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Definition

Pneumocystis jiroveci pneumonia is a fungal infection of the lungs. The disease used to be called Pneumocystis carinii.

Alternative Names

Pneumocystosis; PCP; Pneumocystis carinii

Causes, incidence, and risk factors

This type of pneumonia is caused by the fungus Pneumocystis jiroveci. This fungus is common in the environment and does not cause illness in healthy people.

However, it can cause a lung infection in in people with a weakened immune system due to:

  • Cancer
  • Chronic use of corticosteroids or other medications that weaken the immune system
  • HIV/AIDS
  • Orrgan or bone marrow transplant

Pneumocystis jiroveci was a relatively rare infection before the AIDS epidemic. Before the use of preventive antibiotics for the condition, most people in the U.S. with advanced AIDS would develop it.

Symptoms

Pneumocystis pneumonia in those with AIDS usually develops slowly over days to weeks or even months, and is less severe. People with Pneumocystis pneumonia who do not have AIDS usually get sick faster and are more acutely ill.

Symptoms include:

  • Cough -- often mild and dry
  • Fever
  • Rapid breathing
  • Shortness of breath -- especially with activity (exertion)
Signs and testsTreatment

Antibiotics can be given by mouth (orally) or through a vein (intravenously), depending on the severity of the illness.

People with low oxygen levels and moderate to severe disease are often prescribed corticosteroids as well.

Expectations (prognosis)

Pneumocystis pneumonia can be life threatening, causing respiratory failure that can lead to death. People with this condition need early and effective treatment. For moderate to severe Pneumocystis pneumonia in people with AIDS, the short term use of corticosteroids has decreased death.

ComplicationsCalling your health care provider

If you have a weakened immune system due to AIDS, cancer, transplantation, or corticosteroid use, call your doctor if you develop a cough, fever, or shortness of breath.

Many infections can lead to similar symptoms Your health care provider can help rule out opportunistic infections such as pneumocystis.

Prevention

Preventive therapy is recommended for:

  • Patients with AIDS who have CD4 counts below 200
  • Bone marrow transplant recipients
  • Organ transplant recipients
  • People who take long-term, high-dose corticosteroids
  • People who have had previous episodes of this infection
References

Feinberg JE. Pneumocystis pneumonia. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 362.

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12y ago
Definition

Pneumocystis jiroveci pneumonia is a fungal infection of the lungs. The disease used to be called Pneumocystis carinii.

Alternative Names

Pneumocystosis; PCP; Pneumocystis carinii

Causes, incidence, and risk factors

This type of pneumonia is caused by the fungus Pneumocystis jiroveci. This fungus is common in the environment and does not cause illness in healthy people.

However, it can cause a lung infection in people with a weakened immune system due to:

  • Cancer
  • Chronic use of corticosteroids or other medications that weaken the immune system
  • HIV/AIDS
  • Organ or bone marrow transplant

Pneumocystis jiroveci was a relatively rare infection before the AIDS epidemic. Before the use of preventive antibiotics for the condition, most people in the United States with advanced AIDS would develop it.

Symptoms

Pneumocystis pneumonia in those with AIDS usually develops slowly over days to weeks or even months, and is less severe. People with pneumocystis pneumonia who do not have AIDS usually get sick faster and are more acutely ill.

Symptoms include:

  • Cough -- often mild and dry
  • Fever
  • Rapid breathing
  • Shortness of breath -- especially with activity (exertion)
Signs and testsTreatment

Antibiotics can be given by mouth (orally) or through a vein (intravenously), depending on the severity of the illness.

People with low oxygen levels and moderate to severe disease are often prescribed corticosteroids as well.

Expectations (prognosis)

Pneumocystis pneumonia can be life threatening, causing respiratory failure that can lead to death. People with this condition need early and effective treatment. For moderate to severe pneumocystis pneumonia in people with AIDS, the short term use of corticosteroids has decreased death.

ComplicationsCalling your health care provider

If you have a weakened immune system due to AIDS, cancer, transplantation, or corticosteroid use, call your doctor if you develop a cough, fever, or shortness of breath.

Many infections can lead to similar symptoms. Your health care provider can help rule out opportunistic infections such as pneumocystis.

