🫁 Chapter 290 · Pneumocystis jirovecii (PJP/PCP)

Nelson Textbook of Pediatrics 22nd Edition | Opportunistic fungal pneumonia. Risk: HIV (CD4 <200), primary immunodeficiency (SCID, CD40L, etc.), malignancy, chemotherapy, transplantation, immunosuppressive therapy (steroids, TNF inhibitors). Clinical: fever, nonproductive cough, tachypnea, hypoxia, diffuse bilateral infiltrates (ground-glass). Diagnosis: BAL (Giemsa, GMS, IF, PCR). Treatment: TMP-SMX (first-line), corticosteroids for hypoxia (PaO2 <70 mmHg). Prophylaxis: TMP-SMX for high-risk patients.