What is pcp pneumonia

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Moving beyond risk-based testing: Checklist for supporting hepatitis C birth cohort screening. Pneumocystis pneumonia PCP is a type of pneumonia that can be life-threatening in people with weakened immune systems. The symptoms can include fever, shortness of breath, tightness or pain in the chest, fatigue, night sweats and a dry cough. Fortunately, there are medications that can effectively prevent and treat the illness. Today, PCP is relatively rare; however, it remains common among people who do not know they have HIV, people who are not receiving ongoing HIV care, and people with severely weakened immune systems.

PCP is a type of pneumonia caused by a fungus called Pneumocystis jiroveci. This fungus does not make people with healthy immune systems sick but can cause a lung infection in a person who has a weakened immune system. PCP is one of a number of infections that can develop in people who are living with HIV, called opportunistic infections. These occur only if your immune system is quite weakened and your body becomes vulnerable to infections that would not otherwise affect you. Pneumonia is an infection and inflammation of the lungs.

As the infection progresses, the air spaces in the lungs fill with fluid, making it more and more difficult to breathe. People who have a weakened immune system, due to HIV, cancer, long-term use of corticosteroid drugs or an organ or bone marrow transplant, are at risk of developing PCP.

In people living with HIV, these symptoms may develop very gradually. At first, the symptoms may be so mild that they go unnoticed for several weeks. Because PCP can be so dangerous if not treated early, if you experience symptoms of PCP, such as a persistent dry cough or shortness of breath, it is important that you report them to a doctor as soon as possible. Determining whether a patient is responding to treatment may be difficult.

It is important to remember that oxygenation typically reaches a nadir approximately 72 hours after therapy is begun. If a patient is not responding, a bronchoscopy should be performed to rule out the presence of another opportunistic process.

Recent data indicate that such patients are indeed protected against PCP. Trimethoprim-sulfamethoxazole is the first choice for prophylaxis Table 7. In a meta-analysis of 35 randomized trials, 33 patients regularly taking trimethoprim-sulfamethoxazole had only a 5 percent likelihood of developing PCP. Even though the dosage used for prophylaxis is much lower than that used for treatment, side effects are still common.

Lower dosage regimens should be considered, because they may diminish the risk of side effects without compromising protection. In toxoplasma IgG—positive-patients: use mg dapsone orally once daily, plus pyrimethamine Daraprim , 50 mg orally every week and leucovorin, 25 mg orally every week.

Dapsone is a reasonable alternative to trimethoprim-sulfamethoxazole. Dapsone in combination with weekly pyrimethamine Daraprim protects against PCP and toxo-plasmosis. Patients should be screened for active tuberculosis before starting aerosolized pentamadine therapy to avoid the unnecessary exposure of others. Pretreatment with inhaled bronchodilators minimizes cough and bronchospasm. Although advances in the care of HIV-infected patients have dramatically lowered its incidence, PCP remains a challenging clinical problem.

Signs and symptoms may be insidious in onset and difficult to distinguish from those of other pathogenic processes. Patients must be monitored carefully for clinical response and drug toxicity. Family physicians need to be familiar with the presentation, diagnosis, treatment and prevention of PCP, particularly as the AIDS epidemic continues to expand beyond familiar risk groups and geographic locations.

Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. Wilkin graduated from the University of Texas Medical School at Galveston and completed a residency in internal medicine at the University of Cincinnati Ohio College of Medicine, where she also completed a fellowship in infectious diseases.

Address correspondence to Judith Feinberg, M. Reprints are not available from the authors. Judith Feinberg, M. Figure 2 provided by P. Walzer, M.

Pneumocystis pneumonia—Los Angeles. Update: acquired immunodeficiency syndrome—United States. Declining morbidity and mortality among patients with advanced human immunodeficiency virus. N Engl J Med. Cushion MT. Transmission and epidemiology. In: Walzer PD, ed. Pneumocystis carinii pneumonia. New York: Dekker, — Walzer PD. Pathogenic mechanisms. The risk of Pneumocystis carinii pneumonia among men infected with human immunodeficiency virus type 1.

N Eng J Med. Clin Infect Dis. Pneumocystis carinii pneumonia: a comparison between patients with acquired immunodeficiency syndrome and patients with other immunodeficiencies. Ann Intern Med. AIDS-related spontaneous pneumothorax: risk factors and treatment. Shortcomings of chest radiography in detecting Pneumocystis carinii pneumonia.

J Acquir Immune Defic Syndr. Baughman RP. Current methods of diagnosis. It will also help keep you from getting lung infections like PCP. The best way to prevent PCP if you have a weak immune system is to get regular blood tests and take preventive medicines when needed. Although flu and pneumococcal vaccines prevent people from getting certain types of pneumonia, they do not prevent PCP. In addition, people with weakened immune systems may not be candidates for their use. Talk to your healthcare provider about immunizations and which one may be appropriate for you.

Health Home Conditions and Diseases. What causes PCP? If not treated right away, PCP can be severe and even fatal. Who is at risk for PCP? You are more likely to get PCP if you have a weakened immune system. What are the symptoms of PCP? The most common symptoms to watch for include: Fever that comes on suddenly Cough Trouble breathing. It often gets worse with activity. A dry cough, with little or no mucus Chest tightness Weight loss Night sweats If you have any of these symptoms and think you could have PCP, especially if you have a condition that suppresses the immune system, see your healthcare provider right away.

How is PCP diagnosed? Scientists have changed both the classification and the name of this organism since it first appeared in patients with HIV in the s. Pneumocystis jirovecii used to be classified as a protozoan but is now considered a fungus. When scientists renamed P. The symptoms of PCP can develop over several days or weeks and include 1 , 6 — 8.

PCP is extremely rare in healthy people, but the fungus that causes this disease can live in their lungs without causing symptoms. There is no vaccine to prevent PCP. A healthcare provider might prescribe medicine to prevent PCP for people who are more likely to develop the disease.

Medicine to prevent PCP is recommended for some people infected with HIV, stem cell transplant patients, and some solid organ transplant patients. PCP spreads from person to person through the air. Many people are exposed to Pneumocystis as children, but they likely do not get sick because their immune systems prevent the fungus from causing an infection. The sample is usually mucus that is either coughed up by the patient called sputum or collected by a procedure called bronchoalveolar lavage.

Sometimes, a small sample of lung tissue a biopsy is used to diagnose PCP. PCP must be treated with prescription medicine. Without treatment, PCP can cause death. This medicine is given by mouth or through a vein for 3 weeks. The exact number of cases of PCP in the United States is difficult to determine because there is no national surveillance for the disease. Skip directly to site content Skip directly to page options Skip directly to A-Z link.

Fungal Diseases.