Fever , cough , chest pain and fatigue . These symptoms look like a common flu , don’t they?
But they are also the symptoms of pneumocystosis, a disease caused by a fungus, responsible for causing the death of many AIDS patients .
This disease is considered an opportunistic infection, as it arises in individuals who have weakened immune systems, causing respiratory problems.
Contents
What is pneumocystosis?
Pneumocystosis is a disease caused by a fungus, called Pneumocystus jiroveci, and is considered a type of pneumonia (inflammation of the lungs).
Many people are exposed to this fungus on a daily basis without knowing it, but when the immune system is strong and healthy, the disease usually does not develop.
Therefore, it is known as opportunistic infection, as fungi only attack weak immune systems.
Among the risk factors for infection are, for example, the presence of other diseases, such as AIDS, lupus or those who have undergone organ transplantation.
Pneumocystosis is transmissible through the patients’ drops of saliva, which end up being passed on to people with weakened immunity.
Symptoms include dry cough, fever, shortness of breath, fatigue and chest pain.
The specialist indicated to make the diagnosis of this condition and the treatment for each case is the pulmonologist, and treatments may include the use of medications to eliminate the fungus and respiratory physiotherapy.
In the International Statistical Classification of Diseases and Related Health Problems – ICD 10, we can find pneumocystosis by code B59 .
Pneumocystosis and HIV
In 1981, an alert was issued by the Center of Disease Control (CDC) in the United States about the frequent presence of P. Jirovecci, a fungus that causes pneumocystosis, in patients who have Acquired Immunodeficiency Syndrome, or AIDS.
Read more: Fungus present on the skin can trigger atopic dermatitis
The condition is able to interfere with the body’s process of fighting infections.
After the alert and research carried out, it was found that 80% of AIDS patients developed pneumocystosis, which is one of the main causes of mortality in these patients in the USA.
For this reason, patients with HIV or AIDS often have an auxiliary T-cell count test, which helps to identify pneumocystosis. The disease is detected when helper T cells (CD4 +) are less than 200 cells / mm3.
What causes?
Pneumocystosis is caused by a fungus, called Pneumocystis jiroveci . The agent is normally present in our lungs and does not cause any damage, as long as the body is healthy.
All mammalian species (which includes humans) can have this fungus in the lung, so the condition is called an opportunistic infection, because if there is a drop in immunity, the damage resulting from the fungus is manifested.
But for those who have a weakened immune system due to diseases such as HIV, AIDS, lupus or who have undergone an organ transplant, the infection develops more easily, causing inflammation and the accumulation of fluid in the lungs.
Transmission: Is pneumocystosis contagious?
Pneumocystosis is transmissible through contact with drops of saliva from patients who have the disease (it can be when talking, coughing, sneezing).
Read more: Candida auris: superfungo spreads and worries doctors
It is worth remembering that most people have the fungus, but do not manifest symptoms. Only those who have a weak immune system develop symptomatic infection.
Risk factors
The main risk factor is having weak immunity, which can be caused by factors such as:
- Malnutrition;
- HIV or AIDS carriers;
- Recent organ transplant surgery;
- Hematological cancers (leukemia, lymphoma);
- Use of corticosteroids.
Pneumocystosis symptoms
Pneumocystosis, in general, appears quickly and can manifest symptoms for more than 2 weeks. Between them:
Dry cough
The dry cough occurs due to the infectious process caused by the fungus, which reaches the airways causing irritation in the throat.
Most patients have a dry cough, but in some cases sputum may also occur.
may manifest with prolonged dry cough . In this case, the infectious process reaches the airway and the cough is triggered by stimuli in the bronchi and pleura.
Fever
Fever is one of the symptoms of pneumocystosis, and it usually occurs at low intensity, between 37.5ºC and 38 ° C.
Shortness of breath (dyspnoea)
Shortness of breath is a recurring symptom, as the lungs are unable to supply enough oxygen to the blood. This can cause shortness of breath, even without performing an activity that may require effort, such as walking.
Fatigue
The fatigue excess and steady may indicate the PCP, especially when fatigue appears at different times as to wake up and do everyday activities.
Chest pain
Another characteristic symptom of pneumocystosis is chest pain, from moments that require greater effort to when the patient simply breathes while standing still.
How is the diagnosis made
The specialist to treat pneumocystosis is the pulmonologist , who will be able to analyze the different diseases that affect our lungs. To perform the diagnosis of pneumocystosis, some laboratory tests such as sputum analysis can be used. In addition to this, the following exams are also common:
Chest radiography (X-ray)
Chest radiography, popularly known as x-ray, is an exam that can evaluate the patient and also help in the diagnosis of other diseases.
To be performed, ionizing radiation is used, which produces an image of the chest, in which changes in the lung tissue are observed, which may indicate the presence of the disease.
