Miliary tuberculosis

Case contributed by Mark Holland
Diagnosis almost certain


Acutely unwell with pyrexia and weight loss

Patient Data

Age: 35 years
Gender: Female

Bilateral miliary nodules

Case Discussion

Fulminant infection with Mycobacterium tuberculosis disseminated via bloodstream

Nodules are < 3mm, uniform in size, usually too numerous to count and noncalcified 

May have background of ground-glass opacities or septal thickening

The nodules are distributed randomly with respect to secondary pulmonary lobules

Typical miliary infection may not be seen radiographically for 3-6 weeks after hematogenous dissemination

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