Bloodstream dissemination leads to miliary tuberculosis
with lesions in many organs and a high mortality rate.
The rates for causes avoidable by vaccine-preventable actions (miliary tuberculosis
, acute hepatitis B and tetanus) are low.
Such an imaging feature is also associated with the more common conditions of miliary tuberculosis
or other type of infectious pneumonia, resulting in high risk of misdiagnosis.
Isolation of MTBC from blood cultures has been reported since the early 20th century from patients with miliary tuberculosis
. (2) However, blood culture in mycobacterial infections was rarely requested before the HIV era, (3) but its use has been boosted by improvements in blood culturemedia, mainly for differential diagnosis with Mycobacterium avium-intracellulare complex or Histoplasma capsulatum.
Endogenous infection is secondary to a preexisting primary focus and may result from contiguous (orificial tuberculosis, scrofuloderma), hematogenous (acute miliary tuberculosis
, tuberculous gumma, and lupus vulgaris), or lymphatic dissemination (lupus vulgaris) [2,16].
Miliary histoplasmosis is a rare clinical manifestation that may mimic miliary tuberculosis
and diagnosis may be delayed if a broad differential is not considered in patients undergoing workup for miliary pulmonary nodules.
Patients aged less than 18 years, patients with extrapulmonary or miliary tuberculosis
, and patients with any compelling conditions were excluded from this study.
In the article titled "Miliary Tuberculosis
Presenting with ARDS and Shock: A Case Report and Challenges in Current Management and Diagnosis" , the name of the fifth author was given incorrectly as Neil Bhagwandass.
CNS tuberculosis can manifest in a variety of forms, including tuberculous meningitis, tuberculomas, tuberculous abscesses, tuberculous cerebritis, and miliary tuberculosis
. Among these, tuberculous meningitis is the most common manifestation of CNS involvement across all age groups .
A 28-year-old male patient, recently diagnosed with HIV infection and miliary tuberculosis
(TB) based on characteristic chest CT findings and positive sputum culture, presented to the emergency department with new onset of ataxia (Figure 1A).
We believe that miliary tuberculosis
resulting in adrenal insufficiency (or Addison's disease) may have resulted in the oral and physical symptoms witnessed by the Inuit.