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Miliary tuberculosis

Case contributed by Dr Mark Holland


Generally unwell with lethargy, night sweats and hemoptysis.

Patient Data

Age: 20 years
Gender: Male

Chest x-ray demonstrates very widespread randomly distributed innumerable tiny nodules in both lungs. There is no consolidation or pleural fluid and no mediastinal or hilar nodal enlargement. 


Zoomed cropped image from the left upper zone demonstrates innumerable well defined ~2mm nodules.

Milet seeds. Photo credit: Elke Wetzig Original file: Licence: CC-SA-BY

Case Discussion

This patient has presented with constitutional symptoms and an abnormal chest radiograph with multiple, well-defined, tiny (2 mm) nodules throughout both lungs with no zonal predilection. By far the most likely diagnosis here is of tuberculosis, which was subsequently confirmed. 

Miliary tuberculosis represents haematogenous spread of uncontrolled TB infection.

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Case information

rID: 20025
Published: 29th Oct 2012
Last edited: 25th Dec 2019
System: Chest
Tag: tb
Inclusion in quiz mode: Included

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