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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Pneumocystis jiroveci pneumonia

Pneumocystosis; PCP; Pneumocystis carinii

Last reviewed: November 20, 2013.

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
  • 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
  • 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

  1. 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.

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Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

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. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Adjunctive corticosteroids for Pneumocystis jiroveci pneumonia in patients with HIV‐infectionAdjunctive corticosteroids for Pneumocystis jiroveci pneumonia in patients with HIV‐infection
    Pneumocystis jiroveci pneumonia (PCP), formerly called Pneumocystis carinii pneumonia, is the most common opportunistic infection among patients infected with HIV. In 1990, based on evidence from five randomized control trials, an expert panel recommended the use of corticosteroids for HIV‐infected patients with PCP and substantial hypoxemia (low levels of oxygen in the blood). The objective of this systematic review was to assess the effects of adjunctive corticosteroids on mortality, and the need for mechanical ventilation in patients co‐infected with HIV and PCP. Six studies were included in this review and meta‐analysis. While the number and size of the trials investigating adjunctive corticosteroids for HIV‐infected patients co‐infected with PCP is small, evidence from this review suggests a beneficial effect for patients with substantial hypoxemia.
See all (3) ...

Figures

  • Lungs.
    AIDS.
    Pneumocystosis.

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