Paediatric infections: Pneumocystis pneumonia in infants: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pediatrics · Paediatric infections: Pneumocystis pneumonia in infants

Sample item

A 4-month-old with untreated HIV infection has tachypnoea, hypoxia and a dry cough with minimal chest signs. Chest radiograph shows bilateral diffuse ground-glass shadowing, LDH is raised and there is no response to ceftriaxone. Which treatment is indicated?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. High-dose cotrimoxazole plus steroids

Pneumocystis jirovecii pneumonia peaks at 3 to 6 months in infants with HIV and presents with severe hypoxia but few chest signs. Treatment is high-dose cotrimoxazole for 21 days, with corticosteroids for hypoxaemia. Cotrimoxazole prophylaxis for exposed infants is given from 4 to 6 weeks of age.

Option by option

  • A. Azithromycin alone

    Azithromycin does not treat Pneumocystis.

  • B. High-dose cotrimoxazole plus steroids (correct)

    Correct. High-dose cotrimoxazole with steroids is standard treatment.

  • C. Amphotericin B

    Amphotericin B is for invasive fungal infections caused by other organisms.

  • D. Oral nystatin

    Nystatin treats oral candidiasis and has no effect on lung infection.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, High-dose cotrimoxazole plus steroids. Pneumocystis jirovecii pneumonia peaks at 3 to 6 months in infants with HIV and presents with severe hypoxia but few chest signs.

Why is "Azithromycin alone" not the answer?

Azithromycin does not treat Pneumocystis.

Why is "Amphotericin B" not the answer?

Amphotericin B is for invasive fungal infections caused by other organisms.

Why is "Oral nystatin" not the answer?

Nystatin treats oral candidiasis and has no effect on lung infection.

What concept does this question test?

It tests Paediatric infections: Pneumocystis pneumonia in infants in Pediatrics. Treatment is high-dose cotrimoxazole for 21 days, with corticosteroids for hypoxaemia. Cotrimoxazole prophylaxis for exposed infants is given from 4 to 6 weeks of age.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric infections: Pneumocystis pneumonia in infants?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.