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Pneumonia, Pneumocystis Jiroveci

Thomas J. Hansen, MD, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Pneumocystis jiroveci causes pneumonia primarily in immunocompromised patients.

  • The fungus that causes this pneumonia in humans was previously called Pneumocystis carinii.

  • The name was...

DIAGNOSIS

HISTORY

  • HIV-infected patients

    • Subacute onset over several weeks

      • Progressively worsening dyspnea

      • Tachypnea

      • Cough: nonproductive or productive of clear sputum

      • Low-grade fever, chills

      • Weakness, fatigu...

TREATMENT

The recommended duration of therapy differs in patients who are with/without AIDS: 
  • In patients with PCP who do not have AIDS, the typical duration of therapy is 14 days.

  • Treatment of PCP in p...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

In patients with HIV/AIDS: Patients with previous episodes of PCP should receive lifelong secondary prophylaxis unless they respond well to highly active antiretr...

REFERENCES

1
D’Avignon LC, Schofield CM, Hospenthal DR. Pneumocystis pneumonia. Semin Respir Crit Care Med.  2008;29(2):132–140. [View Abstract on OvidMedline]
2
Krajicek BJ, Thomas CFJr, Limper AH....

ADDITIONAL READING

  • Benson CA, Kaplan JE, Masur H, et al; for the National Institutes of Health, Infectious Diseases Society of America. Treating opportunistic infections among HIV-infected adults and ...

CODES

ICD10

B59 Pneumocystosis 

ICD9

136.3 Pneumocystosis 

SNOMED

  • 415125002 Pneumocystosis jiroveci pneumonia (disorder)

  • 420403001 Pneumocystosis associated with AIDS

CLINICAL PEARLS

  • Colonization with P. jiroveci is common in the pediatric population.

  • PCP only occurs in immunocompromised patients.

  • Patients with HIV are at risk once their CD4 count is <200 cells/μL...

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