Pulse oximetry
Pulse oximetry is a simple test, in which the amount of oxygen that the blood is transporting to the body is measured. In the event of a disease in the lungs, the blood oxygen level will be low.
The examination is simple and non-invasive, and consists of placing your finger inside a small device, similar to a large clip, which performs the measurement.
Histopathological confirmation
The histopathological confirmation test is a kind of biopsy, in which a fragment of tissue or some organ is removed and taken for analysis in the laboratory. Through the microscope, an evaluation is made to diagnose the pathology.
In the case of pneumocystosis, the doctor will be able to collect the sputum produced by the patient, to later check the presence of fungi under the microscope.
Is pneumocystosis curable?
Yes , pneumocystosis is curable when the treatment is carried out in the correct way. With the use of the medications indicated by the doctor, the organism, in general, manages to recover.
But in patients who have diseases that affect the immune system frequently, care for pneumocystosis needs to be more strict so that it is not fatal.
Depending on the disease, the specialist may recommend specific medications so that the disease does not return in these weaker organisms.
Treatment for pneumocystosis
Treatment for pneumocystosis consists of using medications to eliminate the microorganism causing the condition and respiratory physiotherapy to help the health of the lungs depending on the case:
Medicines
The use of medications is the most suitable option for the treatment of pneumocystosis, usually the doctor prescribes antibiotics , such as trimethoprim and sulfamethoxazole to eliminate the fungus responsible for the disease.
Many people who are allergic to sulfa end up having side effects in the use of medications to treat pneumocystosis, in which case corticosteroids are administered together for better effectiveness.
Respiratory fisioterapy
Depending on the case, the doctor may recommend the practice of respiratory physiotherapy to improve the patient’s breathing.
Using specific equipment, physical therapy activities help the lung to release secretions, facilitate the arrival of oxygen to the whole body and also give the lung greater capacity to exercise its activities.
- Respiratory Exerciser NCS Respiron Easy ;
- Respiratory Exerciser NCS New Shaker .
Medicines
The antibiotic medication used to treat pneumocystosis will depend on the patient’s condition:
Sulfamethoxazole + trimethoprim
To eliminate the bacterium that causes pneumocystosis, the most common medication to recommend is sulfamethoxazole + trimethoprim:
- Sulfamethoxazole + Trimethoprim ( Bactrim Tablet , Infectrin Suspension , Sulfamethoxazole + trimethoprim );
Clindamycin hydrochloride
When the case is mild or moderate, the use of clindamycin by the specialist in an alternative to sulfamethoxazole + trimethoprim may be indicated:
- Clindamycin hydrochloride ( Dalacin C , Clindamin C , Clindamycin hydrochloride ).
Prednisone and prednisolone
In patients with HIV, there is greater care in the choice of medications. The most common ones to be recommended in these cases are:
- Prednisone ( Meticorten , Ciclorten , Prednisone );
- Prednisolone ( Predsim Tablet , Pred-Gran , Prednisolone ).
Pentamidine isethionate
When the disease is in a severe phase, with no response to the drugs sulfamethoxazole + trimethoprim, pentamidine isethionate is used intravenously in the patient at the hospital.
Attention!
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Prognosis
Pneumocystosis cases diagnosed at the very beginning have a high probability of success in the treatment, obtaining a cure. When the diagnosis is made late or in patients with HIV, the chance of fatality varies between 30% to 50%.
Complications: what are the consequences?
If pneumocystosis is not treated with the use of medications prescribed by the doctor, the disease can progress and present a fatal risk for people with advanced age and HIV.
Respiratory failure
Respiratory failure arises as a result of the first symptoms of pneumocystosis. Over time, if treatment is not started, failure can progress intensely.
In 20% of cases of pneumocystosis with complications of respiratory failure, there is a need for the patient to use ventilatory support to be able to breathe well.
Death
When the infection occurs associated with AIDS, it presents risk of death to the patient in about 90% of the cases, in which the cells are smaller than 200 cells / mm3.
If pneumocystosis is not treated, it always ends up being fatal to the patient. When the diagnosis occurs and the disease is treated correctly, mortality is lower, in about 15% to 20% of cases.
Prophylaxis: what are the precautionary measures?
For patients who have immunodeficiency, precautionary measures are necessary, as pneumocystosis causes complications that can lead to death in the large number of cases.
When the patient is exposed to risky situations, that is, possible contact with the fungus, prophylaxis is recommended. That is, even without confirmation of pneumocystosis, it is recommended to administer the drugs as a way to reduce risks.
But this should only be done under the doctor’s express guidance.
Preventive measures, especially for patients with immunosuppression, include avoiding contact with people with pneumocystosis or hospital environments that may represent risks of transmission.
Pneumocystosis, a disease caused by the fungus Pneumocystus jiroveci, affects people who have low immunity due to other conditions such as organ transplantation, cancers, among others. It is necessary to watch for any signs that may indicate this disease.
