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Pneumocystis Pneumonia

Pneumocystis Pneumonia is a topic covered in the 5-Minute Emergency Consult.

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  • Originally called Pneumocystis carinii pneumonia, then renamed Pneumocystis jirovecii but still referred to as PCP
  • Most common opportunistic infection in patients with HIV, even with PCP prophylaxis and antiretroviral therapy
  • Believed to be transmitted by respiratory-aerosol route:
    • Cysts colonize respiratory tract.
    • Cysts rupture and multiple trophozoites release and form foamy exudate in alveoli.
  • Most cases are believed to represent reactivation of latent disease, although person-to-person transmission suggested.
  • Actual mode of transmission is unclear.


  • Pneumocystis is classified as a fungus.
  • Pneumocystis occurs in hosts with altered cellular immunity:
    • HIV infection (most common, especially when CD4 count <200 cells/mm3)
    • Cancer
    • Corticosteroid treatment
    • Organ transplantation
    • Malnutrition

Pediatric Considerations
PCP in children is typically more severe.

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Rosen, Peter, et al., editors. "Pneumocystis Pneumonia." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307643/all/Pneumocystis_Pneumonia.
Pneumocystis Pneumonia. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307643/all/Pneumocystis_Pneumonia. Accessed April 23, 2019.
Pneumocystis Pneumonia. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307643/all/Pneumocystis_Pneumonia
Pneumocystis Pneumonia [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 23]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307643/all/Pneumocystis_Pneumonia.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Pneumocystis Pneumonia ID - 307643 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307643/all/Pneumocystis_Pneumonia PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -