Pulmonary Cavitation with Negative Sputum (With Reports of Eight Cases)

¹ National Jewish Hospital, Denver, Colorado

In considering the numerous pathological conditions of the lung which can produce cavitation and mimic tuberculosis, we do not overlook the many instances in which cavernous tuberculosis may be present with sputum persistently negative, even over periods of many years.

However, before making the diagnosis of tuberculosis in a patient with negative sputum whose x-ray picture may be indistinguishable from that produced by tuberculosis, exhaustive studies must be done to rule out other etiological agents. Papanicalaou smears for malignant cells, fungus studies of the sputum plus skin testing and serologic tests for the cavity producing fungus diseases, cardiac evaluation and studies of other organ systems for andications of polyarteritis, should all be part of the work-up of the patient with pulmonary cavitation and negative sputum. Even then, in some instances, final diagnosis cannot be made except by the pathologist, but many mistaken diagnoses of tuberculosis and tragic delays in surgery, will be avoided.