Anaerobes: a new aetiology in cavitary pneumoconiosis

The role of mycobacteria in the cavitation of large pneumoconiotic masses is well established. In other cases softness is attributed to an ischaemic or aseptic necrosis. Five cases are described in which cavitation of the pulmonary masses was caused by anaerobic bacteria, confirmed by the growth of such bacterial in cultures after transtracheal or transpleural puncture. Repeated cultures for mycobacteria gave negative results. Two cases were acute, having serious complications such as bronchopleural fistula, empyema, and serious respiratory insufficiency. The role of anaerobes in cavitary pneumoconiosis has not been recognised previously, probably because of the special conditions required to culture these bacteria and the infrequent use of transtracheal puncture in the diagnosis of this entity. The prevalence of anaerobes as agents capable of cavitating pneumoconiotic masses remains to be established.