Miliary tuberculosis in a high prevalence area of the U.K.: Blackburn 1978-1993

Thirty-nine cases of military tuberculosis treated between 1978-1993 in a district with a high incidence of tuberculosis are reported. Twenty-eight patients were of Indian Subcontinent (ISC) ethnic origin, 10 patients were Caucasian and one patient was Chinese. Mortality at 10% in both Caucasian (chi2 4.94; 0.05 > P > 0.01) and ISC patients (chi2 10.22; 0.001 > P) were significantly lower than in a recently reported series from Edinburgh, as was the proportion of post mortem diagnoses of miliary tuberculosis (chi2 6.35; 0.02 > P > 0.01). Both the rate of miliary tuberculosis and the average age at diagnosis in Caucasian patients were lower than in the Edinburgh series suggesting that miliary tuberculosis could be under-diagnosed in the elderly Caucasian population in the Blackburn district. The better outcome of those diagnosed in life may be partly due to heightened awareness of tuberculosis locally and partly due to treatment by a centralized tuberculosis service.