Skip to main content

Tuberculosis, Miliary

Kevin C. Shannon, MD, MPH, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Clinical disease from widespread hematogenous dissemination of Mycobacterium tuberculosis. Originally named for “millet seed” appearance of nodules often found in lungs. Three types:...

DIAGNOSIS

HISTORY

  • Ask about risk factors and exposures. Needs high index of suspicion; 1/5 of cases are undiagnosed antemortem.

  • Most common symptoms are nonspecific: night sweats (>90%), fatigue/mala...

TREATMENT

  • Diagnosis is often hampered by low clinical suspicion, which delays collection of appropriate fluid/tissue samples for AFB smear and culture.

  • Empiric therapy is often indicated because early ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • General TB follow-up; most states require department of public health notification.

  • Identify and test any close contacts.

Patient Monitoring

See “Tuberculosis.” 

DIET

...

REFERENCES

1
World Health Organization. Global tuberculosis report 2017. Geneva, Switzerland: World Health Organization; 2017. http://www.who.int/tb/publications/global_report/en/. Accessed April 8, 20...

ADDITIONAL READING

Mazurek GH, Jereb J, Vernon A, et al. Updated guidelines for using interferon gamma release assays to detect Mycobacterium tuberculosis infection—United States, 2010. MMWR Recomm Re...

SEE ALSO

Tuberculosis; Tuberculosis, CNS 

CODES

ICD10

  • A19.9 Miliary tuberculosis, unspecified

  • A19.2 Acute miliary tuberculosis, unspecified

  • A19.8 Other miliary tuberculosis

  • A19.0 Acute miliary tuberculosis of a single specified site

  • A19.1 Acute mi...

CLINICAL PEARLS

  • The diagnosis of miliary TB requires a high degree of clinical suspicion. Empiric therapy is generally appropriate while awaiting confirmation of test results.

  • Chest CT scan is more sen...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

 
×