[Miliary or disseminated tuberculosis : epidemiology, diagnosis and management]

Miliary tuberculosis (MT) is one of the most serious forms of tuberculosis. It can be life-threatening. MT is characterized by its frequently disseminated nature throughout the body, hence the name "disseminated tuberculosis". This form results from massive lympho- hematogenous dissemination of Mycobacterium tuberculosis from a focal lesion ruptured into the blood or lymphatic flow. Diagnosing MT may be a challenge that can make perplex even the most experienced clinicians. In the absence of treatment, the disease is fatal. MT is commonly found in children, young adults, and HIV-infected patients. The clinical presentation is often misleading with general signs in the foreground and a poor physical examination. Diagnosis of MT is often difficult due to clinical polymorphism and the lack of bacteriological proof in most cases. The prognosis of this pathology depends on the precocity of the diagnostic and therapeutic management.