Diagnosis and Management of Pneumocystis Carinii Pneumonia (PCP) in HIV Patients at Klungkung Regional Hospital
Abstract
Pneumocystis carinii pneumonia (PCP) is an opportunistic infection caused by the fungus Pneumocystis jerovecii. This condition generally occurs in immunocompromised patients, especially in HIV patients, if not treated optimally, it can be life threatening. This infection is the most common opportunistic infection in HIV patients, especially in patients with CD4 cells less than 200 cells/ul. The following is a case of PCP in HIV infection at the Klungkung Regional Hospital. Case Report: Patient AMA, 52 years old came with the main complaints of shortness of breath, cough since 1 week, and fever. On examination the patient was conscious (E4V5M6) and appeared moderately ill. Blood pressure 130/80 mmHg, pulse rate 106x/minute. Respiratory rate 24x/minute, axillary temperature 370C with oxygen saturation 95% with oxygen 4 lpm nasal cannula. On physical examination, rhonchi were found in the right and left paracardia. Routine blood examination found Hb 9.2g/dL, WBC 12.62 thousand/, hematocrit 26.3%, platelets 272 thousand/?L. Liver function examination SGOT 80 U/L, SGPT 74 U/L, urea 23mg/dL, creatinine 0.3mg/dL, NT-Pro BNP 4102 pg/mL, HIV test results showed reactive, IGRA negative. Microbiological examination of the sputum showed positive results for yeast cells and gram-negative bacilli. Chest x-ray examination revealed cardiomegaly with a CTR of 60%, showing pulmonary congestion and a pneumonic infiltrate. Thorax CT scan with results showing bronchitis accompanied by pneumonia…
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