Abstract

TREATMENT OF MILIARY TUBERCULOSIS: CASE REPORT

Anas Mohiuddin* and Hania Khatoon

ABSTRACT

Miliary tuberculosis is a form of tuberculosis that is characterized by a wide diffusion of TB bacilli in human body and causing lesions (1–5 mm). Its name comes from a peculiar pattern seen on a chest radiograph of many tiny spots distributed throughout the pulmonary fields with the appearance identical to millet seeds—thus the term "miliary" tuberculosis. Miliary TB may infect almost every organ or individual organs like the lungs, liver, spleen and brain. The infection is characterized by an enormous amount of TB bacilli, although it may easily be missed and is fatal if left untreated. Miliary disease is more difficult to identify in patients who are very young or very old. Patients with miliary tuberculosis may experience symptoms for days to weeks or occasionally over several months, symptoms include Weakness, Headache, fatigue, Weight loss, Fever, Cough, Generalized Hepatomegaly, lymphadenopathy, Splenomegaly. The diagnosis of miliary tuberculosis is based on the finding of chest x-ray, sputum culture, bronchoscopy, open lung biopsy, head CT/MRI, blood cultures. The standard ―short course‖ treatment for TB includes isoniazid, rifampicin, ethambutol and pyrazinamide for two months, then rifampicin and isoniazid alone for more four months. There have been cases where the delay in diagnosing and starting of appropriate treatment regimen has worsened the overall patient's health and lead to further complications and death. It is important that a protocol is being developed to identify the patients and start appropriate treatment regimen to prevent a fatal outcome.

Keywords: Tuberculosis (TB), Miliary Tuberculosis, Computerized Tomography (CT), Magnetic Resonance Imaging (MRI),