Miliary pattern, a classic pulmonary finding of tuberculosis disease

• Main Authors: Vanesa Alende-Castro, Cristina Macía-Rodríguez, Emilio Páez-Guillán, Alba García-Villafranca
• Format: Article
• Language: English
• Published: Elsevier 2020-08-01
• Series: Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
• Subjects: Tuberculosis; Miliary; Miliary pattern; Immunosuppression
• Online Access: http://www.sciencedirect.com/science/article/pii/S2405579420300437

Introduction: 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. Methods: 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. Results: 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. Conclusions: 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.