PNEUMOCYSTIS PNEUMONIA (PCP) The most common opportunistic infection in advanced AIDS (80% of AIDS patients have at least one episode). Now considered a fungus (P.jurovecii). Multiple infections are often present simultaneously with the PCP.
PROPHYLAXIS Routine prophylaxis has been successful in improving survival. PCP prophylaxis is indicated if the patient has a CD4 T lymphocyte count lower than 200 cells/mm3, or has oral candidiasis regardless of the CD4 count.
TREATMENT OF PCP Early therapy is essential as success of therapy is related to severity of the disease at the time of initiation of therapy.
TMP-SMX Treatment of choice. Oral form used for mild-moderate cases or after initial response to IV therapy and for prophylaxis.
TMP-SMX Excellent tissue penetration. Produces a rapid clinical response.
hypersensitivity reaction to sulfa drugs are rash and hives. However, there are several life-threatening manifestations of hypersensitivity to sulfa drugs, including Stevens–Johnson syndrome, toxic epidermal necrolysis, agranulocytosis, hemolytic anemia, thrombocytopenia, and fulminant hepatic necrosis, among others.