PCP pneumonia: what to know

PCP, also called Pneumocystis jirovecii pneumonia, is caused by a fungus that can affect the lungs. It is more likely when the immune system is weakened, including from some illnesses or immune-suppressing medicines. Symptoms may build gradually and can include a dry cough, fever, chills, tiredness and breathlessness, particularly with activity.

These features overlap with pneumonia from other causes, influenza and COVID-19. Coughing up phlegm is not required. A clinician may check oxygen levels, examine your breathing and arrange chest imaging or laboratory tests to identify the cause and severity.

Contact a clinician promptly for a new or worsening cough, fever or shortness of breath, particularly if you have reduced immunity. Tell them about HIV, cancer treatment, transplant medicines, steroid use or other immune-suppressing treatment. Do not self-treat with leftover antibiotics or delay assessment because symptoms began gradually.

Treatment is prescription-based and may require monitoring of breathing, oxygen and medicine effects. Rest, drink fluids if you can, avoid smoking and follow infection-control advice. Continue essential medicines unless the treating team tells you otherwise.

Call emergency services or go to an emergency department for severe breathlessness, blue or grey lips, chest pain, confusion, fainting, inability to speak comfortably, or rapidly worsening weakness. Urgent assessment is also needed if fever and breathing symptoms are worsening, because serious infection such as sepsis can develop.

Could this be PCP pneumonia or another infection? Do I need oxygen testing, imaging or laboratory tests? Which medicines are suitable with my current treatment? How will we monitor breathing and side effects? What warning signs mean I should return urgently?