In Germany alone, more than 600,000 people contract pneumonia every year. This inflammation of the lung tissue can have different causes and is divided into different subcategories. A particularly dangerous form of pneumonia is Pneumocystis pneumonia (PCP).
What is Pneumocystis pneumonia?
Pneumocystis pneumonia is an interstitial type of pneumonia. The inflammation does not affect the alveoli, but the interstitium. This is the narrow layer of connective tissue that lies between the alveoli and the blood vessels. So-called opportunistic pathogens are involved in the development of Pneumocystis pneumonia. See polyhobbies for Meanings of Hypochondria.
Therefore, this disease is one of the opportunistic infections. Opportunistic pathogens can be fungi, viruses or bacteria. They take advantage of when the body is in a precarious situation. These pathogens most often attack the organism when the immune system is weakened, i.e. there is an immune deficiency.
Because this is characteristic of people living with AIDS, Pneumocystis pneumonia is considered the most common AIDS-defining disease. Since this type of pneumonia mainly occurs when the person concerned already has a previous illness, it is called secondary pneumonia.
Causes
The opportunistic pathogen responsible for this form of lung disease is Pneumocystis jirovecii, a sac fungus that is ubiquitous in the environment. Man is constantly exposed to it. Because transmission is airborne, the likelihood of contact with the pathogen is very high. Most people become infected during childhood.
However, the immune system of a healthy body is normally able to prevent disease without any problems. However, if the immune system is weakened, the patient is at acute risk. Reasons for a weakened immune system can be, for example, chemotherapy, a congenital immune deficiency or an HIV infection.
The HIV infection is so critical because the HI virus gradually destroys the T helper cells that are responsible for the formation of antibodies. Without sufficient antibodies, the body is no longer able to successfully fight invading pathogens. As a result, the immune cells are no longer able to successfully fight off the fungal pathogen Pneumocystis jirovecii. This results in the critical inflammation of the lung tissue.
Symptoms, Ailments & Signs
The onset of pneumonia is insidious. First of all, the affected person has a dry cough, which gets stronger over time. In addition, the patients suffer from increasing shortness of breath, also known as dyspnea.
Fever can occur but is not a characteristic symptom, as an overly weakened body may not be able to fight off an infection with a fever. Another symptom is tachypnea. The patient’s respiratory rate is increased. So he or she has to take several breaths per minute.
Since the body is severely weakened by the infection, the affected person will lose weight over several weeks if not treated adequately . This can amount to several kilos. Typically, a so-called oral thrush can be detected in the mouth of the patient.
This is a fungal infection of the oral mucosa that appears with white or yellowish coatings. If the disease is left untreated, the patient’s condition will continue to deteriorate. In such a case, it can quickly happen that the disease takes a fatal course.
Diagnosis & course of disease
It can often take a very long time for those affected with a hitherto unrecognized HIV infection to be diagnosed with PCP. Because even if the doctor takes an X-ray with the suspicion of pneumonia, in many cases there are no abnormalities on the image. Only rarely does a butterfly-shaped structure indicate the presence of pneumonia during the X-ray.
A reliable diagnosis can only be made by means of a bronchoscopy with bronchial lavage. A thin tube is inserted through the throat into the bronchi. Tissue samples are taken with small brushes and forceps. In bronchial lavage, the airways are flushed with a saline solution.
The solution is then sucked off. The samples obtained during the investigation are microbiologically examined to detect the fungus. Since the procedure is very uncomfortable for the patient, it is possible to have it performed under sedation or anesthesia.
Complications
In the worst case, Pneumocystis can be deadly for those affected. As a rule, however, death only occurs if the pneumocystis is not treated and the inflammation can also spread to other regions of the body. Those affected suffer from this disease primarily from very severe breathing difficulties and also from a permanent cough.
The throat also hurts and it can lead to shortness of breath. Due to the breathing difficulties, the internal organs are also supplied with less oxygen, so that in the worst case irreversible damage can occur. Pneumocystis also puts a strain on the heart, as the body has to transport more blood to supply the organs with oxygen.
