What Is Fungal Pneumonia or Pneumocystis Pneumonia?
Pneumocystis pneumonia (PCP), or fungal pneumonia, is a severe infection caused by the fungus Pneumocystis jirovecii that causes the buildup of fluid and inflammation in the lungs. This fungus spreads through the air and is very common. Those people with medical conditions that weaken their immune systems, such as HIV-AIDS, or who take certain medications (such as corticosteroids) that reduce the body’s ability to fight foreign bodies and infections are predisposed to PCP, which makes them very sick. After the availability of antiretroviral therapy (ART) for HIV-AIDS, this incidence has been reduced, but PCP is still a public health concern.
Scientists have changed this organism's classification and name since it first appeared in patients with HIV in the 1980s. Pneumocystis jirovecii was classified first as a protozoan but is now considered a fungus.
PCP can also affect other body parts, including the lymph nodes, bone marrow, and liver.
What Are the Symptoms of Fungal Pneumonia?
During the early stages of the infection, there might be an absence of symptoms, or they could be mild. The symptoms develop over a period of several days or weeks and include-
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Fever (usually low in case of HIV, otherwise higher).
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Dry cough.
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Difficulty breathing.
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Chest pain.
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Chills.
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Fatigue (tiredness).
Age can play a role in determining the severity of symptoms in people with fungal pneumonia, including:
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In older adults, the symptoms tend to be mild, but the condition can sometimes lead to mental confusion, thereby requiring immediate medical attention.
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Infants and toddlers with fungal pneumonia may have difficulty feeding, breathing problems (grunts or rattles while breathing), pale-colored skin, a limp appearance, less urine production, and fussiness.
What Are the Risk Factors for Fungal Pneumonia?
PCP rarely occurs in healthy people, but the fungus may be present in their lungs for an extended period without presenting any symptoms. Twenty percent of adults might carry this fungus at any given time, and their immune system removes it after several months.
Fungal pneumonia tends to affect people with compromised immunity. The risk factors include-
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People aged 65 or older.
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Toddlers and infants aged two and younger.
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Human immunodeficiency virus (HIV-AIDS) patients.
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Cancer patients undertaking chemotherapy.
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Patients taking corticosteroids.
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Inflammatory disorders or autoimmune disorders (lupus, rheumatoid arthritis, multiple sclerosis, and others).
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Hematologic (blood) disorders.
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Cancer.
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Solid organ or stem cell transplant.
In addition, immunity is also affected by several lung and heart conditions, which act as risk factors for fungal pneumonia. These factors include-
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Cystic Fibrosis- Life-threatening disorder affecting the lungs and the digestive system.
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Asthma- Inflammatory disease of the airways to the lungs.
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Chronic Obstructive Pulmonary Disease- Chronic obstructive pulmonary disease (COPD) are a group of lung diseases that block the airflow and make it difficult to breathe.
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Emphysema- Lung condition causing shortness of breath.
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Unmanaged Diabetes- Uncontrolled high blood sugar.
How Can Fungal Pneumonia Be Prevented?
Currently, no vaccine is available to prevent PCP. A healthcare provider might prescribe certain medicines to people who are more likely to develop the disease to prevent PCP. The medication most commonly used to avoid PCP is Trimethoprim/ Sulfamethoxazole (TMP/SMX), also known as Co-trimoxazole, and by several different brand names, including Bactrim, Cotrim, and Septra.
Other medicine options are available for people who cannot take TMP/SMX. Medications to prevent PCP are required for some people affected with HIV or who have undergone stem cell transplants and some solid organ transplants. Healthcare providers might also prescribe certain medications to prevent PCP in people taking long-term, high-dose corticosteroids.
How Is Fungal Pneumonia Diagnosed?
One of the main challenges of fungal pneumonia is its resemblance to other diseases. Most people delay consulting a healthcare provider since they assume they have a cold or flu.
Fungal pneumonia is diagnosed with the following tests-
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Evaluation: Initial evaluation is done by assessing the symptoms and medical history and performing a physical examination, including a healthcare provider using a stethoscope to listen to the lungs.
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Chest X-ray: X-ray imaging assesses the buildup of fluid in your lungs, the inflammation pattern, and the disease's severity.
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Blood Testing: A blood sample can help determine the health of the immune system and the body's reaction to the fungus. A complete blood test (CBC) that measures the amount of red and white blood cells and platelets is often ordered.
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Blood Culture: Clinical tests of blood samples may be performed to ensure that the infection has not spread from the lungs to other body parts. The pathogens present in the bloodstream warrant particular care.
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Pulse Oximetry: This test, or any other test that checks blood-oxygen levels, may be conducted in advanced cases. Deficient levels may be an indication of a medical emergency.
In severe cases, additional testing may be required, including:
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Sputum Test: In this test, a sample of the mucus coughed by the patient, called sputum, is tested clinically to find out the cause of the infection.
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Computed Tomography (CT) Scan: A chest CT scan is ordered when the healthcare provider suspects significant lung damage or other complications.
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Pleural Fluid Culture: In this test, the sample of fluid from the pleura (tissue covering the lungs) is screened for the signs of fungi.
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Bronchoscopy: This involves using an endoscopic device with a camera attached at the end of a retractable tube and helps the healthcare providers to have a real-time view of the inside of the air passages and the lungs.
How Is Fungal Pneumonia Treated?
PCP can be fatal if left untreated. Healthcare providers treat PCP with prescription medicine. The most common treatment for PCP is trimethoprim/sulfamethoxazole (TMP/SMX), also called co-trimoxazole. This medicine is administered orally or through a vein (intravenously) for three weeks. The possible side effects of TMP/SMX involve rash and fever. Other treatments are available for those patients who cannot take TMP/SMX.
Conclusion:
Fungal pneumonia represents a medical challenge that is persistent and particularly problematic because it affects people who are already sick with a lowered immunity, adding further to their burden. In addition, this condition's symptoms are often left unnoticed and untreated, which worsens the outcome. Do not hesitate to seek medical attention because fungal pneumonia can be life-threatening if left untreated.
