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Pneumocystis jirovecii pneumonia

Definition

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

Causes

This type of pneumonia is caused by the fungus Pneumocystis jirovecii. 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:

  • Long-term use of corticosteroids or other medicines that weaken the immune system
  • Organ or

    • Pneumocystis jirovecii 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 developed this infection.

    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)

    • Exams and Tests

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

    Tests that may be ordered include:

  • (both arterial and venous)
  • (with lavage)
  • to check for fungus that causes the infection
  • (CBC)
  • Beta-1,3 glucan level in the blood and/or lavage fluid from bronchoscopy

    • Treatment

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

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

    Outlook (Prognosis)

    Pneumocystis pneumonia can be life threatening. It can cause 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:

  • (extremely rare)
  • (collapsed lung)
  • (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, contact your provider if you develop a cough, fever, or shortness of breath.

    Prevention

    Preventive therapy is recommended for:

  • People with HIV/AIDS who have 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 medicines

    • References

    Kovacs JA. Pneumocystis pneumonia. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 313.

    Miller RF Walzer PD, Smulian AG. Pneumocystis species. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 269.

    Schedule An Appointment

    Contact Atlanta Obsetrics and Gynaecology at The Womens Center Millennium Hospital - 404-ATL-BABY

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    Review Date: 12/31/2023

    Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.