Table of ContentsView AllTable of ContentsTypesSymptomsCausesDiagnosisTreatmentPrognosis
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Miliarytuberculosis (TB), also known as disseminated TB, is a rare but potentially fatal complication of TB, most often affecting infants and children younger than 5 as well as people with weakened immune systems.
This disease arises when the infecting bacteria,Mycobacterium tuberculosis, enter the bloodstream, spreading to the lungs and other organs.It causes tubercles, small growths the size of millet seeds, to form in the lungs and leads to a wide range ofsymptoms, depending on the organs it affects.
This article discusses the symptoms, causes, diagnosis, and treatment of miliary TB.
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Types of TB
There are two primary types of TB infection. About 30% of people exposed toM. tuberculosisinfected develop latent TB, meaning they have no symptoms and are not contagious. Of these people, about 5 to 10% develop active, or symptomatic, TB. Only specificmedical testscan detect latent TB and screening is recommended for anyone at greater risk of exposure to TB.
Active TB, the more serious type, is when you experience signs of the condition. Typical symptoms of this form, a precursor to miliary TB, include chronic cough or coughing blood orsputum(thick, colored mucus), weakness or fatigue, chills, and fever, among others.
Why is it called miliary TB?The term “miliary” comes from the most prominent feature of this complication: the development of millet seed-sized growths (tubercles) in the lungs, which are visible in chest X-rays.
Why is it called miliary TB?
The term “miliary” comes from the most prominent feature of this complication: the development of millet seed-sized growths (tubercles) in the lungs, which are visible in chest X-rays.
Miliary TB Symptoms
Because miliary TB represents infection spread, it causes many symptoms specific to the affected organs. The most common are those of active TB and include:
Additional symptoms arise as miliary TB spreads to organs beyond thelungs. These vary based on the affected area. Here’s a breakdown:
When a person with an active, symptomatic case of TB coughs, sneezes, speaks, or sings, they expel tiny, infected droplets into the air. The bacteria spreads when people breathe in these droplets. As such, TB is an airborne infection that most often spreads between people with frequent close contact.
Routes of Transmission
In contrast to latent TB or primary active forms, miliary TB occurs when the infection spreads to other body parts via the blood, primarily due to diseases or conditions that cause weakened immune function. Among the risk factors for developing this condition are:
Though severe, miliary TB can be difficult todiagnosebecause its presentation varies based on the affected body system. Generally, TB is detected through clinical evaluation, medical tests, andimaging methodsto isolate cases. These include:
Additional tests are required to confirm the spread of the disease, indicating miliary TB, including:
Miliary TB is treated like other active types, with extended courses ofantibiotic drugs, taken daily or weekly, lasting between six and 12 months. Specificmethods of treatmentvary based on the organs affected and the presence of HIV/AIDS, cancer, or other diseases.
Often used in combination, medications for TB include:
In cases of miliary TB complications like adrenal insufficiency, meningitis,acute respiratory distress syndrome (ARDS), andpericarditis(the inflammation of heart tissues), corticosteroids can augment therapy.
Though miliary TB is rare—arising in only about 1% of active cases—it can become severe. Studies have found that the chances of death within a year approach 100% if left untreated. However, therapies for miliary TB are effective in approximately 90% of cases.Though challenging, treatments have proven effective in taking on this condition.
Summary
Miliary tuberculosis is a rare complication of TB, a bacterial infection that is contagious when a person with TB is symptomatic. Occurring when the infecting bacteria enters the bloodstream and spreads to other parts of the body, it’s most often seen in those with weakened immunity and children or infants under the age of 4.This condition leads to a wide range of symptoms and is fatal if untreated. Prolonged courses of antibiotic therapy treat the infection and resolve most cases.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sharma S, Mohan A.Miliary tuberculosis.Microbiol Spectr. 2017;5(2). doi:10.1128/microbiolspec.tnmi7-0013-2016US Preventive Services Task Force, Mangione CM, Barry MJ, et al.Screening for Latent Tuberculosis Infection in Adults: US Preventive Services Task Force Recommendation Statement.JAMA. 2023;329(17):1487-1494. doi:10.1001/jama.2023.4899Centers for Disease Control and Prevention.Clinical overview of latent tuberculosis infection.Ray S, Talukdar A, Kundu S, et al.Diagnosis and management of miliary tuberculosis: current state and future.Ther Clin Risk Manag. 