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Chapter-35 Miliary Tuberculosis—Diagnostic Difficulties

BOOK TITLE: Practical Approach to Tuberculosis Management

Author
1. Sharma SK
2. Singhal Rajiv
ISBN
9788180617676
DOI
10.5005/jp/books/10639_35
Edition
1/e
Publishing Year
2006
Pages
6
Author Affiliations
1. All India Institute of Medical Sciences, New Delhi, India, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, A.I.I.M.S., New Delhi, India, 11, Shivaji Nagar, Civil Lines, Jaipur, Rajasthan, India, University of North Dakota School of Medicine and Health Sciences, Physiology and Therapeutics, Grand Forks, ND, USA, Lady Hardinge Medical College, New Delhi, World Health Organization Collaborating Centre for Research and Training in Tuberculosis, Centre of Excellence for EPTB (Ministry of Health and Family Welfare, Government of India), All India Institute of Medical Sciences, New Delhi, India, Galaxy Speciality Center, Jaipur, Rajasthan, India, Galaxy Speciality Centre, Jaipur, Rajasthan, India
2. Aditya Birla Memorial Hospital, Pune, Lady Hardinge Medical College, New Delhi
Chapter keywords
Miliary tuberculosis, Absence of the miliary infiltration, Antitubercular therapy, Antituberculous therapy, Cellular immunodeficiency, Diagnosis of miliary tuberculosis, Disseminated tuberculosis, Hairy cell leukemia, Pathogenesis of miliary tuberculosis

Abstract

To learn and understand the pathogenesis, clinical presentation, diagnostic modalities and treatment option for military tuberculosis. A typical miliary pattern is defined as small ( 1-3 mm ), multiple, round opacities located in bilateral pulmonary interstitium and in other viscera. This pattern is seen in nearly 80 percent (29-100%) of the cases with miliary tuberculosis. Miliary tuberculosis may develop due to spread through the blood stream of large number of tubercle bacilli from a tubercle focus when the patient defences are lowered. The conditions presents with fever, malaise and loss of weight. There can be meningeal irritation due to tuberculus meningitis often complicating miliary tuberculosis. Occupational disease like silicosis, coal workers, pneumoconiosis may be characterized by a general nodular fibrosis of lugs, which resembles miliary pattern, and incidentally both these conditions may be associated with tuberculosis. Elucidated with clinical case reports.

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