Infected cavitating pulmonary infarction.

The differential diagnosis of pulmonary cavitation is broad. The most common causes include infection and malignancy. Pulmonary thromboembolism is a common problem worldwide, with an estimated 650,000 cases in the United States annually. Pulmonary embolism does not usually lead to cavitation, given the dual blood supply of the lung; however, cavitation may complicate 4–7% of all pulmonary infarctions. We present an elderly diabetic woman with coronary artery disease who presented with symptoms suggestive of a lung abscess. Re-evaluation because of persistent unexplained breathlessness and radiologic non-response led to the diagnosis of an infected submassive pulmonary embolism and infarction as the cause of cavitation. We discuss the common causes of pulmonary cavitation, with special emphasis on embolism, and the radiologic appearance and management of pulmonary cavitation.