Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- 170 Candidiasis
- 171 Aspergillosis
- 172 Zygomycosis (Mucormycosis)
- 173 Sporotrichosis
- 174 Cryptococcus
- 175 Histoplasmosis
- 176 Blastomycosis
- 177 Coccidioidomycosis
- 178 Pneumocystis Pneumonia
- 179 Miscellaneous Fungi and Algae
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
178 - Pneumocystis Pneumonia
from Part XXII - Specific Organisms – Fungi
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- 170 Candidiasis
- 171 Aspergillosis
- 172 Zygomycosis (Mucormycosis)
- 173 Sporotrichosis
- 174 Cryptococcus
- 175 Histoplasmosis
- 176 Blastomycosis
- 177 Coccidioidomycosis
- 178 Pneumocystis Pneumonia
- 179 Miscellaneous Fungi and Algae
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
The diffuse bilateral pneumonitis caused by Pneumocystis jirovecii (also called Pneumocystis carinii) occurs almost exclusively in immunocompromised patients with cancer, organ transplantation, congenital immunodeficiency disorders, and acquired immunodeficiency syndrome (AIDS). The organism is known to cause pneumonitis occasionally in patients without underlying immunodeficiency.
CLINICAL FEATURES
The clinical manifestations of Pneumocystis pneumonitis are fever, cough, tachypnea, and dyspnea progressing to cyanosis. The onset may be abrupt or subtle.
With an abrupt onset, fever, marked increase in respiratory rate, and severe dyspnea occur within 24 to 48 hours. The disease progresses rapidly with marked decrease in arterial oxygen tension (PaO2) and increase in alveolar-arterial oxygen gradient. The chest radiograph shows bilateral diffuse alveolar disease with an air bronchogram. Without treatment, the disease worsens and within a month all patients will have died. Even in fatal cases and even in the most severely compromised host, the organism and the disease remain localized to the lung, with rare exception. When specific and supportive treatment is introduced early in the disease, the mortality rate can be reduced to around 10% in most medical centers. Abrupt onset tends to occur in patients with cancer, organ transplantation, and AIDS.
- Type
- Chapter
- Information
- Clinical Infectious Disease , pp. 1229 - 1232Publisher: Cambridge University PressPrint publication year: 2008