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Pneumocystis jirovecii Pneumonia: Sensitivity and Specificity

Introduction: None written.

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Tags: Infection Pulmonary Tag this Diagnosis.


Population / CalculatorPrevalence Comments / Study / Link
HIV, CD4 count 200-350 0.5% [From UpToDate]

One study showed that the incidence of PCP with a CD4 count of 201 to 350 cells/mm3 was 0.5 percent.

HIV, CD4 count < 200 8% [From UpToDate]

Within six months of the CD4 count falling below 200 cells/mm3, 8 percent of patients developed PCP.

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The sensitivity and specificity of findings for Pneumocystis jirovecii Pneumonia are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Finding SensitivitySpecificity Comments, Study
High-Resolution Chest CT (HRCT) Edit 100%89%

May be useful for ruling out PCP


Diagnosis of thoracic complications in AIDS: accuracy of CT.

Hartman TE; Primack SL; Muller NL; Staples CA

AJR Am J Roentgenol 1994 Mar;162(3):547-53.

Specific Findings

Finding SensitivitySpecificity Comments, Study
bronchoalveolar lavage (BAL) Edit 80%100%

Sensitivity can be increased to 98 if BAL is site-directed by chest imaging.


Aerosolized pentamidine: effect on diagnosis and presentation of Pneumocystis carinii pneumonia.

Jules-Elysee KM; Stover DE; Zaman MB; Bernard EM; White DA

Ann Intern Med 1990 May 15;112(10):750-7.

Respiratory specimens from sputum induction Edit 55%100%

Specificity found to be in 55-92% range in meta-analysis below.

Using an immunofluorescent staining technique to evaluate sputum specimens induced by the inhalation of hypertonic saline.


Meta-analysis of diagnostic procedures for Pneumocystis carinii pneumonia in HIV-1-infected patients.

Cruciani M; Marcati P; Malena M; Bosco O; Serpelloni G; Mengoli C

Eur Respir J 2002 Oct;20(4):982-9.

Findings With Unspecified Accuracy

Finding SensitivitySpecificity Comments, Study
Diffusing capacity for carbon monoxide (DLCO) Edit No accuracy specified.

PCP is highly unlikely if the DLCO is normal, defined by 70 percent of the predicted value or greater


Performance of an algorithm to detect Pneumocystis carinii pneumonia in symptomatic HIV-infected persons. Pulmonary Complications of HIV Infection Study Group.

Huang L; Stansell J; Osmond D; Turner J; Shafer KP; Fulkerson W; Kvale P; Wallace J; Rosen M; Glassroth J; Reichman L; Hopewell P

Chest 1999 Apr;115(4):1025-32.

O2 desaturation with exercise Edit No accuracy specified.

Assessment of oxygenation at rest and with exercise. The presence of PCP is highly unlikely if the response to exercise is normal, ie, a decrease in the alveolar-arterial oxygen gradient or an increase in the oxygen saturation with exercise.


Pulmonary function tests.

Stover DE; Meduri GU

Clin Chest Med 1988 Sep;9(3):473-9.

High LDH Edit No accuracy specified.

An LDH of <220 IU/L rules out PCP in an immunocompromised patient

Study: no study specified.

Low CD4 count Edit No accuracy specified.

Study: no study specified.