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Pneumocystis Jiroveci Pneumonia

Medically reviewed by Last updated on Jan 5, 2023.

What is Pneumocystis jiroveci pneumonia (PJP)?

PJP is a lung infection caused by the Pneumocystis jiroveci fungus. PJP is most often seen in people with a weak immune system. PJP is an opportunistic infection. This means that when your immune system is not working well, it cannot fight off the fungus.

What causes PJP?

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 PJP from other people, or from your surroundings. People with healthy immune systems may get PJP germs and have no symptoms or problems. Any of the following may increase your risk for PJP:

  • Conditions that weaken your immune system, such as cancer, HIV infection, and lupus
  • Defects in your genes that weaken your immune system
  • Certain medicines, such as immunosuppressant and steroid medicines
  • Malnutrition that weakens your immune system

What are the signs and symptoms of PJP?

If you have AIDS, you may have worsening breathing problems or fast breathing. You may have a worsening cough with or without mucus. You may also have a fever, chills, weakness, or fatigue. If you do not have AIDS, you may have any of the following:

  • Fever or chest pain
  • Dry cough that may progress to a cough with mucus
  • Trouble breathing
  • Fast breathing and heartbeat

How is PJP diagnosed?

Your healthcare provider will ask about your medical history. He or she will do a physical exam and tests to check for other medical conditions. You may also need any of the following:

  • A bronchoscopy is used to look inside your respiratory system (nose, throat, and lungs). A bronchoscope is a soft tube with a light and camera on the end.
  • Blood tests are used to check your blood for signs of infection.
  • A sputum sample may be tested for the fungus that causes PJP.
  • X-ray or CT scan pictures may be taken of your lungs and your airway. The pictures may be used to check for damage or other problems.

How is PJP treated?

If you have other medical conditions and poor health, you will need to stay in a hospital for treatment. Your healthcare provider 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 need any of the following:

  • Antibiotics prevent or fight a bacterial infection.
  • Steroids help reduce swelling. This may help you breathe more easily.
  • Extra oxygen may be needed 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.

What can I do to prevent infections?

  • Wash your hands often. Use soap, and wash for at least 20 seconds. Rinse with warm, running water for several seconds. Then dry your hands with a clean towel or paper towel. Use hand sanitizer that contains alcohol if soap and water are not available. Wash your hands several times each day. Wash after you use the bathroom, change a child's diaper, and before you prepare or eat food. Do not touch your eyes, nose, or mouth without washing your hands first.
  • Cover a sneeze or cough. Use a tissue that covers your mouth and nose. Throw the tissue away in a trash can right away. Use the bend of your arm if a tissue is not available. Then wash your hands well with soap and water or use a hand sanitizer. Do not stand close to anyone who is sneezing or coughing.
  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Ask about vaccines you may need. Vaccines help prevent infections that can be serious for a person who has PJP. Get a flu vaccine as soon as recommended each year, usually in September or October. A pneumonia vaccine may be recommended every 5 years. Get a COVID-19 vaccine and booster as directed. Ask your healthcare provider about other vaccines you may need, and when to get them.

When should I seek immediate care?

  • You cough up blood.
  • You have severe pain in your chest or trouble breathing.
  • Your lips or fingernails turn blue.

When should I call my doctor?

  • You have a fever.
  • Your skin is itchy, or you have a rash.
  • You have chills, or you feel weak or achy.
  • You have new signs or symptoms.
  • You have trouble sleeping.
  • You have questions or concerns about your condition or care.

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 healthcare providers 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.

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