skip to main content

Pneumocystis jirovecii pneumonia — DTM&H MCQ

Instant feedback + full explanation. One question, done properly.

HardProtozoal infectionsPneumocystis jirovecii pneumoniaDTM&H

A newly diagnosed patient with HIV has probable Pneumocystis pneumonia and a room-air PaO2 of 8.5 kPa. Which initial regimen is most appropriate?

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

Reveal the answer and explanation

Correct answer: A — Start co-trimoxazole and adjunctive corticosteroids within the first 72 hours

The best answer is “Start co-trimoxazole and adjunctive corticosteroids within the first 72 hours”. BHIVA recommends anti-Pneumocystis treatment for 21 days and early adjunctive corticosteroids when PaO2 is below 9.3 kPa, resting saturation is 92% or less, or exertional saturation falls by at least 3%. Co-trimoxazole is first-line unless contraindicated. Fluconazole and azithromycin do not treat P. jirovecii, microbiological uncertainty should not delay therapy in a compatible severe illness, and antiretroviral therapy does not replace acute antimicrobial treatment.

Reference: BHIVA, Pulmonary opportunistic infection guideline 2024: https://onlinelibrary.wiley.com/doi/10.1111/hiv.13637