All are true about pneumocystis carinii pneumonia except?
A. First line treatment should be with intravenous pentamidine
B. CXR may be normal C. Severe hypoxemia is common
D. Pleural effusion is uncommon
Ans.
A. First line treatment should be with
Pneumocystis carinii pneumonia often presents with severe dyspnoea, dry
cough, pyrexia and hypoxia. Chest X-ray may be normal in 10% but typically
shows diffuse bilateral perihilar shadowing. Pleural effusion and
lymphadenopathy is uncommon. Silver staining of the Pneumocystis organism now a
fungus. is positive in over 90% of
patients on lavage or induced sputum specimens. Arterial p02 and transfer
factor are decreased. Treatment of choice is cotrimoxazole but Periamidine may
be given instead intravenous or nebulised. . Mortality following first episode
of Pneumocystis carinii pneumonia is less than 10% and secondary prophylaxis
should be given nebulisedpentamidine, cotrimoxazole, dapsone or pyrimethamine.
. Tuberculosis and severe bacterial infection are commoner causes of opportunistic
infection in HIV-positive Africans with AIDS.
