Lung Cavities: Looking Beyond Tuberculosis

The spectrum of infectious and non-infectious processes associated with pulmonary cavities is vast. In a high-prevalence country like ours, it is natural albeit presumptive, to jump to the diagnosis of Tuberculosis especially when the clinical case definitions of a ‘suspect’ attribute 2 weeks of fever and cough with suggestive radiology to it. We have described three cases that came to us with the clinical picture of sputum-negative tuberculosis and with a lung cavity on chest X-ray. None of the primary pathogens isolated in them was Mycobacterium. Through this short case series, we emphasise the larger point, the need to reach a microbiological confirmation and the realization that not all that cavitates is TB.