Learning objectives
To describe the most relevant radiologic manifestations of cavitary pulmonary infections other than pulmonary tuberculosis.
To describe the clinical and epidemiologic features of cavitary pulmonary infections.
To perform a proper differential diagnosis in order to establish the best possible therapeutic approach.
Background
Fleischner Society define a cavity as a gas-filled space, observed as a lucent or low-attenuation area within a mass, nodule or consolidation with a defined wall > 4mm thick.
Cavities are frequently found on thoracic images and they have many differential diagnoses including infections, autoimmune disorders and neoplasms(primary and metastatic).
Pathological processes of a cavity includingcaseous necrosis as in tuberculosis, cystic dilatation of lung structures as in Pneumocystis pneumonia,suppurative necrosis as in pyogenic lung abscess, or displacement of lung tissue by cystic structures as in...
Findings and procedure details
A series of cases of cavitary lung infections will be presented following the next categories:
Common bacterial infections (Fig 2-6)
Uncommon Bacterial Infections (Fig 7-10)
Non-tuberculous mycobacteria
Fungal infections (Fig 11-19)
Parasitic infections (Fig 20-21)
1.Common bacterial infections:
Infections caused by bacteria can generate pulmonary cavitations by two mechanisms.
The first occurs when entering the airway and evading defense cells, causing necrotizing pneumonia (Fig 2) or lung abscesses (Fig 4-5).
The second mechanism occurs when entering the lung through the bloodstream and cause septic emboli...
Conclusion
Although tuberculosis is the most common cause of cavitary lung infectionsin our country, it is important to keep in mind that there are multiple other microorganisms that can cause cavitation.
Unfortunately, there is no single common factor that differentiates organisms that are frequently associated with pulmonary cavitation from organisms that are rarely associated with pulmonary cavitation and it is neccesary thatimaging findings be combined with clinical features to perform a proper differential diagnosis.
Personal information and conflict of interest
T. Suárez-Poveda; Medellín/CO - nothing to disclose B. D. Norena Rengifo; Medellin, ANTIOQUIA/CO - nothing to disclose A. Arroyave; Medellin/CO - nothing to disclose
References
1.Rozenshtein A, Hao F, Starc MT, Pearson GDN. Radiographic Appearance Dogma Disproved. AJR Am J Roentgenol. 2015;204(May):974-978. doi:10.2214/AJR.14.13483
2. Gadkowski LB, Stout JE. Cavitary Pulmonary Disease. 2008;21(2):305-333. doi:10.1128/CMR.00060-07
3. Park Y, Kim TS, Yi CA, Cho EY, Kim H, Choi YS. Pulmonary cavitary mass containing a mural nodule : differential diagnosis between intracavitary aspergilloma and cavitating lung cancer on contrast-enhanced computed tomography. 2007;(January 2006):227-232. doi:10.1016/j.crad.2006.11.001
4. Diseases CL, Proc MC, Clinic M. Cystic and Cavitary Lung Diseases: Focal and Diffuse. 2003;78(June):744-752. doi:10.4065/78.6.744
5. Parkar AP,...