Pneumocystis pneumonia (PCP)

Chest | Pulmonology | Pneumocystis pneumonia (PCP) (Disease)


Pneumocystis pneumonia (PCP) is a serious infection that causes inflammation and fluid buildup in the lungs. It is caused by a fungus called Pneumocystis jiroveci. Likely spread through the air, this fungus is very common. Most people are exposed to it by age 3 or 4. A healthy immune system can easily control it. But it causes a type of pneumonia in people with weakened immune systems, such as those withHIV (human immunodeficiency virus). This is why its called an opportunistic infection.

Other symptoms can include weight loss and night sweats. A doctor can sometimes diagnose pneumocystis pneumonia by a characteristic X-ray pattern or if suspected in individuals with fever, cough, difficulty breathing who also have very low oxygen levels in their bloodstream.

Causes and Risk factors

Rarely, PCP can affect other parts of the body including the lymph nodes, liver, and bone marrow. In kids who are already seriously ill, symptoms of this form of PCP begin suddenly with a fever, a cough, and difficulty breathing. A child may not cough up any mucus because it is usually too thick to come up with the cough.

Diagnosis and Treatment

It is confirmed by finding the organism in lung fluids that have been examined in the laboratory. The doctor may need to use a bronchoscope to take a tissue sample from inside the lungs. This sample will be sent to a laboratory where special chemical stains can identify the pneumocystis organism.

Antipneumocystic medication is used with concomitant steroids in order to avoid inflammation, which causes an exacerbation of symptoms about four days after treatment begins if steroids are not used. By far the most commonly used medication is co-trimoxazole, but some patients are unable to tolerate this treatment due to allergies. Other medications that are used, alone or in combination, include pentamidine, trimetrexate, dapsone, atovaquone, primaquine, pafuramidine maleate (under investigation), and clindamycin. Treatment is usually for a period of about 21 days. ...