Pneumocystis Pneumonia or PCP

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 occurs, 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, or another condition, 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, see your health care provider right away.

How is PCP diagnosed?

Your health care 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 two antibiotics. They are trimethoprim (TMP) and sulfamethoxazole (SMX).

Other drugs 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 health care provider will check your blood count regularly to see how strong your immune system is. If you have a weak immune system, your health care provider may give you medicine to prevent PCP before it occurs.

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.

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 health care provider:

  • 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 names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • 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.