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 numicistice.

I don't even know how to pronounce this, PJP.

Since everyone changed it from PCP, nobody knows.

Just speak really quick and just say PJP.

Josh, this topic is really interesting because it comes up a lot in our critically ill patients

and immunocompromised patients to wonder if this is part of their hypoxemic respiratory failure.

So I think it's a very important chapter to have down solid.

Today we'll talk about background.

And you split this up into a non-traditional framework of teaching that I

actually love. And you're right. This is how I think clinically everyone thinks about it, but not

traditionally taught. HIV-negative PJP. We'll cover blood tests, microbiology, including how to

get a sample with a bronch and not a bronch, and then then you approach the treatment. Josh, let's get straight into it.

Why break it up into HIV negative and positive PJP?

I feel like these are largely somewhat different animals.

So HIV positive pneumocestis typically is a more indolent process.

Patients can develop this over weeks to months.

It's more mild and kind of the CT

scan is more uniform and classic and it's a lot easier to differentiate HIV positive pneumocystis

from other things just based on how slowly it moves and kind of the very characteristic CT scan. So it's

oftentimes not like a huge diagnostic conundrum, although it may occur in patients

without a known diagnosis of HIV. On the flip side, HIV negative pneumocystis typically occurs a lot

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