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Thursday 29 December 2011

Pneumocystis jirovecii (carinii) pneumonia

- one of the AIDS defining illness
- identified on microscopy by methenamine silver staining which shows a cystic phase of organism or Giemsa staining which demonstrates sporozoites and trophozoites with small punctate nuclei
- organism confined to alveolar space with interstitial infiltration of lymphocytes and plasma cells
- presents with high fever, dry cough, exertional dyspnea and type I respiratory failure (arterial oxygen level strikingly lower than expected from symptoms)
- CXR: diffuse bilateral alveolar and interstitial shadowing beginning in perihilar regions and spreading out in a butterfly pattern
- diagnosis can be made in 90% by staining sputum using indirect immunofluorescence with monoclonal antibodies
- prophylaxis/treated with cotrimoxazole (or pentamidine or clindamycin + primaquine if allergic)
- adjunctive steroids have been shown to reduce mortality in severe PCP



1 comment:

MATINA said...

I was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
liver already present. I started on antiviral medications which
reduced the viral load initially. After a couple of years the virus
became resistant. I started on HEPATITIS B Herbal treatment from
ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
treatment totally reversed the virus. I did another blood test after
the 6 months long treatment and tested negative to the virus. Amazing
treatment! This treatment is a breakthrough for all HBV carriers.