PCP pneumonia

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Risk factors

  • HIV
  • CD4 < 200
  • No prophylaxis

Diagnosis

  • CXR: Bilateral interstitial infiltrates
  • ABG: Hypoxia, ↑A-a gradient
  • Sputum stain & culture (low sensitivity)
  • BAL: Most accurate
  • LDH

Treatment

  • TMP-SMX (rash is the most common SE, bone marrow suppression, K, LFTs)
  • Steroids if PO2<70 or A-a gradient >35.