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Pneumocystis jiroveci pneumonia

Pneumocystis pneumonia; Pneumocystosis; PCP; Pneumocystis carinii

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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
  • HIV/AIDS
  • Organ or bone marrow transplant

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.

Definition

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

Exams and Tests

Your health care provider will examine you and ask about your symptoms.

Tests that may be ordered include:

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:

Prevention

Preventive therapy is recommended for:

  • People with HIV/AIDS who have CD4 counts below 200 cells/microliter or 200 cells/cubic millimeter
  • 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

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)

Treatment

Anti-infection medicines can be given by mouth (orally) or through a vein (intravenously), depending on how severe the illness is.

People with low oxygen levels and moderate to severe disease are often prescribed corticosteroids as well.

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.

Review Date: 12/13/2017
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, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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