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Pneumocystis jirovecii pneumonia — RCPSC IM MCQ

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ModerateInfectious DiseasesPneumocystis jirovecii pneumoniaRCPSC IM

A 44-year-old man with HIV has progressive dyspnoea, dry cough, fever, and oxygen saturation 88 percent on room air. CD4 count is 62 cells/microlitre and HIV RNA is 210,000 copies/mL. CT chest shows diffuse bilateral ground-glass opacities. LDH is elevated. What is the most appropriate management?

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Correct answer: D — Trimethoprim-sulfamethoxazole plus adjunctive corticosteroids

This presentation is highly consistent with Pneumocystis jirovecii pneumonia. Moderate to severe hypoxaemia warrants TMP-SMX plus adjunctive corticosteroids, with antiretroviral timing planned after acute stabilization.

Reference: Canadian HIV care resources; opportunistic infection guidance