Clinical disease from widespread hematogenous dissemination of Mycobacterium tuberculosis. Originally named for “millet seed” appearance of nodules often found in lungs. Three types:
...
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...
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...
General TB follow-up; most states require department of public health notification.
Identify and test any close contacts.
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...
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...
Sign up for a 10-day FREE Trial now and receive full access to all content.
Necrotizing granuloma due to M. tuberculosis. A small tuberculous granuloma with conspicuous central caseation is present in the pulmonary parenchyma.
Necrotizing granuloma due to M. tuberculosis. A small tuberculous granuloma with conspicuous central caseation is present in the pulmonary...
Cavitary tuberculosis. The apex of the left upper lobe shows tuberculous cavities surrounded by consolidated and fibrotic pulmonary parenchyma, which contains small tubercles.
Cavitary tuberculosis. The apex of the left upper lobe shows tuberculous cavities surrounded by consolidated and fibrotic pulmonary parenc...
Miliary tuberculosis. Multiple millimeter-sized nodules are scattered throughout the lung parenchyma.
Tuberculous spondylitis (Pott disease). A vertebral body is almost completely replaced by tuberculous tissue. Note the preservation of the intervertebral discs.
Tuberculous spondylitis (Pott disease). A vertebral body is almost completely replaced by tuberculous tissue. Note the preservation of the...
Mycobacterium tuberculosis. A smear of a pulmonary lesion shows slender, beaded, acid-fast bacilli.
Miliary tuberculosis. The cut surface of the lung reveals numerous uniform, white, nodules.
FIGURE 20.3. Chest radiograph (posteroanterior view only) demonstrating the radiographic presentation of miliary tuberculosis.
FIGURE 20.4. Chest radiographs (posteroanterior and lateral views) demonstrating cavitary reactivation of latent tuberculosis infection in the posterior apical segment of the right upper lobe.
FIGURE 20.4. Chest radiographs (posteroanterior and lateral views) demonstrating cavitary reactivation of latent tuberculosis infection in...
Figure 189.1. Chest radiograph demonstrating apical infiltrate with cavitation, typical of pulmonary tuberculosis.
Gross figure showing multiple small granulomas fill the lung parenchyma, characteristic of miliary tuberculosis.