Rheumatoid arthritis is one of the most prevalent musculoskeletal disorders that, when insufficiently treated, results in detrimental sequelae including joint damage and reduced quality of life. Poor patient adherence to medication is a significant blockade to effective management. The purpose of this review is to highlight and discuss the factors responsible for defiance of antirheumatic medication and ways to overcome these barriers. Education level, health literacy, cohabitation status, multi-morbidities, complicated drug regimen, intermittent co-payments, prescribed regimen adverse effects, and cognitive impairment are a few among many common barrier factors leading to poorer outcomes in rheumatoid arthritis. While there is an abundance of inhibitory factors leading to worsening disease progression, they each can be easily dealt with an effective approach at the beginning or during the treatment course to ensure a better outcome.
Mucormycosis is an opportunistic fungal infection caused by the zygomycetes Mucor and Rhizopus. Most documented conditions and risk factors that predispose to mucormycosis are uncontrolled diabetes mellitus (DM), with or without ketoacidosis, hematological malignancies (HM), transplantation, immunosuppression, and chronic sinusitis. Pulmonary empyema secondary to Mucor in coronavirus disease 2019 (COVID-19)infected patients is rarely documented. Here we present an extremely rare case of pulmonary empyema secondary to Mucor infection complicated by bronchocutaneous fistula in a human immunodeficiency virus (HIV)-infected patient in the setting of acute COVID-19 infection.
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