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Pneumocystis pneumonia (PCP)

Pneumonia pneumocystica · Pneumocystová pneumonie (PCP)

What it is

A fungus nearly everyone meets in childhood that fills the air sacs when immunity falls — advanced HIV, transplants, chemotherapy or long courses of steroids; largely preventable with co-trimoxazole.

Symptoms & signs

  • Dry cough
  • breathlessness building over days to weeks
  • fever
  • oxygen falls on exertion
  • chest tightness

🚩 Get help if…

  • call 112 / 911 now Breathless at rest or lips turning blue
  • call 112 / 911 now Sudden sharp chest pain with breathlessness
  • see a doctor soon Dry cough and breathlessness growing over days with weak immunity
  • see a doctor soon Short of breath climbing stairs with fever

Where it strikes

Medical treatment

  • Chest imaging, oxygen levels and PCR on sputum or lavage
  • High-dose co-trimoxazole for 21 days (rash, low counts and high potassium are common) trials support
  • Prednisolone when oxygen is low — fewer deaths in HIV trials support
  • primaquine with clindamycin, atovaquone or pentamidine when co-trimoxazole cannot be used
  • Co-trimoxazole prophylaxis in HIV with low CD4, and in transplants and chemotherapy trials support

Natural & lifestyle

  • HIV testing and treatment
  • stop smoking

Emerging & experimental

  • Lower-dose co-trimoxazole regimens
  • echinocandins added to treatment

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Echinacea and garlic — sold for immunity; untested here anecdotal / traditional
  • St John's wort and other herbs in HIV — some lower antiretroviral drug levels; check before taking anecdotal / traditional

ICD codes