Miliary tuberculosis: About 16 cases

Introduction: Miliary tuberculosis (MT) is a rare and severe form of tuberculosis (TB) due to hematogenous dissemination of tuberculosis bacillus (BK). Aim: Describe radio-clinical and biological presentation of MT ant to identify prognostic factors in comparison with pulmonary TB. Method: Retrospective comparative study including a group of MT and a group of pulmonary TB. The diagnostic criteria were radiological for definition of miliary and bacteriological or histological for TB. Results: 16 cases of MT and 41 patients with pulmonary TB (control group) were included. Mean age was 48.3±22 years. Compared to pulmonary TB, we note that MT was more significantly associated with bad economic conditions, dyspnea, crackles, absence of night sweats and negativity of tuberculosis skin test. Presence of mediastinal lymphadenopathies, absence of excavation or other images, extra pulmonary localizations especially liver and lymph node and hyponatremia were also more significantly observed in MT. The analysis of the results had identified some mortality predictive factors such as the presence of night sweats, hepatic cytolysis, high sedimentation rate and the presence of excavations in the roentgenogram. Conclusion: MT is a severe form of TB. The presence of night sweats, hepatic cytolysis, accelerated sedimentation rate and presence of excavation in the chest radiograph are predictive of poorer prognosis.