[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Clinical exam](https://durgical.com/en/clinical-exam/) › [Respiratory system](https://durgical.com/en/clinical-exam/#a-respiratory) › Cavitation syndrome

[Clinical exam](https://durgical.com/en/clinical-exam/) · [Respiratory system](https://durgical.com/en/clinical-exam/#a-respiratory)

# 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](https://durgical.com/en/anatomy/segmental-bronchus/)

## Key points

- Large, superficial cavity: cavernous or amphoric breathing (hollow, like blowing across a bottle).
- Around it there is usually consolidation: dullness, increased fremitus and crackles.
- Copious sputum, sometimes foul (abscess) or bloody (tuberculosis).
- Tuberculosis: cavities in the apical and posterior segments of the upper lobes.
- Aspiration abscess: posterior segments of the upper lobes and superior segments of the lower lobes, more often on the right.
- The radiograph shows the cavity, sometimes with an air-fluid level.

## 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](https://durgical.com/en/conditions/pulmonary-tuberculosis/) | 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](https://durgical.com/en/conditions/lung-abscess/) | 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.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/clinical-exam/cavitation-syndrome/)

## See it in 3D

The structures of Durgical's 3D anatomy where it is found.

- [Segmental bronchi](https://durgical.com/en/anatomy/segmental-bronchus/)

## Related

- [Consolidation syndrome](https://durgical.com/en/clinical-exam/consolidation-syndrome/)
- [Respiratory symptoms: cough, sputum, hemoptysis and dyspnea](https://durgical.com/en/clinical-exam/respiratory-symptoms-cough-sputum-hemoptysis-and-dyspnea/)
- [The pleuropulmonary syndromes: the comparison table to know](https://durgical.com/en/clinical-exam/the-pleuropulmonary-syndromes-the-comparison-table-to-know/)
- [Lung auscultation: normal breath sounds](https://durgical.com/en/clinical-exam/lung-auscultation-normal-breath-sounds/)

## Related conditions

- [Lung abscess](https://durgical.com/en/conditions/lung-abscess/)
- [Pulmonary tuberculosis](https://durgical.com/en/conditions/pulmonary-tuberculosis/)
- [Aspiration pneumonia and pneumonitis](https://durgical.com/en/conditions/aspiration-pneumonia-and-pneumonitis/)
- [Lung cancer](https://durgical.com/en/conditions/lung-cancer/)

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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](https://medlineplus.gov/ency/article/000077.htm) (MedlinePlus, U.S. National Library of Medicine, 2024); [Aspiration pneumonia: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000121.htm) (MedlinePlus, U.S. National Library of Medicine, 2024).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/clinical-exam/cavitation-syndrome/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/clinical-exam/cavitation-syndrome/