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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
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{{Miliary tuberculosis}}
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{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}


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{{SK}} Tuberculosis - disseminated; disseminated tuberculosis; disseminated TB; extrapulmonary tuberculosis
==[[Miliary tuberculosis overview|Overview]]==
==[[Miliary tuberculosis historical perspective|Historical Perspective]]==


==Overview==
==[[Miliary tuberculosis pathophysiology|Pathophysiology]]==


'''Miliary tuberculosis''' (or '''disseminated TB''') is a form of [[tuberculosis]] that is characterized by a wide dissemination into the human body and by the tiny size of the lesions (1-5 mm). Its name comes from a distinctive pattern seen on a chest [[X-ray]] of many tiny spots distributed throughout the lung fields with the appearance similar to millet seeds, thus the term "miliary" tuberculosis.  Miliary TB may infect any number of organs including the lungs, liver, and spleen.  It is a complication of 1-3% of all TB cases.<ref name="Lessnau">Lessnau, Klaus-Dieter, "Miliary Tuberculosis", http://www.emedicine.com/med/topic1476.htm, October 3, 2006.</ref>
==[[Miliary tuberculosis causes|Causes]]==


==Differenial Diagnosis of Miliary Pattern on chest X-ray==
==[[Miliary tuberculosis differential diagnosis|Differentiating Miliary tuberculosis from other Diseases]]==


*[[Miliary tuberculosis]]
==[[Miliary tuberculosis epidemiology and demographics|Epidemiology and Demographics]]==
*[[Varicella|Varicella pneumonia]]
*[[hypersensitivity pneumonitis|Acute hypersensitivity pneumonitis]]
*[[Fungal pneumonia]]
*[[Thyroid cancer|Thyroid cancer metastases]]
*[[Renal cell carcinoma|Renal cell carcinoma metastases]]


==Etiology==
==[[Miliary tuberculosis risk factors|Risk Factors]]==


Miliary tuberculosis is a form of tuberculous infection in the lung that is the result of erosion of the infection into a pulmonary vein<ref name=Robbins> Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; & Mitchell, Richard N. (2007). ''Robbins Basic Pathology'' (8th ed.). Saunders Elsevier. pp. 516-522 ISBN 978-1-4160-2973-1</ref>.  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<ref name=Robbins/>.  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.
==[[Miliary tuberculosis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Signs and Symptoms==
==Diagnosis==
A patient with miliary tuberculosis will tend to present with non-specific signs such as low grade fever, cough, and generalized [[lymphadenopathy]].  Miliary tuberculosis can also present with hepatomegaly (40% of cases), splenomegaly (15%), pancreatitis (<5%), and multiorgan dysfunction with adrenal insufficiency.<ref name="Lessnau"/>


==Diagnostic Findings==
[[Miliary tuberculosis history and symptoms|History and Symptoms]] | [[Miliary tuberculosis physical examination|Physical Examination]] | [[Miliary tuberculosis laboratory findings|Laboratory Findings]] | [[Miliary tuberculosis chest x ray|Chest X Ray]] | [[Miliary tuberculosis CT|CT]] | [[Miliary tuberculosis MRI|MRI]] | [[Miliary tuberculosis other imaging findings|Other Imaging Findings]] | [[Miliary tuberculosis other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
:''See:'' [[Tuberculosis treatment]]
Miliary TB is a serious condition; untreated miliary TB is almost always fatal.  About 25% of patients with miliary TB also have [[tuberculous meningitis]].  The standard treatment recommended by the [[World Health Organisation|WHO]] is with [[isoniazid]] and [[rifampicin]] for six months, as well as [[ethambutol]] and [[pyrazinamide]] for the first two months.  If there is evidence of [[meningitis]], then treatment is extended to twelve months.  The US guidelines recommend nine months' treatment.


== References ==
[[Miliary tuberculosis medical therapy|Medical Therapy]] | [[Miliary tuberculosis primary prevention|Primary Prevention]] | [[Miliary tuberculosis secondary prevention|Secondary Prevention]] | [[Miliary tuberculosis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Miliary tuberculosis future or investigational therapies|Future or Investigational Therapies]]
<references/>


{{Bacterial diseases}}
==Case Studies==
{{SIB}}
[[Miliary tuberculosis case study one|Case #1]]


[[da:Miliærtuberkulose]]
==Related Chapters==
*[[Tuberculosis]]


[[Category:Tuberculosis]]
[[Category:Disease]]
[[Category:Bacterial diseases]]
[[Category:Infectious disease]]
 
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Latest revision as of 18:05, 18 September 2017

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Miliary tuberculosis
Miliary tuberculosis.
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Synonyms and keywords: Tuberculosis - disseminated; disseminated tuberculosis; disseminated TB; extrapulmonary tuberculosis

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Miliary tuberculosis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

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