When should treatment be initiated for Pneumocystis jiroveci pneumonia (PJP)?

Updated: Apr 24, 2019
  • Author: Shelley A Gilroy, MD, FACP, FIDSA; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Although a histopathologic demonstration of the organism is required for a definitive diagnosis (see Histologic Findings), treatment should not be delayed. Treatment of PJP may be initiated before the workup is complete in severely ill high-risk patients.

Appropriate histopathologic testing may still be used to confirm a diagnosis of PJP after treatment is initiated. Endotracheal tube aspirates from severely ill patients on mechanical ventilation may be submitted for diagnosis. Pneumocystis organisms persist in the host for days to weeks after therapy is started, allowing time for completion of the appropriate workup.

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