Because hematogenous spread to the lung usually occurs over time, different nodules have shorter or longer growth intervals before discovery. The differential diagnosis for multiple nodules is different from that for single small nodules or large masses.
Most patients are toxic, with high fever and shaking chills.
The white blood cell count is usually elevated and shifted toward neutrophils and neutrophil precursors, and blood cultures are usually positive. With time, the lesions may grow and cavitate. Subpleural nodules are frequently associated with pleural effusions, which may be sterile but often are highly inflammatory parapneumonic effusions or even frank empyema. Other Infections Multiple pulmonary nodules may also be caused by subacute or chronic infections. Patients often have low-grade fever, night sweats, chronic cough, and constitutional symptoms that are similar to those of tuberculosis.