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Health Disseminated miliary TB Disease

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Disseminated / Miliary TB :

Disseminated TB results from widespread blood borne dissemination of TB bacilli . This is either the consequence of a recent primary infection or the erosion of a tuberculosis lesion into a blood vessel . It occurs most often in children and young adults , it is highly fatal . Disseminated TB is an under diagnosed cause of end stage wasting in HIV positive individuals and should be considered in all febrile patients presenting with HIV wasing syndrome . Clinical features : Firstly, many patients can experience a fever lasting several weeks with daily spikes in morning temperatures. non-specific signs, such as coughing and enlarged lymph nodes. Miliary tuberculosis can also present with enlarged liver
, enlarged spleen, inflammation of the pancreas , and multiple organ dysfunction with adrenal insufficiency . Miliary tuberculosis may also present with unilateral or bilateral pneumothorax rarely Stool may also be diarrheal in nature and appearance.

Other symptoms include fever, hypercalcemia, chorodial tubercles and cutaneous lesions. Diagnosis : Chest x-ray may show diffuse ,uniformly distributed ,small miliary nodules , CBC : may show pancytopenia , liver function tests may be abnormal , Bacteriological confirmation is sometimes possible from sputum ,CSF, or bone marrow , Smear microscopy of sputum from cases with miliary TB is usually negative

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