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Chronic Cavitary Infections Other than Tuberculosis: Clinical Aspects

Holt, Michael R., MBBS*,†; Chan, Edward D., MD‡,§,∥,¶

doi: 10.1097/RTI.0000000000000345
Symposium Review Articles

Lung cavitation may be due to infectious or noninfectious pathologic processes. The latter category includes nonmalignant conditions, such as granulomatosis with polyangiitis, and malignant conditions, such as squamous cell carcinoma of the lung. Infectious etiologies that produce lung cavitation usually cause chronic illness, although some, particularly pyogenic bacteria, may produce acute cavitary disease. Tuberculosis is the most common cause of chronic pulmonary infection with cavitation. The goal of this review was to highlight a selection of the better-known infectious agents, other than tuberculosis, that can cause chronic lung disease with cavitation. Emphasis is placed on the following organisms: nontuberculous mycobacteria, Histoplasma, Blastomyces, Coccidioides, Paracoccidioides, Aspergillus, Burkholderia pseudomallei, Paragonimus westermani, and Rhodococcus equi. These organisms generally produce clinical features and radiologic findings that overlap or mimic those of tuberculosis. In a companion article, we have further emphasized aspects of the same conditions that are more pertinent to radiologists.

*Division of Mycobacterial and Respiratory Infections

§Department of Academic Affairs and Medicine

Program in Cell Biology, National Jewish Health

Pulmonary Section, Denver Veterans Affairs Medical Center

Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Denver Anschutz Medical Campus, Denver

Department of Medicine, University of Colorado Denver, Aurora, CO

M.R.H.: investigator for Insmed product (no compensation). E.D.C. declares no conflicts of interest.

Correspondence to: Edward D. Chan, MD, D509, Neustadt Building, National Jewish Health, 1400 Jackson St., Denver, CO 80206 (e-mail:

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