Prevention

Preventive therapy is recommended for:

  • Patients with AIDS who have CD4 counts below 200
  • Bone marrow transplant recipients
  • Organ transplant recipients
  • People who take long-term, high-dose corticosteroids
  • People who have had previous episodes of this infection
References

Feinberg JE. Pneumocystis pneumonia. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 362.

Reviewed By

Review Date: 12/01/2009

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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Co-trimoxazole is used to treat a small number of serious infections but serious side effects limit its use, they are mainly used for;Chronic bronchitisEar infectionsInfection of the bladder or tubes that pass urine (urinary tract infection)Prevention of pneumonia caused by the bacterium pneumocystis carinii (PCP). The risk of this infection is increased in patients with decreased immune system function.Treatment of pneumonia caused by the bacterium pneumocystis carinii (PCP)


What is the life cycle for tuberculosis?

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What kind of infections can you get with full blown aids?

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What is this sulfameth trimethoprim used for?

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Is pneumonia caused or aggravated by air pollution?

Key factsPneumonia is the leading cause of death in children worldwide.Pneumonia kills an estimated 1.4 million children under the age of five years every year - more than AIDS, malaria and tuberculosis combined.Pneumonia can be caused by viruses, bacteria or fungi.Pneumonia can be prevented by immunization, adequate nutrition and by addressing environmental factors.Pneumonia can be treated with antibiotics, but around 30% of children with pneumonia receive the antibiotics they need.Pneumonia is a form of acute respiratory infection that affects the lungs. The lungs are made up of small sacs called alveoli, which fill with air when a healthy person breathes. When an individual has pneumonia, the alveoli are filled with pus and fluid, which makes breathing painful and limits oxygen intake.Pneumonia is the single largest cause of death in children worldwide. 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The most common are:Streptococcus pneumoniae - the most common cause of bacterial pneumonia in children;Haemophilus influenzae type b (Hib) - the second most common cause of bacterial pneumonia;respiratory syncytial virus is the most common viral cause of pneumonia;in infants infected with HIV, Pneumocystis jiroveci is one of the commonest causes of pneumonia, responsible for at least one quarter of all pneumonia deaths in HIV-infected infants.TransmissionPneumonia can be spread in a number of ways. The viruses and bacteria that are commonly found in a child's nose or throat, can infect the lungs if they are inhaled. They may also spread via air-borne droplets from a cough or sneeze. In addition, pneumonia may spread through blood, especially during and shortly after birth. More research needs to be done on the different pathogens causing pneumonia and the ways they are transmitted, as this has critical importance for treatment and prevention.SymptomsThe symptoms of viral and bacterial pneumonia are similar. However, the symptoms of viral pneumonia may be more numerous than the symptoms of bacterial pneumonia.The symptoms of pneumonia include:rapid or difficult breathingcoughfeverchillsloss of appetitewheezing (more common in viral infections).When pneumonia becomes severe, children may experience lower chest wall indrawing, where their chests move in or retract during inhalation (in a healthy person, the chest expands during inhalation). Infants may be unable to feed or drink and may also experience unconsciousness, hypothermia and convulsions.Risk factorsWhile most healthy children can fight the infection with their natural defences, children whose immune systems are compromised are at higher risk of developing pneumonia. A child's immune system may be weakened by malnutrition or undernourishment, especially in infants who are not exclusively breastfed.Pre-existing illnesses, such as symptomatic HIV infections and measles, also increase a child's risk of contracting pneumonia.The following environmental factors also increase a child's susceptibility to pneumonia:indoor air pollution caused by cooking and heating with biomass fuels (such as wood or dung)living in crowded homesparental smoking.TreatmentPneumonia can be treated with antibiotics. These are usually prescribed at a health centre or hospital, but the vast majority of cases of childhood pneumonia can be administered effectively within the home. Hospitalization is recommended in infants aged two months and younger, and also in very severe cases.PreventionPreventing pneumonia in children is an essential component of a strategy to reduce child mortality. 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Pneumonia?

