Miliary tuberculosis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Tuberculosis (TB) infection can develop after inhaling droplets sprayed into the air from a cough or sneeze by someone infected with the Mycobacterium tuberculosis bacteria. Small areas of infection, called granulomas (granular tumors), develop in the lungs.
Pathophysiology
The usual site of TB is the lungs, but other organs can be involved. In the U.S., most people with primary tuberculous get better and have no further evidence of disease. Disseminated TB develops in the small number of infected people whose immune systems do not successfully contain the primary infection.
Disseminated disease can occur within weeks of the primary infection. Sometimes, it does not occur until years after you become infected. You are more likely to get this type of TB if you have a weaken immune system due to disease (such as AIDS) or certain medications. Infants and the elderly are also at higher risk.
Miliary tuberculosis is a form of tuberculous infection in the lung that is the result of erosion of the infection into a pulmonary vein[1]. Once the bacteria reach the left side of the heart and enter the systemic circulation, the result may be to seed organs such as the liver and spleen with said infection. Alternately the bacteria may enter the lymph node(s), drain into a systemic vein and eventually reach the right side of the heart[1]. From the right side of the heart, the bacteria may seed - or re-seed as the case may be - the lungs, causing the eponymous "miliary" appearance.