Pneumocystis jirovecii pneumonia
pneumonia resulting from infection with pneumocystis jirovecii.
Introduction[edit | edit source]
Pneumocystis jirovecii pneumonia (PCP) is a serious infection caused by the fungal organism Pneumocystis jirovecii. Formerly known as Pneumocystis carinii pneumonia, this condition primarily affects individuals with weakened immune systems, such as those with HIV/AIDS, undergoing chemotherapy, or receiving immunosuppressive therapy.
Etiology[edit | edit source]
Pneumocystis jirovecii is the organism responsible for PCP. It is considered a fungus based on molecular analysis, although it shares characteristics with protozoa.
Epidemiology[edit | edit source]
PCP is a global disease and a common opportunistic infection among immunocompromised patients, particularly among individuals with HIV/AIDS before widespread use of antiretroviral therapy (ART).
Pathophysiology[edit | edit source]
The organism attaches to the alveolar lining of the lungs and leads to inflammation and characteristic foamy exudates within the alveoli, hindering normal oxygen exchange.
Clinical Presentation[edit | edit source]
Symptoms of PCP include:
- Progressive shortness of breath
- Nonproductive cough
- Fever
- Weight loss
- Night sweats
Diagnosis[edit | edit source]
Diagnosis of PCP can be challenging and typically involves a combination of clinical presentation, imaging, and laboratory analysis, including:
- Chest X-ray and high-resolution CT scan showing diffuse bilateral infiltrates
- Identification of Pneumocystis organisms in respiratory specimens via microscopy or molecular techniques
- Blood tests showing elevated lactate dehydrogenase (LDH) levels
Treatment[edit | edit source]
Treatment for PCP typically includes antibiotics such as trimethoprim-sulfamethoxazole (TMP-SMX). For patients with sulfa allergies, alternative medications include Pentamidine, Atovaquone, or the combination of Clindamycin and Primaquine.
Prophylaxis[edit | edit source]
Prophylactic measures are recommended for high-risk individuals, such as those with low CD4 counts due to HIV/AIDS. TMP-SMX is commonly used for prevention.
Outcomes[edit | edit source]
With appropriate treatment, the prognosis for PCP can be good, particularly for those without HIV/AIDS. However, the condition can be life-threatening for those with severe immunosuppression.
See Also[edit | edit source]
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Contributors: Prab R. Tumpati, MD