Pneumocystis Jiroveci Pneumonia

GENERAL INFORMATION:

What is pneumocystis jiroveci pneumonia? Pneumocystis jiroveci (yee row VET zee) pneumonia, also known as PCP, is a lung infection caused by fungi (germs). PCP is most often seen in people with problems with their immune system. The immune system is your body's defense against germs and infections. PCP is an opportunistic infection. This means that when your immune system is not working well, PCP is more likely to develop. Infections can also get worse faster, have more and worse signs and symptoms, and even cause death. With PCP, your lungs can have long-term damage, and you may also stop breathing all together. Certain medicines may decrease your risk of getting PCP, and can also be used to treat this infection.

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 the fungi in your body at birth, but it only makes the disease start 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 having PCP:

• Diseases: Conditions that weaken your immune system include cancer, HIV infection, and systemic lupus erythematosus.
  
  
• Genetic: You may have been born with defects in your genes that weaken your immune system. Genes are little pieces of information that tell your body what to do or what to make.
  
  
• Medicine: Certain medicines, such as immunosuppressant and steroid medicines. They may be used to treat inflammation (swelling), asthma, or kidney and joint diseases. You may also need them after an organ transplant.
  
  
• Malnutrition: This happens when you do not get enough nutrients or vitamins. It can occur from not eating or drinking enough. It can also be caused by medical conditions that decrease your bodys ability to absorb nutrients from food. Malnutrition weakens your body and your immune system.

What are the signs and symptoms of pneumocystis jiroveci pneumonia? The most common signs and symptoms include a fever, dry cough, fast heartbeat, and trouble breathing with activity. You may also have any of the following:

• Chest pain.
  
  
• Coughing up sputum (phlegm).
  
  
• Fast breathing.
  
  
• Getting tired very easily.
  
  
• Trouble breathing all of the time.

How is pneumocystis jiroveci pneumonia diagnosed? Your caregiver will ask about medical problems that you have and have had in the past. He will do a physical exam. Tests will be done to check for other medical conditions. You may have any of the following:

• Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
  
  
• Chest CT scan: This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your lungs and airway structures. It may be used to check for damage or other problems.
  
  
• Lung biopsy: Caregivers collect a small amount of tissue from your lungs. Fluid from your lungs may also be collected. The samples are sent to a lab for tests. The tests will show caregivers which germs are causing your condition.
  
  
• Pulmonary function tests: Pulmonary function tests, also called PFTs, help caregivers learn how well your lungs work. PFTs may also help your caregivers decide on the best treatment for you. During the tests, you breathe into a mouthpiece connected to a machine. The machine measures how much air you breathe in and out over a certain amount of time. This helps caregivers to see how well your lungs are moving and working.
  
  
• Sputum sample: Sputum (mucus from your lungs) is collected in a special cup when you cough. It is sent to a lab for tests. The sputum may show what germ is causing your illness. It can also help your caregiver choose what medicine is best for you.
  
  
• 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.

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 of getting 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. It may be given through a nasal cannula, or prongs, instead of a mask. A nasal cannula is a pair of 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 taking 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.
  
  
• Ventilator: A ventilator is a special machine that can breathe for you if you cannot breathe well on your own. You may have an endotracheal tube (ET tube) in your mouth or nose. A tube called a trach may go into an incision (cut) in the front of your neck. The ET tube or trach is hooked to the ventilator. The ventilator can also give oxygen to you.

When should I call my caregiver? Call 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, treatment, or care.

When should I seek immediate help? Call 911 or get to the nearest emergency room if:

• You cough up blood.
  
  
• You have severe (very bad) pain in your chest or trouble breathing.
  
  
• Your lips or fingernails are turning blue or white.

Where can I find more information?

• Centers for Disease Control and Prevention
  National Center for Infectious Diseases
  Phone: 1-888-4437232
  Web Address: http://www.cdc.gov/ncidod/
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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