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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 carinii.

    Causes

    This type of pneumonia is caused by the fungus Pneumocystis jiroveci. This fungus is common in the environment and does not cause illness in healthy people.

    However, it can cause a lung infection in people with a weakened immune system due to:

    • Cancer
    • Chronic use of corticosteroids or other medications that weaken the immune system
    • HIV/AIDS
    • Organ or bone marrow transplant

    Pneumocystis jiroveci was a relatively rare infection before the AIDS epidemic. Before the use of preventive antibiotics for the condition, most people in the United States with advanced AIDS would develop it.

    Symptoms

    Pneumocystis pneumonia in those 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 acutely ill.

    Symptoms include:

    • Cough -- often mild and dry
    • Fever
    • Rapid breathing
    • Shortness of breath -- especially with activity (exertion)

    Exams and Tests

    • Blood gases
    • Bronchoscopy (with lavage)
    • Lung biopsy
    • X-ray of the chest
    • Sputum exam to check for fungus that causes the infection

    Treatment

    Antibiotics can be given by mouth (orally) or through a vein (intravenously), depending on the severity of the illness.

    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 AIDS, the short term use of corticosteroids has decreased death.

    Possible Complications

    • Pleural effusion (extremely rare)
    • Pneumothorax (collapsed lung)
    • Respiratory failure (may require breathing support)

    When to Contact a Medical Professional

    If you have a weakened immune system due to AIDS, cancer, transplantation, or corticosteroid use, call your doctor if you develop a cough, fever, or shortness of breath.

    Many infections can lead to similar symptoms. Your health care provider can help rule out opportunistic infections such as pneumocystis.

    Prevention

    Preventive therapy is recommended for:

    • Patients with AIDS who have CD4 counts below 200
    • Bone marrow transplant recipients
    • Organ transplant recipients
    • People who take long-term, high-dose corticosteroids
    • People who have had previous episodes of this infection

    References

    Feinberg JE. Pneumocystis pneumonia. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 362.

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    • Lungs

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    • AIDS

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    • Pneumocystosis

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      • Lungs

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      • AIDS

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      • Pneumocystosis

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      A Closer Look

      Tests for Pneumocystis jiroveci pneumonia

      Review Date: 12/1/2009

      Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; 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. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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