Miliary tuberculosis

Last revised by Henry Knipe on 18 May 2024

Miliary tuberculosis is an uncommon pulmonary manifestation of tuberculosis.

Miliary tuberculosis represents haematogenous dissemination of uncontrolled tuberculous infection and carries a relatively poor prognosis. It is seen in primary and post-primary tuberculosis and may be associated with tuberculous infection in numerous other tissues and organs.

Miliary deposits appear as 1-3 mm diameter pulmonary nodules that are uniform in size and distribution.

Similar findings to plain radiograph but may more elaborately show extent and distribution.

If treatment is successful no residual abnormality remains.

John Jacob Manget was the first to use the term miliary tuberculosis in 1700 5. Miliary Koch's infiltration is a historical term, now rarely used (c.2024) to describe miliary tuberculosis 6, and refers to Robert Koch who first isolated Mycobacterium tuberculosis.

The differential diagnosis is of pulmonary miliary opacities.

Cases and figures

  • Figure 1: photograph - millet seeds
  • Case 1
  • Case 2
  • Case 3
  • Case 4
  • Case 5
  • Case 6
  • Case 7
  • Case 8
  • Case 9
  • Case 10
  • Case 11
  • Case 12
  • Case 13 Paediatric disseminated tuberculosis

Imaging differential diagnosis

  • Papillary thyroid carcinoma with miliary metastases
  • Healed varicella pneumonia
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