PNEUMONIA, PNEUMOCYSTIS JIROVECI

 Basic information

description

Pneumocystis pneumonia (PCP) is an inflammation of the lungs caused by infection with Pneumocystis jiroveci germs. It occurs in children (including infants) and adults with a weakened immune system. They are usually AIDS patients. Most people have been exposed to these germs by age four, but their immune systems are able to fight off any infection.

FREQUENT SIGNS & SYMPTOMS

• Dry, nonproductive cough.
• Fever.
• Difficulty in breathing (more so with exertion).
• Fatigue.
• Weight loss.
• Night sweats.
• Tightness in the chest.
• Lips, fingernails, or skin may turn blue or gray.

causes

Pneumocystis jiroveci (believed to be a fungus). It is most likely transmitted through the air. It is unknown if it lives in soil or other places. It is also unknown how long it takes symptoms to start after exposure. Person-to-person spread is a possibility, but is not yet proven.

risk increases with

• HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome).
• People with weak immune systems due to illness or drugs.
• Cancer chemotherapy (anticancer drugs).
• Long-term steroid drug use.
• Severe malnutrition (any disorder of nutrition).
• History of Pneumocystis jiroveci pneumonia.

PREVENTIVE MEASURES

It is almost entirely preventable with drugs. Preventive drugs can be prescribed for those at risk.

expected outcomes

With prompt diagnosis and treatment, the outlook is generally good for mild cases. With more severe cases, the risk of complications is higher.

possible complications

• Prolonged illness, sometimes fatal.
• Side effects of drugs, especially skin rash and low white blood cell count.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about the symptoms. Medical tests may include x-rays, a study of a specimen of sputum, and high-resolution CT scan. A bronchoscopy may be done. This involves inserting a tube down the throat to view the lungs and to get a sample of tissue for diagnosis.
• Treatment is with drugs given by mouth or given through a vein (IV).
• Treatment may be done at home for mild cases. For more severe infection, hospital care may be needed.
• To learn more: American Lung Association, 61 Broadway, 6th Floor, New York, NY 10006; (800) 586-4872; website: www.lungusa.org.

medications

• Antibiotics, such as trimethoprim/sulfamethoxazole or pentamidine (oral or aerosol) will be prescribed.
• Corticosteroids may be prescribed.
• Cough medicine may be recommended.

activity

Bed rest is recommended until fever subsides. Normal activities should be resumed gradually.

diet

No special diet. Extra fluid helps to thin lung secretions so they can be coughed up more easily.

 notify our office if

• You or a family member has symptoms of Pneumocystis jiroveci pneumonia.
• The following occur during treatment:
  • Higher fever.
  • Pain becomes worse.
  • Increased shortness of breath.
  • Dark or bluish fingernails, toenails, or skin.
  • Blood in the sputum.
  • Nausea, vomiting, or diarrhea.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

Special Notes: