Cavitary lung lesion: Difference between revisions

Latest revision as of 17:48, 5 January 2024

Differential Diagnosis

Immunocompetent Hosts

Infectious
- Necrotizing infections
  - Bacterial lung abscess
    - Common bacteria: anaerobes ± aerobic or microaerophilic streptococci
    - Other bacteria: Staphylococcus aureus, Klebsiella pneumoniae, Enterobacterales, Pseudomonas aeruginosa, Legionella, Haemophilus influenzae type B, Nocardia, Actinomyces, Burkholderia pseudomallei
  - Mycobacteria: Mycobacterium tuberculosis, non-tuberculous mycobacteria
  - Fungi: Aspergillus, Coccidioides, Histoplasma, Blastomyces dermatitidis, Cryptococcus, Mucorales, Pneumocystis jirovecii
  - Parasites: Entamoeba histolytica, Paragonimus westermani
- Empyema with air-fluid level (i.e. hydropneumothorax)
- Septic pulmonary emboli
Non-infectious
- Malignancy, including primary lung cancer and lung metastases; squamous cell lung cancer in particular has a high rate of necrotizing cavitations
- Pulmonary embolism with infarction
- Vasculitis, including granulomatosis with polyangiitis
- Neoplasm
- Pulmonary sequestration
- Bullae or cysts with air-fluid level
- Bronchiectasis
- Cryptogenic organizing pneumonia
- Sarcoidosis
- Rheumatoid nodules
- Pulmonary Langerhans histiocytosis
- Foreign body aspiration

Immunocompromised Hosts

Common
- Bacteria: Pseudomonas aeruginosa, Enterobacterales, Nocardia, anaerobes and microaerophilic streptococci, Staphylococcus aureus
- Mycobacteria: Mycobacterium tuberculosis, Mycobacterium kansasii
- Fungi: Cryptococcus, Aspergillus, Histoplasma capsulatum
Less common
- Bacteria: Rhodococcus hoagii, Legionella
- Mycobacteria: Mycobacterium avium complex, non-tuberculous mycobacteria
- Fungi: Mucorales, Blastomyces dermatitidis, Pneumocystis jirovecii

@@ Line 7: / Line 7: @@
 ***'''Bacterial [[lung abscess]]'''
 ****Common bacteria: [[anaerobes]] ± aerobic or microaerophilic streptococci
-****Other bacteria: [[Staphylococcus aureus]], [[Klebsiella pneumoniae]], [[Enterobacterales]], [[Pseudomonas aeruginosa]], [[Legionella species]], [[Haemophilus influenzae]] type B, [[Nocardia species]], [[Actinomyces species]], [[Burkholderia pseudomallei]]
+****Other bacteria: [[Staphylococcus aureus]], [[Klebsiella pneumoniae]], [[Enterobacterales]], [[Pseudomonas aeruginosa]], [[Legionella]], [[Haemophilus influenzae]] type B, [[Nocardia]], [[Actinomyces]], [[Burkholderia pseudomallei]]
 ***Mycobacteria: [[Mycobacterium tuberculosis]], [[non-tuberculous mycobacteria]]
-***Fungi: [[Aspergillus species]], [[Coccidioides species]], [[Histoplasma species]], [[Blastomyces dermatitidis]], [[Cryptococcus species]], [[Mucorales]], [[Pneumocystis jirovecii]]
+***Fungi: [[Aspergillus]], [[Coccidioides]], [[Histoplasma]], [[Blastomyces dermatitidis]], [[Cryptococcus]], [[Mucorales]], [[Pneumocystis jirovecii]]
 ***Parasites: [[Entamoeba histolytica]], [[Paragonimus westermani]]
 **[[Empyema]] with air-fluid level (i.e. hydropneumothorax)
 **Septic pulmonary emboli
 *Non-infectious
+**Malignancy, including primary [[lung cancer]] and [[lung metastases]]; [[squamous cell lung cancer]] in particular has a high rate of necrotizing cavitations
 **[[Pulmonary embolism]] with infarction
 **Vasculitis, including [[granulomatosis with polyangiitis]]
@@ Line 29: / Line 30: @@
 *Common
-**Bacteria: [[Pseudomonas aeruginosa]], [[Enterobacterales]], [[Nocardia species]], [[anaerobes]] and microaerophilic streptococci, [[Staphylococcus aureus]]
+**Bacteria: [[Pseudomonas aeruginosa]], [[Enterobacterales]], [[Nocardia]], [[anaerobes]] and microaerophilic streptococci, [[Staphylococcus aureus]]
 **Mycobacteria: [[Mycobacterium tuberculosis]], [[Mycobacterium kansasii]]
-**Fungi: [[Cryptococcus species]], [[Aspergillus species]], [[Histoplasma capsulatum]]
+**Fungi: [[Cryptococcus]], [[Aspergillus]], [[Histoplasma capsulatum]]
 *Less common
-**Bacteria: [[Rhodococcus equi]], [[Legionella species]]
+**Bacteria: [[Rhodococcus hoagii]], [[Legionella]]
 **Mycobacteria: [[Mycobacterium avium complex]], [[non-tuberculous mycobacteria]]
 **Fungi: [[Mucorales]], [[Blastomyces dermatitidis]], [[Pneumocystis jirovecii]]