Pneumocystis pneumonia is an infectious inflammatory process in the lungs that is caused by yeast-like fungi Pneumocystis jirovecii (pneumocysts). Infection can occur by airborne droplets. These parasites are found in the lungs of many healthy people, but cause pathology only in immunodeficient conditions.
Weakening of immunity may be due to the following factors:
- poor nutrition;
- antibiotic treatment;
- the course of chemotherapy;
- blood diseases;
- pregnancy;
- reception of immunosuppressive drugs (for example, with organ transplantation), etc.
However, most often this disease is found in people with a weakened immune system, caused by HIV infection (AIDS). Pneumocystis pneumonia is registered in 70% of HIV-infected people.
How does pneumocystis pneumonia develop?
Infectious agents enter the human body through the respiratory tract. Reaching the lumen of small bronchi and alveoli, they begin to multiply actively. During this period, mucus begins to accumulate in the respiratory tract, which significantly hinders the progress of the air.
The metabolites produced during the development of pneumocysts enter the bloodstream and provoke the production of specific antibodies. This leads to inflammation of the walls of the alveoli of the lungs, which also causes respiratory failure. Progression of the process leads to pulmonary fibrosis, lung emphysema , closed pneumothorax can also develop. In rare cases, pneumocysts invade other organs (liver, kidney, spleen).
Symptoms of Pneumocystis pneumonia
The onset of the disease is usually acute, and is characterized by the following manifestations:
- slight increase in body temperature;
- headache;
- mild dyspnoea with physical exertion;
- general weakness;
- increased sweating;
- pain in the chest;
- cough (more often dry, nasal, less often - with the release of foamy sputum).
After one or two weeks, the following symptoms may appear:
- fever;
- dyspnea at rest;
- increased cough;
- cyanosis of the nasolabial triangle;
- acrocyanosis;
- retraction of intercostal spaces.
In HIV-infected people, the disease develops more slowly, expressed pulmonary symptoms can manifest only after 4-12 weeks. In such patients, pneumocystic pneumonia is often combined with other infections, so intoxication appears to be in the foreground in the clinical picture.
Diagnosis of PCP
The diagnosis is based on radiography or computed tomography. Identify the causative agent of infection is possible by histological examination of bronchoalveolar lavage fluid and transbronchial biopsies, which is carried out by the method of fibrobronchoscopy.
Treatment of PCP
Patients with a pronounced clinical picture of the disease are hospitalized, treatment of PCP with HIV is also conducted in inpatient settings. Appointed drug therapy,
- anti-inflammatory drugs;
- expectorant , mucolytics;
- immunomodulators, etc.
The main drugs that affect the pneumocyst are trimethoprim-sulfamethoxazole and pentamidine isothionate. AIDS patients are more often prescribed alpha-difluoromethylornithine. Oxygen deficiency is recommended for oxygen.