Opportunistic Pneumonia

Question 1

what are the common causative agents

Answer 1

Pneumocystis jirovecii pneumonia (PJP)
Cytomegalovirus (CMV)
Fungal infections (Aspergillus, Candida)
Bacterial infections (Mycobacterium avium complex - MAC)

Question 2

what are the risk factors?

Answer 2

HIV/AIDS (CD4 count <200 → high PJP risk)
Cancer therapy (chemotherapy, radiation)
Organ transplant (immunosuppressive drugs)
Prolonged corticosteroid use (e.g., prednisone, dexamethasone)
Malnutrition

Question 3

what are the general symptoms?

Answer 3

Fever, chills, tachypnea, tachycardia
Dyspnea (progressive), hypoxia (low oxygen levels)
Nonproductive cough (especially in PJP)

Question 4

what are the symptoms of Pneumocystis jirovecii pneumonia (PJP)

Answer 4

Slow onset (weeks)
Bilateral lung infiltrates on X-ray
Severe hypoxia → respiratory failure → mechanical ventilation required

Question 5

what are the symptoms of CMV

Answer 5

Mild symptoms in healthy individuals
Severe pneumonia in immunocompromised patients → Acute respiratory failure (ARF)
Can cause multi-organ failure in transplant patients

Question 6

what are the complications?

Answer 6

Acute respiratory failure (ARF)
Sepsis & multi-organ dysfunction
Lung abscesses & permanent lung damage

Question 7

what does a chest x ray show?

Answer 7

Diffuse or focal infiltrates

Question 8

what does CT show?

Answer 8

Ground-glass opacities in PJP

Question 9

what does lab tests show?

Answer 9

Sputum culture & PCR testing (detects pathogen)
ABGs (assesses severity of hypoxia & respiratory failure)
CD4 count (HIV patients)
CD4 <200 → High risk for PJP

Question 9

what is the First-Line Treatment for PJP:

Answer 9

Trimethoprim/sulfamethoxazole (Bactrim) IV or PO
Corticosteroids (if PaO₂ <70 mmHg) to reduce inflammation

Question 10

what is the treatment for CMV pneumonia

Answer 10

IV ganciclovir or foscarnet (antiviral therapy)
High-dose immunoglobulin (severe cases)

Question 11

how do you prevent opportunistic pneumonia?

Answer 11

Prophylactic Bactrim (HIV/AIDS patients with CD4 <200)
Pneumococcal & influenza vaccinations
Avoiding crowded places & sick contacts
Strict hand hygiene & infection control

Question 12

what is the supportive care for opportunistic pneumonia?

Answer 12

Oxygen therapy for hypoxia
IV fluids for hydration
Bronchodilators (if airway obstruction is present)
Mechanical ventilation for acute respiratory failure

Question 13

when do you seek med care?

Answer 13

Severe dyspnea or respiratory distress
High fever, persistent cough, worsening hypoxia
Confusion, tachycardia, or signs of sepsis