NURS 6501 Week 2 Assignment Case Study Analysis

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NURS 6501 Week 2 Assignment Case Study Analysis

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NURS 6501: Advanced Pathophysiology

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Case Study Analysis

The case presents a 49-year-old female rheumatoid arthritis patient with fever, fatigue, and respiratory complaints. Additional investigations confirmed invasive aspergillosis, a lethal fungal infection in the patient. The immunosuppressive medicines, persisting inflammation and infections are illustrated in the scenario. In this assignment there is a focus on evaluating the patient’s symptoms as they relate to the sickness process, the patients family history and hereditary factors and immunosuppression.

Explanation for the Symptoms Presented

Invasive aspergillosis is fungal infection which leads to fever, chills, and sweating. While fighting Aspergillus, the immune system causes fever and chills (Cighir et al., 2024). Sweating also has an abdominal function in that it helps to cool the body. Invasive aspergillosis also contributes to tiredness due to metabolism expenditure by the body system that fights the infection. Fatigue is also one of the effects of inflammation and if not checked, can lead to other complications.

Aspergillosis commonly begins in the lungs where fungal spores lodge, causing chest discomfort and cough. Fungus can inflame airways, producing coughing. Pleura inflammation, the lining of the lungs and chest cavity, may cause chest discomfort. Invasive aspergillosis can also damage pulmonary blood vessels, causing hemoptysis (blood coughing) (Kumar et al., 2020). Urgent medical assistance is needed for this dangerous symptom. The patient’s job as a grain inspector at an agricultural cooperative may have exposed him to dust and soil-borne Aspergillus spores. 

Genes Associated with Invasive Aspergillosis

While the origin of invasive aspergillosis is unknown, genetic differences may enhance susceptibility. The immune system needs Dectin-1 gene to identify fungal infections like Aspergillus (Kalia et al., 2021). Mutations in this gene may prevent identification, rendering people more vulnerable to invasive fungal infections. TLRs, cell surface receptors, also identify pathogen molecular patterns, including fungus. Variations in TLR genes, especially TLR4, can alter Aspergillus immunity and increase susceptibility. Finally, cytokine genes signal immunological response. Certain cytokine gene polymorphisms, such as those influencing IFN-γ, may weaken the immune response to fungal infections (Cezar-dos-Santos et al., 2020).

Immunosuppression and its Effects on Body Systems

Methotrexate and prednisone, drugs used in the treatment of rheumatoid arthritis, are immunosuppressive agents. These drugs are immunosuppressive and help alleviate inflammation associated with rheumatoid arthritis. However, this suppression makes the body more susceptible o infections from the viruses, bacteria, and the fungus known as Aspergillus.

Aspergillus spores are difficult to be cleared from the lungs when the immune system is weak. Fungal colonization and invasive aspergillosis may occur (Pathakumari et al., 2020). Moreover, gut microbiota plays the important role of an effective immune system barrier. Immunosuppression disrupts the homeostasis of gut microbes making people more vulnerable to pathogens that take advantage of the situation. There are few natural barriers that the human body relies on to keep germs out such as skin and mucous membranes. Immunosuppression adversely affects skin integrity and increases predisposition to infections. These infections occur basically due to compromised mucus membranes of the respiratory and urinary tract. In cases where the immune system is compromised the germs may infiltrate the bloodstream and promote dangerous sepsis.

Conclusion

In conclusion, the patient’s symptoms indicate invasive aspergillosis, likely due to his workplace conditions and the immunosuppressive medications he takes for his rheumatoid arthritis. Understanding the genes involved with risk factor and immunosuppression on multiple physiological system aid in understanding this disease.

References

Cezar-dos-Santos, F., João Paulo Assolini, Calvo, N., Kelvinson Fernandes Viana, Brajão, K., & Eiko Nakagawa Itano. (2020). Infection, Genetics and Evolution, 86, 104586–104586. https://doi.org/10.1016/j.meegid.2020.104586 

Cighir, A., Mare, A. D., Coșeriu, R. L., & Man, A. (2024). Invasive fungal pathogens from the tropical and temperate areas – a challenge in pathology and diagnosis. The Journal of Infection in Developing Countries, 18(01), 1–13. https://doi.org/10.3855/jidc.18206 

Kalia, N., Singh, J., & Kaur, M. (2021). The role of dectin-1 in health and disease. Immunobiology, 226(2), 152071. https://doi.org/10.1016/j.imbio.2021.152071 

Kumar, A. A., Ramsakal, A., & Greene, J. N. (2020). Aspergillus mimicking a rasmussen aneurysm in an immunocompromised setting causing massive hemoptysis: a case report and a review of nontuberculous etiology and pathogenesis of mycotic pulmonary artery aneurysms. Infectious Diseases in Clinical Practice, 28(5), 261. https://doi.org/10.1097/IPC.0000000000000878 

Pathakumari, B., Liang, G., & Liu, W. (2020). Immune defence to invasive fungal infections: A comprehensive review. Biomedicine & Pharmacotherapy, 130, 110550. https://doi.org/10.1016/j.biopha.2020.110550

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