What is pneumocystis pneumonia?

Pneumocystis pneumonia or PCP is a fungal infection in one or both lungs. It is common in people who have a weak immune system, such as people who have AIDS.

The disease is less common in the U.S. than it used to be. When it happens, you need medical attention right away.

What causes PCP?

The fungus Pneumocystis jiroveci causes PCP. Many people live with this fungus in their lungs every day. It’s common all over the world. It usually causes little to no trouble for people with healthy immune systems. But if your immune system is weakened by HIV/AIDS, cancer, organ transplant, medicines that suppress the immune system, or another condition that causes the immune system to not function well, you have a greater chance of getting PCP. PCP takes advantage of your weak immune system to attack.

If not treated right away, PCP can be severe and even fatal.

Who is at risk for PCP?

You are more likely to get PCP if you have a weakened immune system.

What are the symptoms of PCP?

Symptoms of PCP may develop over a period of weeks or months. The most common symptoms to watch for include:

• Fever that comes on suddenly
• Cough
• Trouble breathing. It often gets worse with activity.
• A dry cough, with little or no mucus
• Chest tightness
• Weight loss
• Night sweats

If you have any of these symptoms and think you could have PCP, especially if you have a condition that suppresses the immune system, see your healthcare provider right away.

How is PCP diagnosed?

Your healthcare provider can diagnose PCP based on your health history and a physical exam. Your provider may also do these tests:

• Chest X-ray. This test uses a small amount of radiation to make images of internal tissues, bones, and organs, including the lungs.
• Blood tests. Your provider may do blood tests to see if you have an infection and if it has spread to the blood. He or she may also do an arterial blood gas test to check the amount of oxygen in your blood.
• Sputum culture. This test is done on the material that is coughed up from the lungs and into the mouth. A sputum culture is often used to test for the PCP fungus in your lungs.
• Bronchoscopy. This is direct exam of the main airways of the lungs (bronchi) using a flexible tube (bronchoscope).

How is PCP treated?

If you have severe PCP, your provider will likely treat you in a hospital. You will get an intravenous (IV) medicine that is a combination of 2 antibiotics. They are trimethoprim (TMP) and sulfamethoxazole (SMX).

Other medicines are available to treat the condition. As you get better, you will likely be able to switch to antibiotics in a pill form.

Can PCP be prevented?

If you have a disease that weakens your immune system, your healthcare provider will check your blood count regularly to see how strong your immune system is. If you have a weak immune system, your healthcare provider may give you medicine to prevent PCP before it happens.

Smokers are also at a greater risk of getting PCP. If you smoke, quitting will make your lungs healthier. It will also help keep you from getting lung infections like PCP.

The best way to prevent PCP if you have a weak immune system is to get regular blood tests and take preventive medicines when needed.

Although flu and pneumococcal vaccines prevent people from getting certain types of pneumonia, they do not prevent PCP. In addition, people with weakened immune systems may not be candidates for their use. Talk to your healthcare provider about immunizations and which one may be appropriate for you.

Key points about PCP

• PCP is an infection in one or both of the lungs caused by a fungus.
• A weak immune system is what puts a person at risk for PCP.
• The most common symptoms of PCP are sudden start of fever, cough, trouble breathing that often gets worse with activity, dry cough with little or no mucus, and chest discomfort.
• Severe PCP is often treated in a hospital with antibiotics given in an IV (intravenously or into a vein).

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.