Pneumocystis pneumonia (PCP)
Pneumocystis is a yeast-like fungus commonly found in the lungs of healthy people, but being a source of opportunistic infection (pneumonia) it can cause a lung infection in immunocompromised (HIV-infected).
Pneumocystis pneumonia is especially seen in people with cancer, HIV/AIDS, malnourished, very young, and the use of medications that affect the immune system (=transplant patients).
P/c: fever, non-productive cough, dyspnoea, weight loss, night sweats, pneumothorax is common complication of PCP.
- CXR which shows widespread pulmonary infiltrates and previous TB cavity – filled with fungal hyphae of PCP!
- Arterial oxygen level (pO2) strikingly lower than would be expected from symptoms – very hypoxic.
- Histological identification of the causative organism in sputum or bronchio-alveolar lavage
- Cysts/’ping pong ball’ aggregates…
- Thickened alveolar septa with fluffy eosinophilic exudate in the alveoli
The disease attacks the interstitial, fibrous tissue of the lungs, with marked thickening of the alveolar septa and alveoli and leading to significant hypoxia which can be fatal if not treated aggressively
Treatment and management (conservative/medical/surgical)
Co-trimoxazole (trimethoprim and sulfamethoxazole) and steroids