This can also lead to a heart attack. Furthermore, Pneumocystis often leads to weight loss and the mucous membranes are attacked by fungi. Treatment of pneumocystis is usually not associated with complications. With the help of antibiotics, the symptoms are completely treated. The life expectancy of the affected person is not affected if the treatment is successful.
When should you go to the doctor?
Symptoms such as a dry to mucous cough, chest pain and high fever indicate pneumonia. A doctor must determine whether Pneumocystis pneumonia is present and, if necessary, start treatment immediately. Depending on the severity of the pneumonia, it may be enough to prescribe mild antibiotics. In the case of severe symptoms, inpatient treatment in a specialist clinic is necessary. In order to be able to decide this at an early stage, a rapid medical clarification is absolutely necessary. Therefore, medical advice should be sought at the latest if chest pain or fever increases.
Patients with an immune deficiency, for example AIDS patients and people with an immune disorder, are particularly at risk. Anyone who belongs to the risk groups should go to the family doctor quickly if the symptoms mentioned at the beginning occur. In addition, an ENT doctor or a lung specialist can be consulted. During antibiotic therapy, a doctor must monitor the healing process. If complications arise, the patient must be taken to the hospital immediately. If infants or young children show signs of Pneumocystis pneumonia, call emergency services.
Treatment & Therapy
Once Pneumocystis pneumonia has been diagnosed, high-dose antibiotic therapy is given. This usually has to be continued for at least three weeks. Co-trimoxazole is usually administered intravenously for this purpose. If the person concerned has an intolerance, this is very problematic, since all alternative preparations are less effective and sometimes have very dangerous side effects.
Since the patient’s condition initially deteriorates after the start of treatment, and they sometimes even need breathing assistance, the affected person is usually admitted to a clinic. Only in very mild cases can the patient treat the disease at home by taking antibiotics orally. Cortisone preparations can also be administered to curb the inflammatory reactions in the lungs.
Prevention
While infection with Pneumocystis jirovecii cannot be prevented, the onset of the disease can be prevented with appropriate prophylactic measures. Healthy people protect themselves best by primarily taking care to avoid infection with the HI virus. In patients who are already HIV-positive or have an immune deficiency for another reason, antibiotics are used preventively.
Aftercare
Those affected with Pneumocystis pneumonia usually only have a few and limited follow-up measures available. For this reason, the patient should consult a doctor as soon as the first symptoms and signs of the disease appear, so that further complications can be prevented. As a rule, self-healing is also not possible, so that the person concerned is usually always dependent on medical examination and treatment.
The sooner a doctor is consulted, the better the further course of the disease. Most of those affected are dependent on taking various medications, whereby care must be taken to ensure the correct dosage and regular intake. Furthermore, when taking antibiotics, it should be noted that they must not be taken together with alcohol. Regular checks and examinations by a doctor are also very important in order to detect further damage caused by Pneumocystis pneumonia at an early stage. This disease may result in a reduced life expectancy for those affected.
You can do that yourself
In the field of self-help, the person concerned should take various measures to support his body’s own defense system in its functional activity. In order for the organism to be able to defend itself sufficiently against pathogens and germs, the affected person should attach importance to a healthy lifestyle.
Food intake should be balanced and rich in vitamins. Being overweight should be avoided as this puts an additional strain on the body. It is advised that the person concerned makes sure that their own weight is within the normal range of the BMI. Sporting activities, good sleep hygiene and staying in the fresh air strengthen the immune system. Stress, hectic and stressful conditions should be avoided. Likewise, the consumption of harmful substances should be avoided. This includes in particular nicotine, alcohol, drugs or non-prescribed medication. Environments that are enriched with pollutants such as gases or other unpleasant odors should be avoided.
Since the disease can lead to shortness of breath, panic reactions should be avoided. These increase anxiety and further deteriorate health. It is important to remain calm at all times so that no consequences occur. In severe cases, Pneumocystis pneumonia can lead to premature death. It is therefore particularly important to seek medical help as soon as the first irregularities occur.