It can cause pneumonia in patients with HIV and accounts for 40% of all AIDS-defining illness.
If CD 4 count is less than 200 PCP prophylaxis (=co-trimexazole) should be started.
Features of PCP:
- dry cough
- few chest signs on examination
- desaturation on exercise
CXR typically shows mid-lower bilateral interstitial infiltrates, but it may look normal.
Sputum cultures are often negative so BAL may be needed.
- IV pentamidine if severe
- steroids if hypoxia
- use of steroids decreases respiratory failure by 50% and death by 1/3)
On to battle 3 of the day and a classic condition - myasthenia gravis.