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HIV/AIDS

Updated 26 June 2014

Pneumocystis carinii pneumonia (PCP)

Pneumocystis carinii is a fungus that is the most important cause of pneumonia in people with HIV/AIDS.

Summary

  • Pneumocystis carinii is a microscopic fungus that affects the lungs, and is the most important cause of pneumonia in people with HIV/Aids.
  • Common symptoms of PCP include tiredness, fever, breathlessness and a dry cough.
  • Where tests to identify Pneumocystis are unavailable, a person will often be treated for PCP based on their symptoms alone.
  • Treatment for PCP is usually with the medication co-trimoxazole.
  • Anyone with a CD4 cell count below 200/ul is at risk for PCP, and should take daily co-trimoxazole to help prevent it.

What is pneumocystis carinii pneumonia (PCP)?
Pneumocystis carinii is a microscopic fungus that affects the lungs, and is the most important cause of pneumonia in people with HIV/AIDS. People with HIV usually become susceptible to pneumocystis carinii pneumonia (PCP) when their CD4 cell count falls below 200/ul. In many people, this will be the first illness that marks the onset of AIDS and around 80% of people with AIDS will get PCP at some time.

Symptoms and signs of PCP
The most common symptoms of PCP are tiredness, fever, breathlessness and a dry cough that does not produce sputum. Symptoms may begin quite suddenly or may develop over a few weeks. In hospital, an X-ray may show a typical pattern of widespread fluffiness in the lungs, and oxygen levels in the blood will be low because the lungs are not functioning properly.

How is PCP diagnosed?
If pneumonia is suspected, your doctor will order tests to help determine its severity. A chest X-ray may show a typical pattern of widespread fluffy patches in the lungs, known as "diffuse infiltrates". Tests to measure oxygen levels in the blood will be low because the lungs are not functioning properly. The oxygen level is first checked with an oximeter, a device that is placed on your fingertip. If the result of this test is abnormal, you may also need a test of arterial blood gases (ABG), in which a sample of blood is drawn from a wrist or thigh artery and sent to the laboratory for analysis. If your oxygen level is very low, you may require hospitalisation.

How is PCP treated?
Treatment for PCP is usually co-trimoxazole (“Bactim”, “Septran”, “Purbac”), which is given intravenously in severe cases or orally in mild cases. In severe cases, prednisone may be added to reduce inflammation in the lungs. Treatment is for 14 – 21 days. Patients with very low oxygen levels will need supplementary oxygen by a face mask or even via a ventilator.

What can I do to prevent PCP?
Anyone with a CD4 cell count below 200/ul is at risk for PCP, and should take daily co-trimoxazole to help prevent it.

 

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