NURS 6501 Module 1 Assignment: Case Study Analysis Background

NURS 6501 Module 1 Assignment: Case Study Analysis Background

Invasive Aspergillosis is a leading cause of death among patients with chronic and immune-suppressing diseases like rheumatoid.  The disease is mainly caused by the opportunistic mold Aspergillus fumigatus, which is majorly pathogenic and airborne (Challa, 2018). Once inhaled, the pathogens are deposited in the alveolar and bronchioles of the lungs. The infection spreads more rapidly from the lungs to other organs like the brain, kidney, and heart, causing further infection. Delayed diagnosis of the disease impairs its successful treatment. Diagnosis of the disease is based on histological and cultural examination of the spores in tissues. Other methods of diagnosis like detection of components of Aspergillus like galactomannan (GM), DNA, and 1,3- β-D-glucan are being pursued to enable timely diagnosis of the disease for proper management. The purpose of this paper is to present an effective disease analysis of Aspergillosis as presented by the 49-year old patient and determine factors that may affect the progression of the disease in the patient.

Symptoms

In cases of neutropenia and immune suppression, the immune system is compromised, hence the body lacks defense, predisposing patients to opportunistic pathogens. Symptoms of Aspergillosis in patients include fever, coughing, dyspnea, pleuric chest pains, and hemoptysis in severe cases. Other symptoms of the disease may occur if the disease spreads to other organs. Rapidly progressive hypoxemia can also occur in severe diseases. Risk factors for developing Aspergillosis include bone marrow transfers, occurring either at the initial stages of prolonged neutropenia before engraftment or after graft following administration of corticosteroids in the management of graft-host adverse reactions.

Diagnosis

Diagnosis of the disease is based on demonstration of the mold spores on tissues after Gomori methenamine silver staining (GMS). Affected tissues have numerous spores and hyphae characteristic of aspergillus mold. Positive cultures obtained from sputum, needle biopsy, and bronchoalveolar fluid can be used as diagnostic tests (Jenks & Hoenigl, 2020). Clinical signs of the disease like fever and chest pains associated with coughing are used to classify the disease.

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Genes that May Be Associated with the Development of Invasive Aspergillosis

Susceptibility markers for Invasive Aspergillosis are mainly found in the genes and are widely used in signaling the activation of nuclear factor-kappa B (NFκB). Current studies show that a growing number of well-defined simple nucleotide polymorphisms in genes determine the susceptibility of patients to Aspergillosis. Genes encoding for cytokines or chemokines and their respective receptors, single nucleotide polymorphisms (SNPs) in toll-like receptor genes, and other genes of inmate immunity like C-type lectins have been associated with the disease. The cells act as pathogen recognition receptors, leading to activation of the NFkB pathway, and can increase the risk of contracting the disease. In high-risk populations, the presence of the common genetic polymorphisms found in NFκB1, NFκB2, RelA, RelB, Rel, and IRF4 genes increase the susceptibility of the disease ( Lupiañez et al., 2016).