HIV in Children

PNEUMOCYSTIS CARINII (PCP)

Dr. Ira Shah
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Last Updated : 1st September 2012
It is the most common opportunistic infection (OI) in infants (children less than 1 year of age) with a high mortality rate of about 35% (1, 2, 3). Pneumocystis is an organism with biological characteristics similar to that of fungi and protozoa. It is now renamed as pneumocystis jiroveci (for the human strain) (4). P. carinii is now referred to the organism found in rats. PCP is a common AIDS - defining illness.

Mechanism of action


PCP is usually acquired in childhood. Serum antibodies are found in over 80% of children by 4 years of age (5). In immunocompetent infants, it may lead to mild respiratory symptoms or children are usually asymptomatic (6). In immunodeficient individuals it infects the alveoli leads to interstitial edema and results in progressive hypoxemia and respiratory failure (7). Extrapulmonary affection is rare in children and include ear, eye, thyroid, spleen, GI tract, peritoneum, liver, pancreas, bone marrow, meninges, heart and muscle (6).

Clinical features


Patients present with fever, tachypnea, dyspnea and cough. On examination, there may be bilateral basal crepts with respiratory distress and hypoxia.

PNEUMOCYSTIS CARINII (PCP)
Dr. Ira Shah
Incharge Pediatric HIV and TB Clinic, B.J.Wadia Hospital for Children, Mumbai, India Consultant in Pediatric Infectious Diseases, Nanavati Hospital, Mumbai, India.
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