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Table 3 Causes of pulmonary cavities in children

From: Necrotizing pneumonia: an emerging problem in children?

Primary infectious causes
 Bacterial infections
  - Necrotizing pneumonia
  - Lung abscess
  - Septic pulmonary emboli
 Uncommon bacterial infections
   - Actinomyces spp
   - Nocardia spp
   - Burkholderia pseudomallei (melioidosis)
 Mycobacterial infections
  - Mycobacterium tuberculosis
  - Non-tuberculous mycobacteria spp
 Fungal infections
  - Aspergillus
  - Mucormycoses
  - Other – eg. Cryptococcus spp., Pneumocystis jirovecii
 Helminthic infections
  - Echinococcus spp
  - Other – eg. Paragonimus westermani
Secondarily infected congenital lung malformations
 - eg. bronchogenic cysts, congenital pulmonary adenomatoid malformation and bronchopulmonary sequestration
 - or a congenital diaphragmatic hernia with an intercurrent respiratory illness
Other causes
 Traumatic pseudocysts
 Underlying immunodeficiencya
  - eg. chronic granulomatous disease or hyper IgE syndrome with recurrent infections and pneumatoceles persisting >1 yr
  - eg. primary germ cell tumor, lymphoproliferative disorders Langerhan cell histiocystosis
 Vasculitis syndromes
  - eg. Wegener granulomatosis, Churg-Strauss syndrome
  1. aUncommonly, the initial presentation of chronic granulomatous disease may be with necrotizing pneumonia in a previously well child. This should be considered when the isolated pathogen is one of the catalase +ve organisms associated with pulmonary disease in this disorder (eg. S. aureus, Aspergillus, Pseudomonas, Burkholderia or Nocardia species)