All right, so welcome back to the Internet Book of Critical Care podcast.

I'm here with Adam Thomas and we're going to talk about numisitis Jurekidemonia or PJP.

You know, we keep saying that the name which just changed, Josh, but I think it was like

more than a decade ago, right?

But the friend formerly known as PCP, correct?

Correct. Correct. Correct. Yeah. We're dating ourselves. Yeah. But I guess like if you infect rats versus

humans, it's important to delineate. So PJP it is. Today, your big paradigm approach to this in the

chapter is HIV positive versus HIV negative and subsequent workups and pre-test probabilities

and treatments that are delineated from there. We'll cover the usual. How to work it up? What blood

tests specifically to focus on? Do a little spaced repetition with what a beta D glucan is,

et cetera, et cetera. And then Josh will talk about that early invasive versus non-invasive strategy ethos in

general. Of course, the Canadian name that is SEPTRA, an easy drug to say, is the hallmark here,

but Josh will talk to us about what the second line agents are, or if you got Stephen Johnson

syndrome, what to do with those patients. So let's get straight into it. Why do I need to delineate HIV positive versus HIV-negative ground glass opacifications

and if it's PJP, but nowadays Josh, ground glass opacifications is never fun, right?

Ah, makes me sad. But yeah, there's a big difference between HIV positive pneumocystis and HIV negative

pneumocystis.

So long short, pretty short, in patients with advanced HIV-slash-AIDS, the body just doesn't

really mount much of a response to numicistus.

So numicistis kind of just like happily grows in the lung and just kind of like chills out

and it's like a sub-acute illness.

And there's a very high burden of pathogen in the lung.

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