Miliary Tuberculosis is a form of TB that occurs when a blood vessel gets eroded and a large number of TB bacteria get distributed all over the body through the vascular system.
“Miliary” pertains to the millet-sized tubercular foci (here shown in the lungs) that are distributed throughout the vital organs everywhere. Here is an image of a miliary TB in the spleen.
Each one of these would within days and weeks grow into a caseous mass, which eventually would overcome the patient. TB in children occurs often in children less than 4 years of age and in older persons with a weak immune system as well as AIDS patients.
The diagnosis can be very confusing with a fever of unknown origin, general debility and in the case of AIDS with symptoms both due to TB as well as AIDS.
A chest X-ray shows nodules in the lungs. Bronchoscopy with cytological washings and biopsy of suspicious areas in the bronchial tree will lead to the correct TB diagnosis. The histology report will show tuberculous granulomas, but the commercially available polymerase chain reaction to TB is more rapid and very specific. Treatment for tuberculosis is started immediately and multi-drug antituberculous therapy will very quickly stabilize and cure the patient’s condition.
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