A PROSPECTIVE STUDY OF AETIOLOGICAL PROFILE OF CAVITARY LESION ON CHEST X-RAY OF PATIENTS ATTENDING TO DEPARTMENT OF PULMONOLOGY OF TERTIARY CARE HOSPITAL

Abstract

Puligunta Chakradhar, Madduri Veerasekharaiah, Dasari Chakradhar

BACKGROUND A cavity has been defined as “a gas containing space with in the lung, surrounded by a wall whose thickness is greater than 1 mm.”1 According to Fleischner society, cavity is defined pathologically as: “a gas-filled space within a zone of pulmonary consolidation or within a mass or nodule, produced by the expulsion of a necrotic part of the lesion via the bronchial tree.” Lillington defined cavity as “an abnormal air space that appears on the chest radiograph as a roughly spherical circumscribed area of radiolucency.” MATERIALS AND METHODS This is a prospective study conducted on 80 patients with cavitary lesions in chest x-ray, attending the department of pulmonology, Santhiram General Hospital, Nandyal. This study was conducted for 18 months from January 2016 to July 2017. Baseline chest x –rays and CTs were taken for all the patients. RESULTS In our study, 80 patients were included out of whom, 52 (65%) patients were males and 28 (35%) patients were females. Male to female ratio is 1.85:1. Majority of patients 55/80 (68.75%) were in the age group of 31-50 years. The commonest presentation was cough in 64 patients (80%), followed by loss of appetite in 56 patients (70%), fatigue in 52 patients (65%), fever in 48 patients (60%), excessive night sweats in 40 patients (50%), chest pain in 28 patients (35%), dyspnoea in 28 patients (35%), and haemoptysis in 16 patients (20%). CONCLUSION Pulmonary tuberculosis is the leading cause for cavitary lung lesions followed by pneumonia, of which Klebsiella pneumoniae is the predominant organism isolated followed by Staphylococcus aureus and Streptococcus pneumoniae. Malignancy also has significant contribution in the aetiological profile of cavitary lung disease. In developing countries, pulmonary tuberculosis is still the leading cause of cavities in lung. One patient presented with cavitating necrotizing pneumonia and this pneumonia failed to resolve. This patient was subsequently evaluated with CT chest and collagen profile and diagnosed as SLE.

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