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Miliary tuberculosis.

B Stenius-Aarniala, P Tukiainen

    Acta Medica Scandinavica
    |January 1, 1979
    PubMed
    Summary
    This summary is machine-generated.

    Miliary tuberculosis often affects older adults with chronic diseases. Diagnostic procedures like laparoscopy and liver biopsy are crucial for unexplained fever and elevated alkaline phosphatase, guiding antituberculosis therapy.

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    Area of Science:

    • Internal Medicine
    • Infectious Diseases
    • Pulmonology

    Background:

    • Miliary tuberculosis (MTB) is a severe disseminated form of Mycobacterium tuberculosis infection.
    • Older adults and immunocompromised individuals are particularly vulnerable.
    • Diagnosis can be challenging due to nonspecific symptoms and varied presentations.

    Observation:

    • A retrospective study of 26 miliary tuberculosis cases with a mean age of 62 years.
    • Common symptoms included fever (85%), fatigue, and abdominal pain.
    • Elevated serum alkaline phosphatase (81%) and hematological abnormalities were frequent.
    • Radiographic findings included miliary mottling (13 patients), pleural effusion, and mediastinal lymphadenopathy.

    Findings:

    • Underlying chronic diseases (70%) and immunosuppressive treatment (35%) were common comorbidities.

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  • Liver involvement was frequently observed.
  • Antituberculosis therapy was initiated in 12 patients, with two fatalities shortly after treatment initiation.

    • Implications:

    • Laparoscopy and liver needle biopsy are valuable for diagnosing unknown fever and elevated alkaline phosphatase.
    • A therapeutic trial of antituberculous drugs is recommended in suspected miliary tuberculosis cases.
    • Early diagnosis and appropriate treatment are critical for improving outcomes in miliary tuberculosis.