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Pneumocystis jiroveci pneumonia


Definition:

Pneumocystis jiroveci pneumonia is a fungal infection of the lungs. The disease used to be called Pneumocystis carini or PCP pneumonia.

Alternative Names:

Pneumocystosis; PCP; Pneumocystis carinii

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
  • 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 this infection.

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:
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 the incidence of death.

Possible Complications:
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 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
References:

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


Review Date: 11/20/2013
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. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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