Pneumonia cavitation

If pneumonia is not treated well, it will turn into pulmonary cavitation. If this happens, your condition will become very serious, and to a certain extent, there is no way to treat it well. It is best to diagnose your symptoms as soon as possible, otherwise it will cause a lot of complications. The most serious symptom is what people often call lung cancer.

1. Confirm the diagnosis of pneumonia

First, it is important to distinguish pneumonia from upper and lower respiratory tract infections. Although respiratory tract infections have symptoms such as cough, sputum and fever, they each have their own characteristics. Upper and lower respiratory tract infections do not have lung parenchymal infiltration and can be distinguished by chest X-ray examination. Second, pneumonia must be distinguished from other pneumonia-like conditions.

2. Pneumonia often needs to be differentiated from the following diseases:

(1) Pulmonary tuberculosis often presents with systemic poisoning symptoms, such as low-grade fever in the afternoon, night sweats, fatigue, weight loss, insomnia, palpitations, etc. Chest X-rays show that the lesions are mostly at the apex of the lung or above and below the clavicle, with uneven density, slow dissipation, and may form cavities or spread within the lungs. Mycobacterium tuberculosis can be found in sputum. General antibacterial drug treatment is ineffective.

(2) Lung cancer: There are usually no symptoms of acute infection or poisoning. Sometimes there is hemoptysis or blood in sputum, which may be accompanied by obstructive pneumonia. The effect of antibiotic treatment may not be good. Enlarged hilar lymph nodes or atelectasis may be seen on imaging. If lung inflammation is not easily absorbed after antibiotic treatment, or if pneumonia reappears in the same area after temporary absorption, close follow-up is required. For patients with a history of smoking and older patients, further examinations such as chest CT, bronchoscopy and sputum exfoliated cells can be performed to confirm the diagnosis if necessary.

(3) The early clinical manifestations of acute lung abscess are similar to those of pneumococcal pneumonia. However, as the course of the disease progresses, a large amount of purulent and smelly sputum may be coughed up, which is a characteristic of lung abscess. Chest X-ray shows abscess cavity and air-fluid level, which can be easily differentiated from pneumonia.

(4) Pulmonary thromboembolism often has risk factors for venous thrombosis, such as thrombophlebitis, cardiopulmonary disease, trauma, surgery, and tumor history. Symptoms such as hemoptysis, syncope, and dyspnea may occur. Chest X-rays show regional reduction in lung markings, and sometimes wedge-shaped shadows with the tip pointing to the hilum of the lung can be seen. Arterial blood gas analysis often shows hypoxemia and hypocapnia. Tests such as D-dimer, CT pulmonary angiography, radionuclide lung ventilation/perfusion scanning, and MRI can help with the differential diagnosis.

(5) Non-infectious pulmonary infiltrates also need to exclude non-infectious lung diseases, such as pulmonary interstitial fibrosis, pulmonary edema, atelectasis, pulmonary eosinophilic infiltration and pulmonary vasculitis.