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It is very important that your antibiotics are started very soon after you are admitted.You are more likely to be admitted to the hospital if you:Have another serious medical problemHave severe symptomsAre unable to care for yourself at home, or are unable to eat or drinkAre older than 65 or a young childHave been taking antibiotics at home and are not getting betterHowever, many people can be treated at home. If bacteria are causing the pneumonia, the doctor will try to cure the infection with antibiotics. It may be hard for your health care provider to know whether you have a viral or bacterial pneumonia, so you may receive antibiotics.Patients with mild pneumonia who are otherwise healthy are sometimes treated with oral macrolide antibiotics (azithromycin, clarithromycin, or erythromycin).Patients with other serious illnesses, such as heart disease, chronic obstructive pulmonary disease, or emphysema, kidney disease, or diabetes are often given one of the following:Fluoroquinolone (levofloxacin [Levaquin], gemifloxacin [Factive], or moxifloxacin [Avelox])High-dose amoxicillin or amoxicillin-clavulanate, plus a macrolide antibiotic (azithromycin, clarithromycin, or erythromycin)Cephalosporin antibiotics (for example, cefuroxime or cefpodoxime) plus a macrolide (azithromycin, clarithromycin, or erythromycin)If the cause is a virus, typical antibiotics will NOT be effective. Sometimes, however, your doctor may use antiviral medication.You can take these steps at home:Control your fever with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children.Do not take cough medicines without first talking to your doctor. Cough medicines may make it harder for your body to cough up the extra sputum.Drink plenty of fluids to help loosen secretions and bring up phlegm.Get lots of rest. Have someone else do household chores.Expectations (prognosis)With treatment, most patients will improve within 2 weeks. Elderly or debilitated patients may need longer treatment.Those who may be more likely to have complicated pneumonia include:Older adults or very young childrenPeople whose immune system does not work wellPeople with other, serious medical problems such as diabetes or cirrhosis of the liverYour doctor may want to make sure your chest x-ray becomes normal again after you take a course of antibiotics. However, it may take many weeks for your x-ray to clear up.ComplicationsPossible complications include:Acute respiratory distress syndrome (ARDS), a severe form of respiratory failureEmpyema or lung abscesses. These are infrequent, but serious, complications of pneumonia. They occur when pockets of pus form inside or around the lung. These may sometimes need to be drained with surgery.Respiratory failure, which requires a breathing machine or ventilatorSepsis, a condition in which there is uncontrolled swelling (inflammation) in the body, which may lead to organ failureCalling your health care providerCall your doctor if you have:Worsening respiratory symptomsShortness of breath, shaking chills, or persistent feversRapid or painful breathingA cough that brings up bloody or rust-colored mucusChest pain that worsens when you cough or inhaleNight sweats or unexplained weight lossSigns of pneumonia and weak immune system, as with HIV or chemotherapyInfants with pneumonia may not have a cough. Call your doctor if your infant makes grunting noises or the area below the rib cage is retracting while breathing.PreventionWash your hands frequently, especially after blowing your nose, going to the bathroom, diapering, and before eating or preparing foods.Don't smoke. Tobacco damages your lung's ability to ward off infection.Vaccines may help prevent pneumonia in children, the elderly, and people with diabetes, asthma, emphysema, HIV, cancer, or other chronic conditions:A drug called Synagis (palivizumab) is given to some children younger than 24 months to prevent pneumonia caused by respiratory syncytial virus.Flu vaccineprevents pneumonia and other problems caused by the influenza virus. It must be given yearly to protect against new virus strains.Hib vaccineprevents pneumonia in children from Haemophilus influenzaetype b.Pneumococcal vaccine (Pneumovax, Prevnar) lowers your chances of getting pneumonia from Streptococcus pneumoniae.If you have cancer or HIV, talk to your doctor about additional ways to prevent pneumonia and other infections.ReferencesHiggins K, Singer M, Valappil T, Nambiar S, Lin D, Cox E. Overview of recent studies of community-acquired pneumonia. Clin Infect Dis. 2008;47:S150-156.Van der Poll T, Opal SM. Pathogenesis, treatment, and prevention of pneumococcal pneumonia. Lancet. 2009;374:1543-1556.Recommended Childhood and Adolescent Immunization Schedules -- United States, 2010. Committee on Infectious Diseases. Pediatrics. 2010;125:195-196.Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2010. Ann Intern Med. 2010. 152:36-39.Li JZ, Winston LG, Moore DH, Bent S. Efficacy of short-course antibiotic regimens for community-acquired pneumonia: a meta-analysis. Am J Med. 2007;120:783-790.Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007 Mar 1;44 Suppl 2:S27-72.


