Clinical profile, laboratory characteristics and outcome in miliary tuberculosis.
We report a retrospective series of 100 non-HIV adult patients with miliary tuberculosis (MTB) treated in a tertiary care centre. There were 51 males. Their mean age was 35 years. Predisposing conditions existed in 34. Twelve patients had larger-than-miliary (> 2 mm) shadows in their chest roentgenograms. Five presented with acute respiratory failure, and early treatment cured four of them. Hyponatraemia occurred in 42/60 patients (70%) for whom values were available. Twelve patients (12%) died of MTB. Temperature > or = 39.3 degrees C (p < 0.01), hypoalbuminaemia (p < 0.01), hyponatraemia (p < 0.001), history of vomiting (p < 0.001) and presence of crepitations on auscultation (p < 0.001) were independent predictors of mortality. Diagnosis of MTB is difficult even in an endemic area, as the clinical symptoms are non-specific and the chest roentgenograms do not always reveal classical miliary changes. A high index of clinical suspicion and diligent efforts in confirming the diagnosis are needed, as early therapy yields good results.
Sharma
S K
SK
Department of Medicine, All India Institute of Medical Sciences, New Delhi.
Mohan
A
A
Pande
J N
JN
Prasad
K L
KL
Gupta
A K
AK
Khilnani
G C
GC
D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002648:Child; D003906:Developing Countries; D005260:Female; D006801:Humans; D008099:Liver / Q000382:microbiology; D008168:Lung / Q000000981:diagnostic imaging; D008198:Lymph Nodes / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D014391:Tuberculosis, Miliary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy