Case 1: Prophylaxis for Pneumocystis Pneumonia

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You answered:

	This patient should receive Pneumocystis pneumonia prophylaxis, but prior to initiating prophylaxis, a sputum sample should be sent to perform Pneumocystis jiroveci resistance testing.

This answer is incorrect. This HIV-infected patient should receive Pneumocystis prophylaxis based on his oral candidiasis and AIDS-defining illness (two or more episodes of bacterial pneumonia in a 1-year period is an AIDS-defining illness). This answer is not correct because Pneumocystis jiroveci resistance testing is not commercially available and not recommended.

Choose another answer:

	The patient does not need Pneumocystis pneumonia prophylaxis; he should start prophylaxis if his CD4 count decreases to less than 200 cells/mm³.
	The patient should start on Pneumocystis pneumonia prophylaxis using trimethoprim-sulfamethoxazole at a dose of one double strength tablet per day.
	The patient should receive Pneumocystis pneumonia prophylaxis, but first should undergo bronchoscopy to rule out active Pneumocystis pneumonia prior to receiving prophylaxis.

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