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Quais são os sintomas da aids?

A manifestação inicial do HIV, presente em 50 a 70% dos casos, é semelhante a uma gripe ou mononucleose infecciosa e ocorre 2 a 4 semanas após a infecção. Pode haver febre, mal-estar, linfadenopatia (gânglios linfáticos inchados), eritemas (vermelhidão cutânea), e/ou meningite viral. Estes sintomas são geralmente ignorados, ou tratados enquanto gripe, e acabam por desaparecer, mesmo sem tratamento, após algumas semanas. Nesta fase há altas concentrações de vírus, e o portador é altamente infeccioso.A segunda fase é caracterizada por baixas quantidades dos vírus, que se encontram apenas nos reservatórios dos gânglios linfáticos, infectando gradualmente mais e mais linfócitos T CD4+; e nos macrófagos. Nesta fase, que dura em média 10 anos, o portador é soropositivo, mas não desenvolveu ainda SIDA/AIDS. Ou seja, ainda não há sintomas, mas o portador pode transmitir o vírus. Os níveis de T CD4+ diminuem lentamente e ao mesmo tempo diminui a resposta imunitária contra o vírus HIV, aumentando lentamente o seu número, devido à perda da coordenação dos T CD4+ sobre os eficazes T CD8+ e linfócitos B (linfócitos produtores de anticorpo).A terceira fase, a da SIDA, inicia-se quando o número de linfócitos T CD4+ desce abaixo do nível crítico (200/mcl), o que não é suficiente para haver resposta imunitária eficaz contra invasores. Começam a surgir cansaço, tosse, perda de peso, diarreia, inflamação dos gânglios linfáticos e suores noturnos, devidos às doenças oportunistas, como a pneumonia por Pneumocystis jiroveci, os linfomas, infecção dos olhos por citomegalovírus, demência e o sarcoma de Kaposi. Sem tratamento, ao fim de alguns meses ou anos a morte é inevitável. O uso adequado da Terapia Antirretroviral garante que o paciente sobreviva por um período mais longo, apesar de conviver com efeitos colaterais dos medicamentos.Excepções a este esquema são raras. Os muito raros "long term non-progressors" são aqueles indivíduos que permanecem com contagens de T CD4+ superiores a 600/mcl durante longos períodos. Estes indivíduos talvez tenham uma reação imunitária mais forte e menos suscetível à erosão contínua produzida pelo vírus, mas detalhes ainda são desconhecidos.


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Just to summarize, following are the main HIV symptoms:Rapid weight lossDry coughRecurring fever or profuse night sweatsProfound and unexplained fatigueWollen lymph glands in the armpits, groin, or neckDiarrhea that lasts for more than a weekWhite spots or unusual blemishes on the tongue, in the mouth, or in the throatPneumoniaRed, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelidsMemory loss, depression, and other neurological disorders.HIV is the virus that causes the disease called AIDS. At first, there can be rash, fever, sore throat, and not feeling well. Later it seems to go away. This is called the latent stage and lasts for a few weeks or more than 20 years. The last stage is called AIDS and a low T cell count is seen, with cancers and various infections which the person can't fight off.The following are excellent examples of symptoms of HIV: heavy or ragged breathing, a rash in the infected area (usually purple/ yellow), gas, spotty fision, and most importantly an extreme sexual desire toward people of the same gender.fever, swollen lymph nodes, sore throat, rash, muscle pain, malaise, and mouth and esophageal sores.turning blueThe symptoms of a HIV infection are fever, fatigue, rash, headache, swollen lymph nodes, sore throat and many more symptoms. However, some of the symptoms are very close to having a flu or cold.there are many signs with hiv,i cant tell u more details,but you can to datingpoz...C óM to learn more about it.There are technically no SET signs for HIV. You have to be tested to be sure that you actually have the virus. For some, a few weeks after exposure, mononucleosis like symptoms develop. Then they go away. The virus can remain physically undetected for 7 or more years until AIDS develops. Check the links for details.Not everyone gets symptoms following infection. About 75% of people get very heavy flu-like symptoms - google 'HIV seroconversion symptoms' for details.The symptoms of HIV varies depending on the stage of the infection, some of them are: mouth and genital ulcers, joint pain, fatigue, soaking night sweats, rashes, chronic diarrhoea, fever for several weeks, to name a few.Being HIV positive does not mean that you are going to get sick right away. It might be a very long time, even years, before any symptoms develop.


