How is Pneumocystis jiroveci pneumonia (PJP) diagnosed and when should treatment be initiated?

Updated: Apr 24, 2019
  • Author: Shelley A Gilroy, MD, FIDSA; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Answer

While officially classified as a fungal pneumonia, PJP does not respond to antifungal treatment. Although a histopathologic demonstration of the organism is required for a definitive diagnosis (see Histologic Findings), treatment should not be delayed. [1] Treatment of PJP may be initiated before the workup is complete in severely ill high-risk patients. Treatment of PJP depends on the degree of illness at diagnosis, determined on the basis of the alveolar-arterial gradient. See the A-a Gradient calculator.


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