Differential Diagnosis
- Single most likely diagnosis
- Necrotizing pneumonia with abscess formation: This diagnosis is the most likely due to the presence of a fluid-filled cavity with air bubbles within it, which is consistent with an abscess. The progression of the disease and the presence of adjacent pleural effusion also support this diagnosis.
- Other Likely diagnoses
- Fungal infection: The presence of progressive nodules and the fact that the patient may be a candidate for lung lobectomy suggest that a fungal infection, such as aspergillosis or histoplasmosis, could be a possible diagnosis.
- Weak or narrowed granulomatosis with polyangiitis (GPA): The presence of progressive nodules and the possibility of lung lobectomy suggest that GPA, a form of vasculitis that can affect the lungs, could be a possible diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Tuberculosis (TB): Although less likely, TB can present with similar radiographic findings, including cavitation and nodules. Missing this diagnosis could have serious consequences, as TB requires specific treatment.
- Malignancy: The presence of progressive nodules and the possibility of lung lobectomy raise the concern for malignancy, such as lung cancer. Although less likely, this diagnosis should not be missed, as it would require prompt and specific treatment.
- Rare diagnoses
- Parasitic infections (e.g., paragonimiasis): These infections can cause similar radiographic findings, including cavitation and nodules. Although rare, they should be considered in the differential diagnosis, especially if the patient has a history of travel or exposure to endemic areas.
- Pulmonary vasculitis (e.g., ANCA-associated vasculitis): These conditions can cause similar radiographic findings, including nodules and cavitation. Although rare, they should be considered in the differential diagnosis, especially if the patient has a history of autoimmune disorders or vasculitis.