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.
In this case, disseminated infection including
miliary tuberculosis and fungal infection, drug-induced interstitial pneumonia, intravenous talc granulomatosis, extrinsic allergic alveolitis, and pneumoconiosis needed to be differentiated; however, a definite diagnosis was made by the histological finding of non-necrotizing epithelioid granuloma with multinucleated giant cells (Figure 1b).
Challenges in the diagnosis and treatment of
miliary tuberculosis.
Histiocytic hemophagocytosis in
miliary tuberculosis.
There are four major categories of cutaneous tuberculosis: (1) inoculation from an exogenous source (primary inoculation tuberculosis, tuberculosis verrucosa cutis); (2) endogenous cutaneous spread contiguously or by auto-inoculation (scrofuloderma, tuberculosis cutis oroficialis); (3) hematogenous spread to the skin (lupus vulgaris, acute
miliary tuberculosis, and tuberculosis ulcer, gumma, or abscess); (4) tuberculids (erythema induratum [Bazin's disease], papulonecrotic tuberculids, and lichen scrofulosorum).
Miliary tuberculosis accounts for 2% of all forms of active tuberculosis.
Josephine was allegedly buried in a pauper's plot in the cemetery in 1902, after she succumbed, according to her death certificate, to
miliary tuberculosis and ulceration of the breast.
Ayrancioglu, "A case of tuberculous meningitis with multiple intracranial tuberculomas and
miliary tuberculosis and choroid tubercles," Infection, vol.
Recurrent bilateral pneumothorax complicating
miliary tuberculosis with bone marrow involvement.
Diffuse hepatic involvement with pulmonary or
miliary tuberculosis, diffuse hepatic infiltration without recognizable pulmonary involvement is the second form and the third very rare form presents as a focal/local tuberculoma or abscess.
Fatal
miliary tuberculosis in an HIV-infected Cameroon woman: disseminated histoplasmosis due to Histoplasma capsulatum capsulatum [in French].
miliary tuberculosis - acute tuberculosis characterized by the appearance of tiny tubercles on one or more organs of the body (presumably resulting from tubercle bacilli being spread in the bloodstream)