Nov 21, 2012
My wife does not have aids but there is a possibility that she has pneumocytis carnii. She has been on cellcept and methyltresate for scleroderma. Shortly after being put on injectable methyltrexate she developed severe respiratory failure. She had sats of 70% when in ER. It has been 4 months and her lung doctors have done nothing to DX why she has this problem. She is on oxygen and getting worse every day. She has restrictive lung disease of the small airways and thE CT showed a mossaic pattern. Is pneumocytis carnii a possible cause of her problem and what can be done to DX it. She also has congestive heart failure that is not able to be under good control because she cannot take the normal diuretics, only edicrine. This is why the doctors are afraid to do any invasive procedures for DX. But if nothing is done to treat this condition she will not live much longer. I would hate to have her die if she has something that could be treated. Amy suggestion as to what I should do or say to her doctors?
Response from Dr. Young
Hello and sorry to hear about your wife.
Pneumocystis can indeed cause pneumonia in people who don't have HIV, particularly those who are immunosuppressed. The diagnosis of PCP in non-HIV infected people can be challenging, but typically I'd start the search by looking in a high quality sputum specimen by PCR technology. Failing that, bronchoscopy with biopsy would be required to confirm the diagnosis.
In some circumstances, we'll treat patients who have sufficient risk and suspicion of the infection. The treatment of choice for PCP is trimethoprim/sulfamethoxazole.
I hope that helps, BY
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