Pregnancy Deaths from Pneumocystis Carinii Pneumonia: Chemoprophylaxis Preserves Life

Abstract

The advent of HIV/AIDS brought opportunistic infections such as Pneumocystis jiroveci pneumonia (PJP), formerly known as Pneumocystis carinii pneumonia (PCP) to the fore. This is a fungal opportunistic infection that is an human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) defining illness. It poses significant risks to both the mother and the fetus. Pneumocystis carinii pneumonia can have a sub-clinical insidious onset but can rapidly progress to acute respiratory failure leading to maternal and fetal demise. The best form of management of pneumocystis carinii pneumonia is prevention. Widespread chemoprophylaxis with co-trimoxazole reduces morbidity and mortality. The management calls for a multidisciplinary approach involving the physician, obstetrician and pneumologist. Pneumocystis carinii pneumonia has a more aggressive course during pregnancy with increased morbidity and mortality, maternal and fetal outcomes remaining dismal. Therefore, it is important that widespread HIV testing and use of co-trimoxazole chemoprophylaxis are made readily available to reduce morbidity and mortality. It must be a differential diagnosis of any pregnant HIV seropositive patient presenting with pulmonary symptomatology.