pulmonary disorders
Pneumocystis jirovecii Pneumonia
Introduction
Pneumocystis jiroveciiis a common cause of pneumonia in immunosuppressed patients, especially in those infected with human immunodeficiency virus (HIV) and in those receiving systemic corticosteroids. Symptoms include fever, dyspnea, and dry cough. Diagnosis requires demonstration of the organism in an induced sputum specimen or bronchoscopic sample. Treatment is with antibiotics, usuallytrimethoprim/sulfamethoxazole ordapsoneplustrimethoprim,clindamycin/primaquine,atovaquone, orpentamidine. Patients with PaO2<70 mm Hg receive systemic corticosteroids. Prognosis is generally good with timely treatment. (See also Overview of Pneumonia and Pneumocystis jiroveciiis a ubiquitous organism transmitted by aerosol route and causes no disease in immunocompetent patients. However, some patients are at risk of developingP. jiroveciipneumonia: Patients with Human Immunodeficiency Virus (HIV) Infection and CD4+ T cell counts Organ transplant recipients Patients with hematologic cancers Patients taking corticosteroids or other immunosuppressive drugs Most patients have fever, dyspnea, and a dry, nonproductive cough that evolves over several weeks (HIV infection) or over several days (other causes of compromised cell-mediated immunity). Dyspnea is common. 