Medical Archive

Definition and description

Epidemiology

Pneumocystis
(Respiratory)
Inhaled by most in childhood
Diffuse, bilateral interstitial infiltration.
Subacute, dyspnea & fever? ??.
??? 3-4? ??? ??, but
?? CD<200 HIV patient?? ??

Pathogenesis and pathology

Clinical features

Clinical presentation

Immunosuppression?? ? ??? ????? 3~4? ??? ??
?? : dyspnea, fever, nonproductive cough, tachypnea, tachycardia, cyanosis, ??? ??

Physical examination

Laboratory findings

Radiographic findings

CXR : peri-hilar region?? ???? bilateral diffuse infiltrate (??? ?? ????..)

Diagnosis

BAL ? Staining?? ?? (Methenamine silver) or IF with monoclonal Ab

Course and prognosis

Treatment

• TMP-SMX or pentamidine
• GC in severe PCP. Indications include:
  • SaO2 <92%
  • PaO2 ?70mmHg
  • PAO2 – PaO2 > 35mmHg
• Alternate oral regimens for mild/moderate PCP
  • Dapsone-TMP
  • Primaquine with clindamycin
  • Atovaquone suspension.
• Alternate regimens for moderate/severe disease
  • IV pentamidine
  • Primaquine with IV clindamycin.

Prevention

TMP-SMX (Bactrim) (CD4 count <200/?g??? candidiasis Hx?? ? ????? ??)