Pneumocystis Jiroveci Pneumonia

What is pneumocystis jiroveci pneumonia?

Pneumocystis jiroveci pneumonia, also known as PCP, is a lung infection caused by fungi (germs). PCP is most often seen in people with a weak immune system. PCP is an opportunistic infection. This means that when your immune system is not working well, PCP is more likely to develop.

What causes pneumocystis jiroveci pneumonia?

A type of fungus causes PCP, but no one knows why certain people get PCP while others do not. You may have been born with the fungus, but only get sick when your immune system becomes weak. You may get the germs that cause PCP from other people, or from your surroundings. People with healthy immune systems may get PCP germs and have no symptoms or problems. Any of the following may increase your risk for PCP:

  • Diseases: Conditions that weaken your immune system, including cancer, HIV infection, and lupus.

  • Genetic factors: You may have been born with defects in your genes that weaken your immune system.

  • Medicine: Certain medicines, such as immunosuppressant and steroid medicines. They may be used to treat inflammation, asthma, or kidney and joint diseases. You may also need them after an organ transplant.

  • Malnutrition: This can be caused by poor nutrition or medical conditions that decrease your body's ability to absorb nutrients from food. Malnutrition weakens your body and your immune system.

What are the signs and symptoms of pneumocystis jiroveci pneumonia?

  • Fever

  • Dry cough that may progress to a cough with mucus

  • Trouble breathing

  • Fast breathing and heartbeat

  • Chest pain.

How is pneumocystis jiroveci pneumonia diagnosed?

Your caregiver will ask about your medical history. He will do a physical exam and tests to check for other medical conditions. You may have any of the following:

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • Sputum sample: Sputum (mucus from your lungs) is collected in a cup when you cough. The sample is sent to a lab to be tested for the germ that is causing your illness. It can also help your caregiver choose the best medicine to treat the infection.

  • Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.

  • Chest CT scan: A special x-ray machine uses a computer to take pictures of your lungs and your airway. It may be used to check for damage or other problems.

How is pneumocystis jiroveci pneumonia treated?

If you have other medical conditions and poor health, you will need to stay in a hospital for treatment. Your caregiver will treat conditions that weaken your immune system. You may need to stop taking certain medicines or getting treatments that weaken your immune system. You may have one or more of the following:

  • Antibiotic medicine: Antibiotics are used to kill germs. These medicines may also be given to decrease your risk for PCP.

  • Steroids: This medicine may be given with other medicines if you do not have enough oxygen in your blood. If you use this medicine, you may be less likely to need a machine to help you breathe.

  • Oxygen: You may need extra oxygen to help you breathe easier. It may be given through a plastic mask over your mouth and nose, or it may be given through nasal prongs. These are short, thin tubes that rest just inside your nose. Tell your caregiver if your nose gets dry or if the mask or prongs bother you. Ask your caregiver before you take off your oxygen. Never smoke or let anyone else smoke in the same room while your oxygen is on. Doing so may cause a fire.

  • A ventilator is a machine that gives you oxygen and breathes for you when you cannot breathe well on your own. An endotracheal (ET) tube is put into your mouth or nose and attached to the ventilator. You may need a trach if an ET tube cannot be placed. A trach is a tube put through an incision and into your windpipe.

What are the risks of pneumocystis jiroveci pneumonia?

  • PCP may make it difficult to breathe. You may need a machine to help you breathe until the infection is treated. Medicines to treat PCP may cause an allergic skin reaction. You may have nausea, vomiting, fever, and swelling in your kidneys. Medicines can also affect your bone marrow and decrease your ability to make blood cells. This causes weakness, and increases your risk for more infections. Even after treatment, some germs may be left in your airways. These germs may cause another infection.

  • If you are not treated for PCP, your airways or lungs will keep getting damaged and scarred. You will have more trouble breathing, and your body will not get enough oxygen. When your body does not get enough oxygen, organs such as your brain can be damaged. Air may collect around your lung, making it collapse. This causes severe difficulty breathing, and may cause death. PCP can weaken your body and cause you to have more infections.

When should I contact my caregiver?

Contact your caregiver if:

  • You have a fever.

  • You have chills, or feel weak or achy.

  • You have new signs or symptoms.

  • You have trouble sleeping.

  • Your skin is itchy, or you have a rash.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You cough up blood.

  • You have severe pain in your chest or trouble breathing.

  • Your lips or fingernails turn blue or white.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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