مريض بفيروس نقص المناعة، وعدد خلايا CD4 أقل من ٢٠٠، ويشتكي ضيق نفس متزايد مع الجهد وسعالاً جافاً، وتشبعه ينخفض مع المشي. ما الالتهاب الرئوي الأرجح؟

A client with HIV and CD4 below 200 has worsening exertional dyspnoea, dry cough and desaturation on walking. Which pneumonia is most likely?

1. New adult-onset asthma
2. Pneumocystis pneumonia (PCP)
3. Viral bronchiolitis
4. Pneumococcal pneumonia only

Answer: B) Pneumocystis pneumonia (PCP). PCP is an opportunistic infection when CD4 falls below 200, with gradual dyspnoea, dry cough and exertional hypoxaemia. Co-trimoxazole treats and prevents it, with steroids for severe cases.