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An AIDS Patient With Pneumocystis jiroveci Pneumonia

Nicholas R Munoz1, Armin Hojjat1, Ajay Adial2

  • 1Internal Medicine, Temecula Valley Hospital, Temecula, USA.

Cureus
|July 18, 2025
PubMed

Insights

Pneumocystis pneumonia (PCP) is a fungal infection common in AIDS patients. Trimethoprim-sulfamethoxazole (TMP-SMX) is the recommended treatment for PCP in acquired immunodeficiency syndrome (AIDS) cases.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Immunocompromised Host

Background:

  • Pneumocystis jiroveci is an opportunistic fungal pathogen.
  • It commonly causes severe pneumonia in individuals with compromised immune systems, particularly those with acquired immunodeficiency syndrome (AIDS).
  • Trimethoprim-sulfamethoxazole (TMP-SMX) is the established first-line treatment for Pneumocystis pneumonia (PCP).

Observation:

  • A case report details a 68-year-old male with a 15-year history of human immunodeficiency virus (HIV) non-compliance, who presented with AIDS.
  • The patient developed bilateral pneumonia, diagnosed as PCP caused by Pneumocystis jiroveci.
  • Initial treatment involved TMP-SMX alongside supportive care, including oxygen and vasopressors.

Findings:

  • The patient's condition improved with TMP-SMX and supportive measures.
  • Oxygen requirements decreased, vasopressors were discontinued, and mental status improved, leading to ICU discharge.
  • This case highlights the efficacy of TMP-SMX in treating PCP in an advanced AIDS patient.

Implications:

  • PCP should be strongly considered in immunocompromised patients presenting with pneumonia.
  • TMP-SMX remains the treatment of choice for PCP in the context of AIDS.
  • Prophylactic continuation of TMP-SMX is advised until CD4+ T-cell counts indicate sufficient immune recovery.
Keywords:
acquired immunodeficiency syndrome (aids)antiretroviral therapyhuman immunodeficiency virus (hiv)infectious disease pathologymultifocal pneumoniaopportunistic fungal infectionpneumocystis jiroveci pneumonia

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