Clinical exam · Respiratory system
Cavitation syndrome !
- Syndrome
A cavity inside the lung, sometimes with air and fluid, that drains into a bronchus and produces a lot of sputum.
Updated 2026-11-01
See it in 3D: Segmental bronchi
What it is
Cavitation syndrome appears when an area of lung necroses, drains into a bronchus and leaves an air-filled cavity. Its classic physical signs appear only if the cavity is large, superficial and connected to a bronchus; most are found by imaging. In Colombia tuberculosis is the first cause to rule out; lung abscess after aspiration is the other classic cause.
Key findings
- Small or deep cavities give no exam signs.
- Every patient with lung cavitation in the region should be tested for tuberculosis with sputum smear or a molecular test.
Pathophysiology
- Lung necrosis (caseous in tuberculosis, suppurative in abscess) liquefies and drains through a bronchus.
- An air-filled cavity with stiff walls makes bronchial airflow resonate and produces amphoric breathing.
- Aspiration while lying down carries oropharyngeal contents to the dependent posterior and superior segments.
- Inflamed tissue around the cavity behaves like a consolidation.
| Inspection | Palpation (fremitus) | Percussion | Auscultation |
|---|---|---|---|
| Cavitary tuberculosis: weight loss, fever, apical retraction | Increased fremitus over the area | Dullness; tympany if the cavity is large and superficial | Cavernous or amphoric breathing, crackles; pectoriloquy |
| Lung abscess: foul breath, poor dentition, reduced consciousness | Increased fremitus | Localized dullness | Cavernous breathing, crackles; copious purulent sputum |
Common causes
- Pulmonary tuberculosis.
- Lung abscess after aspiration (alcohol use, reduced consciousness, swallowing disorders, poor dental hygiene).
- Necrotizing pneumonia (staphylococcus, Klebsiella).
- Cavitating lung cancer (squamous cell carcinoma).
- Fungal infection and hydatid cysts, less often.
Tests that confirm it
- Chest radiograph and CT: cavity, wall thickness and air-fluid level.
- Sputum smear, molecular test and culture for tuberculosis.
- Bronchoscopy if tumour or obstruction is suspected.
Test yourself
Think of the answer, then tap the question to see it.
What is amphoric breathing?
A hollow, resonant breath sound, like blowing across the mouth of a bottle, over a large superficial cavity connected to a bronchus.
Which cause of cavitation must be ruled out first in Colombia?
Pulmonary tuberculosis.
In which segments does an aspiration abscess most often form?
The posterior segments of the upper lobes and the superior segments of the lower lobes, more often on the right.
See it in 3D
The structures of Durgical's 3D anatomy where it is found.
Related
- Consolidation syndrome
- Respiratory symptoms: cough, sputum, hemoptysis and dyspnea
- The pleuropulmonary syndromes: the comparison table to know
- Lung auscultation: normal breath sounds
Related conditions
Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis.
Sources: Pulmonary tuberculosis: MedlinePlus Medical Encyclopedia (MedlinePlus, U.S. National Library of Medicine, 2024); Aspiration pneumonia: MedlinePlus Medical Encyclopedia (MedlinePlus, U.S. National Library of Medicine, 2024).
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Representative model, for educational purposes only.