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The most likely underlying disease responsible for the patient’s diagnosis of pneumocystis pneumonia is HIV/AIDS. The condition is a fungal infection that occurs in stage three HIV patients and is mostly unresponsive to antifungal medication (McCance et al., 2018).

 

The HIV virus usually targets the CD4 helper T lymphocytes due to their ability signal other cells to perform their functions. When the HIV penetrates into the CD4 cells, they release RNA and encoded enzymes into the cell. Reverse transcriptase converts the HIV RNA into DNA which integrates with the cell DNA using integrase (McCance et al., 2018). The HIV DNA starts replicating itself producing new virions which are converted to mature infectious virions by protease and leave the cells to find other C4 cells to infect. The C4 cells develop a shorter lifespan after infection and their ability to fight off pathogens is compromised (Nursing Times, 2020). This weakens the individual’s immune system and makes them susceptible to infections.

 

The first stage of HIV infection is the acute phase where there is a slight decrease in the number of CD4 cells in the blood. Numerous antibodies produced to fight off the virus causing flu-like symptoms like headaches, fevers and rashes in the individual. Next is the chronic phase where the body starts producing specific antibodies to the HIV virus and the proliferation rate slows down. If diagnosis is not done and treatment offered at this stage, the individual goes into the last stage of acquired immunodeficiency syndrome (AIDS). The immune system becomes severely damaged and the patient becomes susceptible to opportunistic infections and related cancers such as pneumonia and Kaposi’s sarcoma.

 

The recommended treatment for the pneumocystis pneumonia is trimethoprim-sulfamethoxazole (TMP-SMX) or clindamycin with primaquine if they are allergic (Sax, 2021). Acetaminophen can be administered to treat the patient’s fever and a nasal cannula used to address his hypoxia. The patient should be put on antiretroviral (ARV) therapy to manage the HIV infection and reduce the risk of spreading the virus (Sax, 2021). The rehabilitation for his substance use should be started to ensure withdrawals are addressed.

 

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