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Q J Med 1995; 88: 29-37
© 1995 Association of Physicians

Clinical profile, laboratory characteristics and outcome in miliary tuberculosis

S.K. SHARMA, A. MOHAN, J.N. PANDE, K.L. PRASAD, A.K. GUPTA1 and G.C. KHILNANI

Department of Medicine, All India Institute of Medical Sciences New Delhi, India 1 Department of Hospital Administration, All India Institute of Medical Sciences New Delhi, India

Address correspondence to Dr S.K. Sharma, Additional Professor, Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India

Received 10 March 1994 Accepted for publication 15 September 1994.


  Abstract

We report a retrospective series of 100 non-HIV adult patients with miliary tuberculosis (MTB) treated in a tertiary care centre. There were 51 males. Their mean age was 35 years. Predisposing conditions existed in 34. Twelve patients had larger-than-miliary (>2mm) shadows in their chest roentgenograms. Five presented with acute respiratory failure, and early treatment cured four of them. Hyponatraemia occurred in 42/60 patients (70%) for whom values were available. Twelve patients (12%) died of MTB. Temperature ≥39.3°C (p<0.01), hypoalbuminaemia (p<0.01), hyponatraemia (p< 0.001), history of vomiting (p< 0.001) and presence of crepitations on auscultation (p< 0.001) were independent predictors of mortality. Diagnosis of MTB is difficult even in an endemic area, as the clinical symptoms are non-specific and the chest roentgenograms do not always reveal classical miliary changes. A high index of clinical suspicion and diligent efforts in confirming the diagnosis are needed, as early therapy yields good results.


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