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Infectious Diseases — UKMLA MCQ

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HardInfectious DiseasesUKMLAMRCP Part 1

A patient treated for Pneumocystis pneumonia deteriorates after starting therapy, with worsening hypoxaemia but no pneumothorax. Which mechanism should be considered?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — An inflammatory pulmonary response during organism killing

The best answer is “An inflammatory pulmonary response during organism killing”. Early respiratory worsening can reflect an inflammatory response as Pneumocystis organisms are killed, particularly in severe disease, while complications and alternative infection are reassessed. This is one reason adjunctive corticosteroids are used for significant hypoxaemia; deterioration still warrants urgent clinical review rather than automatic abandonment of effective treatment.

Reference: BHIVA: Pulmonary opportunistic infection guideline: https://bhiva.org/clinical-guideline/oi-guidelines-pulmonary/