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Pneumocystis jirovecii pneumonia — SCE Respiratory MCQ

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HardRespiratory InfectionsPneumocystis jirovecii pneumoniaSCE Respiratory

A 36-year-old man with untreated HIV presents with dry cough, fever and hypoxaemia. PaO2 on air is 8.5 kPa and CT shows bilateral ground-glass opacities. Serum beta-D-glucan is raised. What is the most appropriate management?

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Correct answer: E — Co-trimoxazole with adjunctive corticosteroids

The presentation is consistent with Pneumocystis jirovecii pneumonia, and significant hypoxaemia supports adjunctive corticosteroids alongside high-dose co-trimoxazole. Amoxicillin and oseltamivir do not treat Pneumocystis. Inhaled colistin is used for selected chronic Pseudomonas bronchiectasis, not acute PCP.

Reference: BHIVA Opportunistic Infection Guideline; BNF Co-trimoxazole