From the Guidelines

Steroids are not entirely safe for a cavitary lung lesion, but may be beneficial in specific cases with severe disease and septic shock.

The use of corticosteroids in patients with community-acquired pneumonia (CAP) has been studied extensively, with conflicting results 1.
In patients with severe CAP, the use of corticosteroids may be associated with a significant reduction in mortality, particularly in those with septic shock refractory to fluid resuscitation and with vasopressor use 1.
However, the IDSA/ATS 2019 guideline gives a strong conditional recommendation against routine use of adjunctive steroids in patients treated for CAP, except in cases of severe disease requiring mechanical ventilation or oxygen therapy 1.
In the context of COVID-19, short-course low-dose steroids may be beneficial in the early stages of disease to suppress the "cytokine storm" and prevent progression to severe disease, but may not be effective in later stages such as ARDS and multiorgan failure 1.

The dose of methylprednisolone recommended for use in SCAP patients with septic shock is 0.5 mg/Kg IV every 12 hours for 5 days, or Prednisone 50 mg daily for those who can take oral medication 1.
Caution should be exercised when using corticosteroids in patients with viral CAP, as meta-analyses in influenza patients have shown increased mortality with corticosteroid use 1.
The use of corticosteroids in COVID-19 patients should be interpreted with caution, as the quality of included studies is extremely low and there are many biases, and the results should not be generalized to patients with early course of disease and mild symptoms 1.

From the Research

The use of steroids for cavitary lung lesions is a complex issue, with varying outcomes depending on the underlying cause of the lesion.

In some cases, steroids have been shown to be effective in treating cavitary lung lesions, such as in Horton's disease 2 and ulcerative colitis 3.
However, in other cases, steroids may not be effective or may even worsen the condition, such as in Legionnaire's disease 4.
The use of steroids in patients with cavitary lung lesions requires careful consideration of the underlying cause of the lesion and the potential risks and benefits of treatment.
In some cases, the use of steroids may be justified, such as in cases of sarcoidosis 5 or idiopathic inflammatory myopathy 6, but close monitoring and adjustment of treatment as needed is crucial.

The potential risks and benefits of using steroids for cavitary lung lesions include:

Improvement in symptoms and resolution of lesions in some cases 2, 3, 6
Worsening of infectious processes, such as in Legionnaire's disease 4
Development of cavitation within granulomas with hyalinization due to steroid therapy 5
Importance of correct diagnostic methods for recognizing and treating infections to avoid mistreatment with steroid therapy 4