cutaneous exposure, the fungus enters the skin via puncture wounds, cuts, or scrapes.
Mucormycosis, though rare is an infection attributed to the organisms belonging to a group of fungi by the name mucormyomycotina. Such fungi are found soil are normally associated with decomposing organic matter such as compost piles, leaves or rotten wood. Though noncontagious, it pathophysiological progression is very fast and if no timely treatment is administered. Those who have had pulmonary exposure usually end up having pneumonia. Upon being inhaled, it invades the alveoli after which the spores penetrate the spaces found between cells as it spreads to the proximal cells (Ibrahim et al., 2012). As the fungi spread in the lungs, the immune system is activated which leads to an increase in the leucocytes of the victim as his or her body responds by exhibiting inflammation and the leaking of fluids from the adjacent blood vessels into the alveoli leading to pneumonia and an impairment in oxygen transportation. The reaction of the immune system results in fever chills, and fatigue which are typical symptoms of pneumonia.
There are some nursing interventions that might be used including administering oxygen in a bid to resolve the hypoxia while positioning the patient in a high Fowler position. The nurse could also administer medication as per the doctors' prescriptions in the treatment of fungal infection and the restoration of pulmonary function.
The medication used in the treatment of mucormycosis are primarily antifungals particularly amphotericin agents, posaconazole, isoconazole and many others. Amphotericin B is the drug of choice when it comes treatment of mucormycosis due to its proven efficacy give at administered at 1-1.5 mg/kg/d (Ibrahim et al., 2012). Posaconazole is the second-line drug when it comes to the treatment of mucormycosis. It is given orally at doses of 400 mg twice daily. Research has shown that its use has a higher success rate (50-70%) when compared to its comparator, typically amphotericin B (only 25%) (Sun & Singh, 2011). This suggests that with time its may become the drug of choice for the treatment of mucormycosis. Isavuconazole is another antifungal agent indicated for invasive mucormycosis infections attributed to Mucorales fungi.
Other medical treatments include surgery. This involves the repetitive removal of necrotic tissue, for example, enucleation of the eye so as to bar dissemination. The other treatment is hyperbaric oxygen therapy which is beneficial particularly to diabetic patients with extensive cutaneous disease. It not only enhances the oxidative killing of amphotericin B but also improves neutrophil activity (Sun & Singh, 2011). It also increases the release of tissue growth factor thus improving the rate of wound healing. High concentration of oxygen has also been found to inhibit the growth of Mucorales. The other medical treatment is immune augmentation through granulocyte transfusion. This poses as a helpful bridge before neutrophil recovery is achieved (Sun & Singh, 2011).
References
Ibrahim, A. S., Spellberg, B., Walsh, T. J., & Kontoyiannis, D. P. (2012). Pathogenesis of mucormycosis. Clinical Infectious Diseases, 54(SUPPL. 1).
Sun, H. Y., & Singh, N. (2011). Mucormycosis: Its contemporary face and management strategies. The Lancet Infectious Diseases.
