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Tuberculosis, Miliary

Kevin C. Shannon, FAAFP, MPH, MD Reviewed 04/2024
 


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; 20% 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, as early init...

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
Schildknecht, KR,, Pratt RH, Price SF, et al. Tuberculosis—United States, 2022. MMWR Morb Mortal Wkly Rep. 2023:72:297-303.
2
World Health Organization. Global Tuberculosis Report 2022. Gene...

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...

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