Miliary pattern, a classic pulmonary finding of tuberculosis disease

• Published in: Journal of clinical tuberculosis and other mycobacterial diseases Vol. 20; p. 100179
• Main Authors: Alende-Castro, Vanesa, Macía-Rodríguez, Cristina, Páez-Guillán, Emilio, García-Villafranca, Alba
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2020; Elsevier
• Subjects: Immunosuppression; Miliary; Miliary pattern; Tuberculosis; Miliary; CT; Miliary pattern; Immunosuppression; Tuberculosis; HIV; TST; AFB; BAL; PCR; TB; IGRA; HIV, human immunodeficiency virus; TB, tuberculosis; AFB, acid-fast bacilli; PCR, polymerase chain reaction; CT, computed tomography; BAL, broncoalveolar lavage; IGRA, interferon-gamma release assay; TST, tuberculin skin
• ISSN: 2405-5794; 2405-5794
• DOI: 10.1016/j.jctube.2020.100179

The increase in age of the population and in the use of immunosuppressive treatment makes tuberculosis (TB) with hematogenous or lymphatic dissemination a current problem. We collected all the patients diagnosed with tuberculosis with miliary pulmonary pattern at the Santiago de Compostela University Teaching Hospital (NW Spain) from 1 January 2006 to 31 December 2015. A total of 27 patients were included, 70.4% women, with a median age of 69.0 years old. A cause of immunosuppression was observed only in 51.9% of patients. The majority of the cases (65.0%) presented pulmonary affectation. The most frequently isolated species was Mycobacterium tuberculosis (88.9%). Multiresistance to first-line antituberculosis drugs was observed only in 3.7%. 92.6% of the patients received treatment with Isoniazid, Rifampicin and Pyrazinamine, associated in 48.1% of them with Ethambutol. Two patients died during admission and there were no recurrences in the 2-years follow-up. Miliary tuberculosis remains a current pathology. Most patients do not have a known cause of immunosuppression. The response to the typical treatment is usually good.