[Miliary tuberculosis of the lungs]

The study concerned 37 adults patients with miliary tuberculosis, who were treated at the Institute for Lung Diseases and Tuberculosis in Belgrade, over the period from 1987 to 1990. This number of patients is 1.37% of the total number of hospitalized patients with TB. The average age was 51 yrs (21-78). The sex distribution was equal. Associated diseases and predisposing conditions existed in 28 (76%) patients, most often haematologic diseases, systemic diseases of the connective tissue, and alcoholism. Classical X-ray finding of the lungs was present in 89% of the patients, and poor and atypical in 11%. The accompanying pleural exudation was observed in 13.5% of the patients, smaller cavernae in 5.4%, and enlarged mediastinal lymph nodes in one patient. The diagnosis of miliary TB was bacteriologically or pathohistologically confirmed in 31 (84%) patients, on autopsy in 2 cases and by antituberculotic test in 4 cases. Positive Loewenstein culture media were obtained in 62% of patients, from sputum in 64% of cases, in the liquor in 5.4%, and from the pleural fluid in 2.7% of patients. (BK was found by direct sputum microscopy in 6 pts - 16%). Positive pathohistological findings was obtained in 18 (49%) patients: by pleural biopsy in 2 cases, lung biopsy in 8 (bronchoscopy in 5 pts, aspiration needle biopsy in 2 pts), and by biopsy of extrathoracic tissues and organs in 8 pts. Early diagnosis was established in 62% patients.