Pneumocystis jiroveci (carinii) pneumonia
- Refer to Infection Unit consultant.
- Consider adding prednisolone 1mg/kg in severe cases (e.g. PO2 <8kPa). (BHIVA guidelines recommend 40mg twice daily for 5 days, 40mg daily for 5 days, then 20mg daily for 11 days.)
- Send induced sputum or broncho-alveolar lavage for pneumocystis PCR and culture for mycobacteria, fungi and viruses.
- Consider immune deficiency and testing for HIV.
IV Co-trimoxazole 120mg/kg/day (in severe cases)
or orally (non-severe) in 3 or 4 divided doses
In HIV patients reduce on day 4 to 90mg/kg/day for 18 days.
(in line with BHIVA guidelines)
Seek specialist advice from Infection Unit