Definition

Pneumocystis pneumonia (PCP) is a form of pneumonia. It affects people who have a weakened immune system. PCP is the most common serious infection among people with AIDS.

Causes

PCP is caused by a fungus. Most believe that the fungus is spread in the air, but it is not clear if the fungus lives in soil or elsewhere. In healthy people, the fungus can exist in the lungs without causing pneumonia. However, in people who have a weakened immune system, the fungus can spread and cause a lung infection.

Risk Factors

A weakened immune system can put you at risk for PCP. The immune system may be weakened in people who:

• Have AIDS
• Have cancer
• Are getting treatment for cancer
• Are using medications that may weaken the immune system, such as steroids
• Have a history of PCP infection

Symptoms

Symptoms of PCP usually develop over the course of a few weeks or months. The main symptoms of PCP are:

• Shortness of breath
• Fever
• Dry cough
• Tightness or pain in the chest
• Weakness

See your doctor immediately if you have any these symptoms.

Diagnosis

Your doctor will ask about your symptoms and medical history. To confirm PCP, a sample of mucus from your lungs will be examined under the microscope. Your doctor will collect samples by giving you either:

• A vapor treatment to make you cough
• A bronchoscopy

Treatment

Treatment depends on the severity of the infection.

• Oral or intravenous anti-infectious agents will be given
• Oral corticosteroids may be given if breathing problems occur
• Supportive treatments, such as oxygen, to help with breathing

Even when treatment is given for PCP, the death rate is 15% to 20%.

Prevention

PCP infections can cause damage to your lungs and affect your overall health. Preventing a PCP infection is an important first step. A healthy immune system is the best prevention for PCP. See your doctor as recommended to help monitor your immune system. If you have HIV, follow your treatment program to keep your immune system healthy. This will help prevent a PCP infection.

If you are at risk for PCP, your doctor may recommend that you take antibiotic medication to prevent getting it. Take preventative medication as recommended, do not skip doses. PCP prevention with medication may be recommended if:

• You have HIV and your CD4 cell count falls below 200.
• You plan to use immune suppressing medications for a long period of time.
• You have other conditions such as a temperature above 100˚F that lasts for more than 2 weeks, or a fungal infection in your mouth or throat.

Talk to your doctor about a pneumonia vaccine. This only protects you from a different kind of pneumonia. It will not prevent you from getting PCP.

Centers for Disease Control and Prevention http://www.cdc.gov

Canadian HIV/AIDS Information Centre http://www.cpha.ca/

Pneumocystis pneumonia (PCP). Dynamed website. Available at:
http://www.ebscohost.com/dynamed
Updated June 8, 2015. Accessed June 16, 2015.

Wilkin A, Feinberg J. Pneumocystis carinii pneumonia. Am Fam Physician. 1999;15(60):1699-1708.