Differential Diagnosis for Lung Cavitatory Lesion with Symptoms
Single Most Likely Diagnosis
- Tuberculosis (TB): This is often the first consideration for a lung cavitatory lesion, especially in endemic areas or in patients with risk factors such as immunocompromised status or exposure history. TB can cause caseating granulomas that lead to cavitation.
Other Likely Diagnoses
- Pneumonia (especially Staphylococcus aureus or Klebsiella pneumoniae): Certain bacterial pneumonias are known to cause lung cavitation, particularly in hospitalized or immunocompromised patients.
- Lung Abscess: A localized collection of pus within the lung parenchyma, often resulting from aspiration or bacterial infection, which can cavitate.
- Squamous Cell Carcinoma of the Lung: This type of lung cancer can cause cavitation, especially when it obstructs an airway and leads to post-obstructive pneumonia or when it directly invades the lung parenchyma.
Do Not Miss Diagnoses
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis, GPA): An autoimmune disease that can cause lung cavitation and is critical to diagnose early due to its potential for severe morbidity and mortality if left untreated.
- Invasive Fungal Infections (e.g., Aspergillosis): In immunocompromised patients, fungal infections can cause lung cavitation and have a high mortality rate if not promptly treated.
- Nocardiosis: A bacterial infection that can cause lung cavitation, particularly in immunocompromised individuals, and requires specific antibiotic treatment.
Rare Diagnoses
- Parasitic Infections (e.g., Paragonimiasis, Echinococcosis): Certain parasitic infections can cause lung cavitation, though they are less common and typically associated with specific geographic or exposure histories.
- Rheumatoid Nodules: In patients with rheumatoid arthritis, lung nodules can occasionally cavitate, though this is a rare manifestation.
- Pulmonary Langerhans Cell Histiocytosis: A rare disease that can cause lung cavitation, typically in smokers, and is characterized by the proliferation of Langerhans cells in the lung.