[Disseminated pulmonary tuberculosis. Current features and frequency of haematogenous forms (author's transl)]

Seventy-five cases of disseminated tuberculosis of the lung were observed between 1960 and 1978. On radiology, they presented as fine or coarse miliary nodules or diffuse infiltrates. The disease occurred at all ages and were afebrile in 25% of the cases. It was frequently haemategenous, as shown by the presence of extrathoracic foci (Pott's disease, tuberculosis of the urinary or genital tracts), or, more often, by associated lesions indicating bacteraemia, such as meningitis, granulations on the fundus oculi, miliary tuberculosis of the liver and positive urine culture with normal urographic findings. Positive urine cultures, which were encountered in 32% of the patients, appeared to be reliable criterion of dissemination through the blood stream. Disseminated pulmonary tuberculosis usually responded to modern combined antibiotic therapy, but 8 patients over 60 years of age died during the first six weeks of treatment. Relapses were rare with prolonged therapy including isoniazid and streptomycin and did not occur after rifampicin was introduced into the therapeutic regimen.