skip to main content

Pneumocystis jirovecii pneumonia — SCE Respiratory MCQ

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

HardRespiratory infectionsPneumocystis jirovecii pneumoniaSCE Respiratory

A 43-year-old man with untreated HIV presents with fever, dry cough and progressive breathlessness. SpO2 is 88% on air, chest radiograph shows bilateral perihilar interstitial shadowing and LDH is raised. CD4 count is 48 cells/µL; ABG on air shows PaO2 7.4 kPa. CT pulmonary angiography is negative for embolism. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: C — High-dose co-trimoxazole with adjunctive corticosteroids

Severe Pneumocystis jirovecii pneumonia in HIV is treated with high-dose co-trimoxazole, and adjunctive corticosteroids are indicated with significant hypoxaemia. Bacterial CAP treatment alone would miss the likely opportunistic pathogen. A raised LDH and bilateral interstitial pattern are supportive but not diagnostic without microbiology.

Reference: BHIVA opportunistic infection guidance; BTS oxygen guidance