Please respond to this post
a. The physicians order seems to be appropriate given the patient’s current clinical status. Because of the patient’s immunocompromised state, she is more at risk of developing infection. In addition, because of the prescribed antibiotics that she is already on, the normal bacterial flora that would normally keep the fungi at bay are unbalanced which in turn is permitting “fungal overgrowth and setting the stage for opportunistic infections” (Norris, 2019, p. 221). In patients such as this, being immunocompromised and neutropenic, the potential for fungal infections is much greater and can manifest with atypical symptoms. “Pathogenic fungi are opportunistic but can cause fungal infection disease in patients with immunocompromised conditions, such as malignancy, chemotherapy, transplantation, acquired immunodeficiency syndrome, and usage of immunosuppressant drugs” (Riley, 2021). Given that the patient is already on antibiotic therapy, the next plan of action would be to include the antifungal drug.
b. As stated above, the clinical manifestations of fungal infections in immunocompromised patients can be atypical and may not always include a fever or positive cultures. If the reasons for her symptoms are due to a fungal infection, it would be affecting things like her lungs or other organs rather than circulating in her bloodstream like a bacterial infection. Because her ANC is currently 0, that also means she has there is a lack of inflammatory responses, including fever. Because of all the risk factors this patient has, including recent chemotherapy and ANC of 0, she has a greater risk of an invasive fungal infection which is associated with a high mortality rate in immunocompromised patients (Houston et al., 2023).
