According to Mold & Bacteria Consulting Laboratories (2017), “Mucor is a mold found in soil, plants, manure, decaying fruits, vegetables and as a common contaminant of stored and processed foods in the kitchen.” A patient is likely to become infected with Mucor handling contaminated food while cooking or gardening. It has been found that those who are immunosuppressed are more susceptible to Mucor infections. The progression of infection into pneumonia would be, and already immunocompromised individual is exposed to the mold, the mold inflames the alveoli in the lungs, and the lungs fill with fluid or pus. Interventions to treat this patient include treatment with antifungal medications, such as amphotericin B to kill the mold, couch medicine to allow the patient to rest at night, and fever reducers / pain relievers to limit discomfort (Mayo Clinic, 2017).
The following laboratory values are considered abnormal: high HCO3, low Ca, low PO4, high fasting glucose, high WBC, low lymphocytes, high pH, low PaO2, and a low PaCO2 (NCLEX, n.d.). Low Ca and PO4 levels could be low due to potential vitamin D deficiency or malnutrition caused by being ill (Merck manual 2017). A high WBC with low lymphocytes are common when the body is fighting an infection, especially a viral infection (Mayo Clinic, 2015). A high fasting glucose is indicative of diabetes, but can also be elevated in times of stress on the body, such as fighting an infection (Mayo Clinic, 2014). Further testing should be followed. The patient’s blood gas of a high HCO3, high pH, low PaO2, and low PaCO2 indicate uncompensated metabolic alkalosis. The patient is in this state due to hypoventilation as indicated by the low PaO2 and is due to the decreased lung function from the pneumonia (Cherney, Khan, 2017).
Three medications and treatments for this patient include, administration of amphotericin B, control of the underlying immunocompromising condition, and mechanical ventilation (Centers for Disease Control and Prevention, 2015). Amphotericin B or another antifungal agent is recommended to kill the fungal infection. Controlling the underlying immunocompromising condition would be vital in order to prevent further infections. Mechanical ventilation would be necessary until lung function is improved and blood gasses are normalized.
Centers for Disease Control and Prevention. (2015). Information for Healthcare Professionals About Mucormycosis. Retrieved from https://www.cdc.gov/fungal/diseases/mucormycosis/health-professionals.html.
Cherney, K., Khan, A. (2017). Alkalosis. Retrieved from http://www.healthline.com/health/alkalosis#overview1.
Mayo Clinic. (2014). Diabetes. Retrieved from http://www.mayoclinic.org/diseases-conditions/diabetes/basics/tests-diagnosis/con-20033091.
Mayo Clinic. (2015). High White Blood Cell Count. Retrieved from http://www.mayoclinic.org/symptoms/high-white-blood-cell-count/basics/causes/sym-20050611