Cavitating pneumonia is a complication that can occur with severe necrotizing pneumonia and in some publications, it is used synonymously with the latter term 2. It is a rare complication in both children and adults.
Cavitation associated with Mycobacterium tuberculosis is separately discussed in the pulmonary tuberculosis article.
Cavitation can occur from a variety of organisms.
Albeit rare, cavitation is most commonly caused by Streptococcus pneumoniae, and less frequently Aspergillus spp., Legionella spp. and Staphylococcus aureus 4.
In children, cavitation is associated with severe illness, although cases usually resolve without surgical intervention, and long-term follow-up radiography shows clear lungs without pulmonary sequelae 1,6.
Although the absolute cavitary rate may not be known, according to one series, necrotizing changes were seen in up to 6.6% of adults with pneumococcal pneumonia 7. Klebsiella pneumoniae is another organism that is known to cause cavitation 8.
May show a subtle area of radiolucency superimposed on a region of consolidation.
- 1. Donnelly LF, Klosterman LA. Cavitary necrosis complicating pneumonia in children: sequential findings on chest radiography. AJR Am J Roentgenol. 1998;171 (1): 253-6. doi:10.2214/ajr.171.1.9648799 - Pubmed citation
- 2. Sawicki GS, Lu FL, Valim C et-al. Necrotising pneumonia is an increasingly detected complication of pneumonia in children. Eur. Respir. J. 2008;31 (6): 1285-91. Eur. Respir. J. (full text) - doi:10.1183/09031936.00099807 - Pubmed citation
- 3. Koşucu P, Ahmetoğlu A, Cay A et-al. Computed tomography evaluation of cavitary necrosis in complicated childhood pneumonia. Australas Radiol. 2004;48 (3): 318-23. Australas Radiol (full text) - doi:10.1111/j.0004-8461.2004.01314.x - Pubmed citation
- 4. Hodina M, Hanquinet S, Cotting J et-al. Imaging of cavitary necrosis in complicated childhood pneumonia. Eur Radiol. 2002;12 (2): 391-6. Eur Radiol (abstract) - doi:10.1007/s003300101008 - Pubmed citation
- 5. Franquet T. Imaging of pneumonia: trends and algorithms. Eur. Respir. J. 2002;18 (1): 196-208. Pubmed citation
- 6. Kerem E, Bar Ziv Y, Rudenski B et-al. Bacteremic necrotizing pneumococcal pneumonia in children. Am. J. Respir. Crit. Care Med. 1994;149 (1): 242-4. doi:10.1164/ajrccm.149.1.8111589 - Pubmed citation
- 7. Pande A, Nasir S, Rueda AM et-al. The incidence of necrotizing changes in adults with pneumococcal pneumonia. Clin. Infect. Dis. 2012;54 (1): 10-6. Clin. Infect. Dis. (full text) - doi:10.1093/cid/cir749 - Pubmed citation
- 8. Gadkowski LB, Stout JE. Cavitary pulmonary disease. Clin. Microbiol. Rev. 2008;21 (2): 305-33, table of contents. doi:10.1128/CMR.00060-07 - Free text at pubmed - Pubmed citation