DRG Category: 177

Mean LOS: 8.9 days

Description MEDICAL: Respiratory Infections and Inflammations with Major CC

DRG Category: 975

Mean LOS: 6.8 days

Description MEDICAL: HIV with Major Related Conditions with CC

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Pneumocystis carinii pneumonia (PCP) is an acute or subacute pulmonary infection that can be fatal. It occurs in 5% to 10% of transplant patients and is the most common infection in people with HIV infections and the leading cause of death in this population. With prophylactic medications, an estimated 1% to 20% of people with HIV infection develop PCP at some point in their lifetimes. PCP is viewed as an opportunistic infection because normal cell-mediated immunity protects most humans from infection. Epidemiological surveys have found that by age 3 to 4, most humans have been exposed to the pathogen.

Early in the infection, the organisms line up along the alveolar wall near the type I pneumocytes. The alveoli become infiltrated with a fluid that contains proteins, organisms in varying states of development, cellular debris, and surfactant. As the alveoli become clogged with fluid and wastes, gas exchange is impaired. As the disease progresses, alveoli hypertrophy, type I pneumocytes die, and the patient has markedly diminished gas exchange. PCP affects both lungs and can lead to complications such as pulmonary insufficiency, respiratory failure, and death. People infected with HIV have a 10% to 20% mortality rate, whereas other immunocompromised individuals have a 40% mortality rate.