What is a circle rash that doesn't itch?

Sounds like it could be ring worm. I'd have it checked by a doctor to know for sure. It could just be an irritation that happens to be in a circle.AnswerIt is probably a ringworm; however, you should see your doctor and get some medication. AnswerDon't waste your money on a doctor. Just go to your local pharmacy and ask him what he thinks it is and and see if he can give you something over the counter for it. Most Pharmacist know just as much as doctors. AnswerIf the center is clear and it is a ring shape and has bad itching it probably is ringworm. The old and proven remedy is to soak a cottonball in Clorox Bleach. Thoroughly soak the area let dry leave it on a while. This does burn, but 1 time should be enough to smother the worm. AnswerRingworm is not a worm. It is a fungal infection slightly under the skin. Do not use bleach on your body, it's for your clothes or cleaning up disgusting things on floors or counters. Go buy some antifungal over the counter medication. if problem persists, consult your doctor. AnswerAs a retired cosmetologist & instructor, & mother of 2 sets of now adult twins and a 13 yr old as well, I think I might be able to help on the ringworm thing. It is a fungal infection, but from my experience and I have had plenty of it, over the counter medicines don't work, especially if it has already developed the full ring, for every over the counter med you continue to try and every home remedy you try, it will continue to get larger and larger, and as it does, it does damage to the skin tissue, nails (if involved), and especially any hair folicles. The only true treatment I have ever found successful, included antibiotic creams with INTERNAL Prescription Medication/antibiotics at the same time. (Depending on it's severity, and strain, it can in some cases require medications that use poisons in which cases the blood / medication levels of the patient have to be monitored closely. Getting a correct diagnosis and correct treatment is best done through a dermatologist not a regular MD. I have had one of my children end up with minor permanent damage to hair follicles, and hair no longer grows where the infection occurred, thankfully it was an underneath area, don't wait to seek out a doctor to find out for sure the sooner it's treated, the less complicated the treatment needs to be- if it's treated both internally and externally at the same time. I agree with the above statement except treating it with an antibiotic. Antibiotics are only for bacteria. Since it was stated that ringworm is caused by a fungus, antibiotics may further worsen the problem. However, one fungus is treated by antibiotics, Pneumocystis jiroveci, but that is only seen in immunocompromised people such as AIDS patients. It should be treated internally (terbinafine or itraconazole) and externally (terbinafine 1% cream - Lamisil). Do not suck on a tube of Lamisil for internal treatment. It's not the same thing. Since you need a prescription for the internal medication, you might as well go to the doctor anyway.Most of the above answers say ringworm, but i had this red patch on the inside of my arm. In fact, I get it every spring. It was nothing. Just some sort of irritation of the skin.AnswerIf it's in the shape of a circle, not raised, white if your tan and red if your not then it may not be ringworm. I am speaking from my own personal experience, because I've never had ringworm. I went to my dermatologist for this one. But the skin on my chest leading up to my neck is very sensitive and there is a fungus that lives on just about everyone and is normally introduced through family members (the close proximity). I have several perfectly round, sometimes itchy, spots. My doctor gave me a cream that's usually used for such fungal things as say ringworm. It's called 'Oxistat', I am to apply it once a day for three weeks or so and can stop when I see that the spots are gone. However, because my skin is so sensitive in this area they will most likely reappear sometime in the future. Normally from sweat or over exposure to the sun. Anyway, just incase anyone was wondering if it could be anything besides ringworm, here's your answer. Circle with red circle inside? If so get checked for Lyme disease.


Chest x-ray?

A chest x-ray is a diagnostic imaging test that uses a small amount of radiation to create images of the structures within the chest, including the heart, lungs, ribs, and diaphragm. It is commonly used to detect conditions such as pneumonia, lung cancer, heart failure, and rib fractures.