Pneumocystosis – symptoms, course, treatment

Pneumocystosis is an infectious disease. This is pneumonia caused by the fungus Pneumocystis jiroveci. It usually occurs in people with weakened immune systems.

Pneumocystosis – forms of the disease

From the medical point of view, there are two forms of the disease (sporadic and epidemic) and two clinical forms – pulmonary and extra-pulmonary.

The sporadic form of the disease usually affects only people with AIDS, lymphocytic leukemia and those taking immunosuppressive drugs (for cancer, organ and bone marrow transplants, autoimmune diseases). Epidemic forms are found in hospitals in wards for premature, dystrophic and abandoned children. Adults with a healthy immune system usually do not get sick, but can remain asymptomatic carriers and infect others via droplets.

Pneumocystosis – course

The fungus Pneumocystis jiroveci is a very widespread microorganism that is transmitted by droplets. Patients with a healthy immune system do not develop pneumonia even after infection. People with reduced immunity are ill. When the microorganism enters the body and is not suppressed by the immune system, it multiplies quickly and impairs lung function. The disease can also develop in children who have not yet completed the process of lung tissue development.

Pneumocystosis – symptoms

The symptom of the disease is usually fever and a dry cough without productation. The cough gets worse over time.

The lesions caused by the fungus are usually paraviocular but can also be focal. Then, emphysema blisters appear in their environment, which negatively affects the reduction of lung capacity and gas exchange. The changes characteristic of this type of pneumonia are visible on X-rays in the form of bilateral periaval infiltrates. But it is worth adding that 20-30 percent. of patients, the picture of the lungs is normal.

Gasometric examination reveals hypoxemia with an increase in the alveolar-arterial oxygen gradient.

The diagnosis requires histopathological demonstration of the presence of the microorganism, which is done by staining with methanamine silver, i.e. urotropin. The test material (sputum) is obtained by provoking the patient to cough or is collected during bronchoscopy. You can also examine the bronchoalveolar lavage.

Pneumocystosis – treatment

Like most infectious diseases, pneumocystosis is treated medically. In general, intravenous co-trimoxazole over a period of 3 weeks is recommended. In people with symptoms of respiratory failure, administration of corticosteroids is necessary. Very often, the administration of drugs is started before the final diagnosis is made in order not to lead to respiratory failure. Patients with AIDS who do not tolerate cotrimoxazole receive pentamidine compounds (due to complications, it is not recommended to administer these preparations by inhalation), pyrimethamine with sulfadoxine and clindamycin with primaquine. Symptoms should disappear after a week. Supportive treatment is also recommended after you stop taking your medications. HIV-infected or AIDS patients are at risk of relapse of pneumocystosis.

The overall mortality rate in Pneumocystis jiroveci pneumonia is 15-20%. The risk of death is higher in people with HIV, people with AIDS, after contracting this type of pneumonia, and in the elderly.

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