Undiagnosed Cavitary lesion on bottom of lower left lobe.

Posted by lisa8116 @lisa8116, Oct 9, 2022

Went to hospital because coughing up pinkish sputum. My symptoms include chills, body aches, coughing with some pain in the back in the area of the lesion. Chest x ray disclosed an area of cancer, CT revealed a mass 33mm wide. The internal medicine team said they are leaning toward infection, pulmonary specialist said he thinks it is an abscess and after negative tests for tuberculosis (hospital policy) prescribed 800mg 2xdaily of Augmenting for 6 weeks and after that plans to take another CT scan to see if the mass is reduced. I'm a 58 year old female housewife. I'm an instructor in public school system (elementary). Until these symptoms developed I ran 2 miles 4 days a week for a couple of years. However, I have a history of smoking and vaping. (Quit smoking about 5 years ago and started vaping). I was informed by the hospital that my vitals are excellent, that of a much younger person. Prior to going to the hospital I visited my primary care doctor for chills and body aches. They did blood tests which showed low B12 ( approximately 77 level), also a slightly elevated CRP level. I've googled around and found that the Mayo Clinic is the best rated hospital for pulmonary diseases so I am hoping to get some insight into what a pulmonary specialist there might think. Based on my own google research such lesions can be infectious or non-infectious with non-infectious being the most serious because it can be cancer. No knowing what I have and having to wait a long time to find out is very stressful. While I am hopeful it is an infectious based on what the doctors say they are leaning toward they are non committal at this point. I'm hoping a pulmonologist at Mayo Clinic may give me their thoughts. Thank You, Lisa

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@lisa8116 Welcome to Mayo Connect, the online community for people to support each other when facing health challenges. We are not the doctors or staff of May, just others living with often complex and confusing symptoms and diagnoses.

When I saw the words "cavitary lesion" my antennae went up - these are as often indicators of other infection or disease as they are of cancer. The fact that your care team thinks so as well is encouraging. I am not a pulmonologist or doctor, but I am a lung patient who went for years without the correct diagnosis, with symptoms like yours, being repeatedly treated unsuccessfully for asthma & bronchitis, with courses of antibiotics. Cavities (or abscesses) are indicators that the infection has been present for some time.

Some of the other infections that can cause your symptoms include NTM (Non-tubercular mycobacteria - there are several strains) and pseudomonas. These are harder to diagnose because they require a sputum culture to be grown out for several weeks to reveal the infectious agent. Six weeks of augmentin may "knock down" these infections, but won't cure them.

If your followup reveals improvement but not a cure, you may want to ask your pulmonologist about being tested for other infections, or ask to be referred to an infectious disease doc who can do it.

Are you beginning to feel any better? And are you trying to stop vaping?


Hi Sue. Thank you for your reply. What you said sounds encouraging and like you I plan to dig in and research what I can. Regarding vaping, I stopped immediately, it's been 5 days. Regarding other other infection types I will keep your words in mind and mention that to the pulmonologist at the next visit. Your question as to whether I am improving ....I think a little.....most body aches and chills gone, but I can still feel my lung when inhaling deeply. Also, still coughing, but I don't think as much....but not sure yet. Sorry to sound gross with this next comment....I have not been coughing up as much blood...just a tiny amount. Thanks again Sue for your reply I really appreciate it. Lisa

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