Moderate Pneumocystis jiroveci pneumonia

Moderate Pneumocystis Jiroveci Pneumonia

Pneumocystis jiroveci pneumonia (PJP) is a type of pneumonia caused by the fungus Pneumocystis jiroveci, which is found in lungs affected by the infection. This condition is usually seen in people whose immune systems are compromised due to certain underlying health conditions or treatments, such as HIV infection, cancer, and organ transplantation.

Moderate Pneumocystis jiroveci pneumonia (PJP) presents as persistent, productive, recurrent cough with fever. Other symptoms include shortness of breath and difficulty breathing. Chest radiograph often shows diffuse bilateral infiltrates which may worsen with time, causing respiratory failure and necessitating intensive care.

The diagnosis of PJP is confirmed by demonstration of organisms in induced sputum specimen, or biopsy of lung tissue. Induced sputum evaluation commonly involves cytology, gram stain and fungal culture. In immuno-compromised patients, broncho-alveolar lavage is used to obtain fluid for this purpose.

Management of moderate Pneumocystis Jiroveci pneumonia involves supportive care, along with the use of antibiotics, and antifungal agents. Trimethoprim/sulfamethoxazole (TMP-SMX) is the drug of choice for moderate Pneumocystis Jiroveci pneumonia.


The prognosis of PJP depends on the severity of the affected person’s underlying medical condition. The condition may rapidly respond with proper treatment, or may worsen and result in respiratory failure in immuno-suppressed or critically ill patients.


Prevention of PJP includes avoiding exposure to air pollutants such as tobacco smoke and ensuring good overall health to help maintain a strong immune system. In immunosuppressed patients, use of prophylactic antibiotics has been recommended by some clinicians.


The potential complications of PJP depend largely on the underlying cause or disease associated with the infection, and may include:

  • Oxygen deficiency
  • Fluid in the air sacs (pulmonary edema)
  • Respiratory failure