PNEUMONIA, PNEUMOCYSTIS CARINII

General Information

DEFINITION--Inflammation of the lung caused by a protozoan single-celled microscopic organism. This is an opportunistic germ, one that the body usually wards off, but which infects the body when there is breakdown and failure of the immune system as with AIDS, Hodgkin's disease and other causes of immune system failure.

BODY PARTS INVOLVED--Lower-respiratory system (bronchial tubes and lungs).

SEX OR AGE MOST AFFECTED--All ages, both sexes, but most common in adult men.

SIGNS & SYMPTOMS

• Slow onset of dry, non-productive cough.
• Fever.
• Air hunger.
• Shortness of breath.
• Rapid heart rate.
• Anxiety.
• Purple lips and fingernails.

CAUSES--The protozoan Pneumocystis carinii is transmitted from person to person.

RISK INCREASES WITH

• AIDS.
• Hodgkin's disease.
• Cancer chemotherapy.
• Taking cortisone or corticosteroid medicines.
• Blood transfusions.
• X-ray treatments.

HOW TO PREVENT--Will be dependent on your risk factors and whether you have had previous infection with Pneumocystis carinii pneumonia.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Arterial blood gases.
• X-rays.
• Stained specimen of sputum obtained by bronchoscopy or lung biopsy to identify the organism.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Treatment may be done at home for mild cases; for moderate to severe infection, you will be hospitalized. You may require mechanical breathing support.

POSSIBLE COMPLICATIONS

• Prolonged illness, sometimes fatal.
• Side effects of medication, especially skin rash and low white blood-cell count.

PROBABLE OUTCOME--Outcome is variable depending on general health and degree of infection.

How To Treat

GENERAL MEASURES----No special self-care measures.

MEDICATION--Your doctor may prescribe:

• Antibiotics, such as trimethoprim/sulfamethoxazole or pentamidine (oral or aerosol).
• Corticosteroids.
• Cough medicine to make the cough more tolerable.
• Nose drops, sprays or oral decongestants to reduce congestion in the upper-respiratory system.
• New drugs that are currently being investigated.
• Preventive medications for HIV or AIDS patients.

ACTIVITY--Bed rest is necessary until fever subsides. Normal activities should be resumed gradually.

DIET--No special diet. Increase fluids to at least 1 glass of water or other beverage every hour. Extra fluid helps thin lung secretions so they can be coughed up more easily .

Call Your Doctor If

• You have symptoms of pneumocystis pneumonia.
• The following occurs during treatment: Fever. Pain that is not relieved by heat or prescribed medication. Increased shortness of breath. Dark or bluish fingernails, skin or toenails. Blood in the sputum. Nausea, vomiting or diarrhea.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.