Miliary tuberculosis and acute respiratory distress syndrome

Abstract

Miliary tuberculosis is a serious and uncommon form of tuberculosis due to hematogenous dissemination of Mycobacterium tuberculosis. This study aimed to describe the epidemiological and clinical features of miliary tuberculosis. Data were collected from clinical files between August 2016 and July 2018. In 2 years, 24 cases were recorded, representing a proportional morbidity of 13%. Among them, 71% were smokers and 38% had diabetes. The presence of a BCG vaccination scar was observed in 2 patients (8%). Human immunodeficiency virus (HIV) serology was positive in 4 cases (17%). The symptomatology was dominated by: fever (100%), cough (83%), and chest pain (79%). Radiological images with micronodular opacities were the most common (54%), followed by macronodular densities (33%), and reticulonodular densities (13%). The evolution was favorable in 77%, with no patient lost to follow-up, but 7/24 (29%) died, either before the initiation of therapy (n = 2) or during therapy (n = 5). Miliary tuberculosis is an acute and severe form of life-threatening tuberculosis. It requires a prompt and accurate diagnosis and treatment. An improved accessibility to early diagnosis and treatment and prevention of TB infection should reduce its prevalence.