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.
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Pathology
Cavitation can occur from a variety of organisms.
Pediatric population
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.
Adult population
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.
Radiographic features
Plain radiograph
May show a subtle area of radiolucency superimposed on a region of consolidation.
Late sequelae
pneumatocele formation
lung abscess formation