The evaluation of pneumocystis pneumonia begins with a history and physical examination.

Physical findings in someone with pneumocystis pneumonia may include:

• A normal lung exam in mild cases
• Signs of severe difficulty breathing
• Rib retractions
• Nasal flaring
• Use of accessory muscles
• Cyanosis
• Lips or nailbeds turn blue
• Dry skin
• Dry mouth
• Decreased urination
• Fever
• Rapid pulse
• Rapid breathing
• Wet rales and rhonchi:
• Sounds in the chest during examination with a stethoscope
• Wheezing

Most people with PCP have an impaired immune system. Additional physical findings may be present due to an immune system deficiency.

Tests are necessary to confirm the diagnosis of pneumocystis pneumonia, and determine its severity.

Tests that may be used to evaluate pneumocystis pneumonia include:

• Chest x-ray:
• Normal chest x-ray
• Chest x-ray showing pneumonia
• Pulse oximetry:
• Measures the oxygen level in the bloodstream
• Bronchoscopy:
• A flexible fiberoptic scope is used to look at the air passageways
• Nuclear gallium scan of the lung