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Pneumocystis jiroveci pneumonia
Pneumocystosis; PCP; Pneumocystis carinii
Pneumocystis jiroveci pneumonia is a fungal infection of the lungs. The disease used to be called Pneumocystis carini or PCP pneumonia.
Causes
This type of pneumonia is caused by the fungus Pneumocystis jiroveci . This fungus is common in the environment and rarely causes illness in healthy people.
However, it can cause a lung infection in people with a weakened immune system due to:
- Cancer
- Long-term use of corticosteroids or other medicines that weaken the immune system
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HIV/AIDS
HIV/AIDS
Human immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the virus attacks and weakens the immune ...
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Pneumocystis jiroveci was a rare infection before the AIDS epidemic. Before the use of preventive antibiotics for the condition, most people in the United States with advanced AIDS often developed this infection.
Symptoms
Pneumocystis pneumonia in people with AIDS usually develops slowly over days to weeks or even months, and is less severe. People with pneumocystis pneumonia who do not have AIDS usually get sick faster and are more severely ill.
Symptoms include:
- Cough, often mild and dry
- Fever
- Rapid breathing
- Shortness of breath, especially with activity (exertion)
Exams and Tests
Your health care provider will examine you and ask about your symptoms.
Tests that may be ordered include:
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Blood gases
Blood gases
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
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Bronchoscopy
(with lavage)
Bronchoscopy
Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.
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Lung biopsy
Lung biopsy
A lung needle biopsy is a method to remove a piece of lung tissue for examination. If it is done through the wall of your chest, it is called a tran...
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X-ray of the chest
X-ray of the chest
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
ImageRead Article Now Book Mark Article - Sputum exam to check for fungus that causes the infection
- CBC
- ß-1,3 glucan level in the blood
Treatment
Anti-infection medicines can be given by mouth (orally) or through a vein ( intravenously ), depending on how severe the illness is.
Intravenously
Intravenous means "within a vein. " Most often it refers to giving medicines or fluids through a needle or tube inserted into a vein. This allows th...
People with low oxygen levels and moderate to severe disease are often prescribed corticosteroids as well.
Outlook (Prognosis)
Pneumocystis pneumonia can be life threatening, causing respiratory failure that can lead to death. People with this condition need early and effective treatment. For moderate to severe pneumocystis pneumonia in people with HIV/AIDS, the short term use of corticosteroids has decreased the incidence of death.
Possible Complications
Complications that may result include:
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Pleural effusion
(extremely rare)
Pleural effusion
A pleural effusion is a buildup of fluid between the layers of tissue that line the lungs and chest cavity.
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Pneumothorax
(collapsed lung)
Pneumothorax
A collapsed lung occurs when air escapes from the lung. The air then fills the space outside of the lung, between the lung and chest wall. This bui...
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Respiratory
failure (may require breathing support)
Respiratory
The words "respiratory" and "respiration" refer to the lungs and breathing.
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When to Contact a Medical Professional
If you have a weakened immune system due to AIDS, cancer, transplantation, or corticosteroid use, call your provider if you develop a cough, fever, or shortness of breath.
Prevention
Preventive therapy is recommended for:
- People with HIV/AIDS who have CD4 counts below 200 cells/microliter
- Bone marrow transplant recipients
- Organ transplant recipients
- People who take long-term, high-dose corticosteroids
- People who have had previous episodes of this infection
- People who take long-term immunomodulatory drugs
References
Kovacs JA. Pneumocystis pneumonia. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 341.
Walzer PD, Smulian AG, Miller RF. Pneumocystis species . In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 271.
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Lungs - illustration
The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.
Lungs
illustration
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AIDS - illustration
AIDS (acquired immune deficiency syndrome) is caused by HIV (human immunodeficiency virus), and is a syndrome that leaves the body vulnerable to a host of life-threatening illnesses. There is no cure for AIDS, but treatment with antiviral medicine can suppress symptoms. AIDS is universally fatal, in large part due to the proliferation of opportunistic infections.
AIDS
illustration
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Pneumocystosis - illustration
Pneumocystosis is an infection of the lungs caused by the microorganism Pneumocystis carinii. Pneumocystosis is almost exclusively seen in individuals whose immune systems have been compromised by AIDS or chemotherapy. Pneumocystosis is usually a terminal event in AIDS patients.
Pneumocystosis
illustration
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Lungs - illustration
The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.
Lungs
illustration
-
AIDS - illustration
AIDS (acquired immune deficiency syndrome) is caused by HIV (human immunodeficiency virus), and is a syndrome that leaves the body vulnerable to a host of life-threatening illnesses. There is no cure for AIDS, but treatment with antiviral medicine can suppress symptoms. AIDS is universally fatal, in large part due to the proliferation of opportunistic infections.
AIDS
illustration
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Pneumocystosis - illustration
Pneumocystosis is an infection of the lungs caused by the microorganism Pneumocystis carinii. Pneumocystosis is almost exclusively seen in individuals whose immune systems have been compromised by AIDS or chemotherapy. Pneumocystosis is usually a terminal event in AIDS patients.
Pneumocystosis
illustration
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Pneumonia
(In-Depth)
Review Date: 12/10/2015
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
