Miliary tuberculosis

Case contributed by Dr Prashant Mudgal

Presentation

Known case of tubercular lymphadenopathy presented with persistent fever and cough.

Patient Data

Age: 27 years
Gender: Female
X-ray

Multiple tiny nodular infiltrates noted diffusely distributed in bilateral lung fields.

CT

There are multiple tiny centrilobular and peribronchovascular branching nodular densities noted scattered diffusely and equally in bilateral lungs both in upper and lower lobes. Scattered distribution of multiple, miliary, micronodular and low-density lesions noted in liver.

Findings are suggestive of disseminated tuberculosis (miliary tuberculosis)

Case Discussion

Miliary tuberculosis can occur as primary infection or may develop months to years after initial infection, as the host immunity compromises, micobacteremia and hematogeneous dissemination may take place. The disseminated miliary nodules are histologically similar to the tubercular granuloma with central caseation and peripheral epitheloid and fibrous tissue.

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