Cavitary Pulmonary Infarction Mimicking Koch’s Disease

Pulmonary infarction (PI), defined as localized destruction (necrosis) of lung tissue due to obstruction of the arterial blood supply by an embolus, is a rare condition because of the dual blood supply of the lungs. It occurs more in elderly patients who typically have associated co-morbidities, such as chronic heart and lung disease, which affect blood circulation. Pulmonary infarction may present with chest pain, fast breathing, blood tinged cough and fever, resembling more common conditions such as bacterial pneumonia and tuberculosis. High index of suspicion is required for early diagnosis of this condition as mortality from this condition can be as high as 70%. We present a case of cavitary pulmonary infarction in a middle-aged female with no major risk factors for pulmonary embolism who was initially managed as a case of pulmonary tuberculosis. The clinical presentation, pathogenesis, imaging findings and management of PI have also been discussed. The purpose of this report is to increase the awareness of this less common condition among clinicians and highlight the radiologic differences between PI and the more common inflammatory diseases of the lung.