2013;9:9-26. doi:10.2147/TCRM.S29179Mert A, Arslan F, Kuyucu T, et al.Miliary tuberculosis: epidemiological and clinical analysis of large-case series from moderate to low tuberculosis in an endemic country.Medicine (Baltimore). 2017;96(5):e5875. doi:10.1097/MD.0000000000005875Centers for Disease Control and Prevention.Testing for tuberculosis.Centers for Disease Control and Prevention.Clinical testing guidance for tuberculosis: interferon gamma release assay.Carranza C, Pedraza-Sanchez S, de Oyarzabal-Mendez E, Torres M.Diagnosis for latent tuberculosis infection: new alternatives.Front Immunol. 2020;11. doi:10.3389/fimmu.2020.02006Underwood J, Cresswell F, Salam AP, et al.Complications of miliary tuberculosis: low mortality and predictive biomarkers from a UK cohort.BMC Infect Dis. 2017;17(1):295. doi:10.1186/s12879-017-2397-6
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sharma S, Mohan A.Miliary tuberculosis.Microbiol Spectr. 2017;5(2). doi:10.1128/microbiolspec.tnmi7-0013-2016US Preventive Services Task Force, Mangione CM, Barry MJ, et al.Screening for Latent Tuberculosis Infection in Adults: US Preventive Services Task Force Recommendation Statement.JAMA. 2023;329(17):1487-1494. doi:10.1001/jama.2023.4899Centers for Disease Control and Prevention.Clinical overview of latent tuberculosis infection.Ray S, Talukdar A, Kundu S, et al.Diagnosis and management of miliary tuberculosis: current state and future.Ther Clin Risk Manag. 2013;9:9-26. doi:10.2147/TCRM.S29179Mert A, Arslan F, Kuyucu T, et al.Miliary tuberculosis: epidemiological and clinical analysis of large-case series from moderate to low tuberculosis in an endemic country.Medicine (Baltimore). 2017;96(5):e5875. doi:10.1097/MD.0000000000005875Centers for Disease Control and Prevention.Testing for tuberculosis.Centers for Disease Control and Prevention.Clinical testing guidance for tuberculosis: interferon gamma release assay.Carranza C, Pedraza-Sanchez S, de Oyarzabal-Mendez E, Torres M.Diagnosis for latent tuberculosis infection: new alternatives.Front Immunol. 2020;11. doi:10.3389/fimmu.2020.02006Underwood J, Cresswell F, Salam AP, et al.Complications of miliary tuberculosis: low mortality and predictive biomarkers from a UK cohort.BMC Infect Dis. 2017;17(1):295. doi:10.1186/s12879-017-2397-6
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sharma S, Mohan A.Miliary tuberculosis.Microbiol Spectr. 2017;5(2). doi:10.1128/microbiolspec.tnmi7-0013-2016US Preventive Services Task Force, Mangione CM, Barry MJ, et al.Screening for Latent Tuberculosis Infection in Adults: US Preventive Services Task Force Recommendation Statement.JAMA. 2023;329(17):1487-1494. doi:10.1001/jama.2023.4899Centers for Disease Control and Prevention.Clinical overview of latent tuberculosis infection.Ray S, Talukdar A, Kundu S, et al.Diagnosis and management of miliary tuberculosis: current state and future.Ther Clin Risk Manag. 2013;9:9-26. doi:10.2147/TCRM.S29179Mert A, Arslan F, Kuyucu T, et al.Miliary tuberculosis: epidemiological and clinical analysis of large-case series from moderate to low tuberculosis in an endemic country.Medicine (Baltimore). 2017;96(5):e5875. doi:10.1097/MD.0000000000005875Centers for Disease Control and Prevention.Testing for tuberculosis.Centers for Disease Control and Prevention.Clinical testing guidance for tuberculosis: interferon gamma release assay.Carranza C, Pedraza-Sanchez S, de Oyarzabal-Mendez E, Torres M.Diagnosis for latent tuberculosis infection: new alternatives.Front Immunol. 2020;11. doi:10.3389/fimmu.2020.02006Underwood J, Cresswell F, Salam AP, et al.Complications of miliary tuberculosis: low mortality and predictive biomarkers from a UK cohort.BMC Infect Dis. 2017;17(1):295. doi:10.1186/s12879-017-2397-6
Sharma S, Mohan A.Miliary tuberculosis.Microbiol Spectr. 2017;5(2). doi:10.1128/microbiolspec.tnmi7-0013-2016
US Preventive Services Task Force, Mangione CM, Barry MJ, et al.Screening for Latent Tuberculosis Infection in Adults: US Preventive Services Task Force Recommendation Statement.JAMA. 2023;329(17):1487-1494. doi:10.1001/jama.2023.4899
Centers for Disease Control and Prevention.Clinical overview of latent tuberculosis infection.
Ray S, Talukdar A, Kundu S, et al.Diagnosis and management of miliary tuberculosis: current state and future.Ther Clin Risk Manag. 2013;9:9-26. doi:10.2147/TCRM.S29179
Mert A, Arslan F, Kuyucu T, et al.Miliary tuberculosis: epidemiological and clinical analysis of large-case series from moderate to low tuberculosis in an endemic country.Medicine (Baltimore). 2017;96(5):e5875. doi:10.1097/MD.0000000000005875
Centers for Disease Control and Prevention.Testing for tuberculosis.
Centers for Disease Control and Prevention.Clinical testing guidance for tuberculosis: interferon gamma release assay.
Carranza C, Pedraza-Sanchez S, de Oyarzabal-Mendez E, Torres M.Diagnosis for latent tuberculosis infection: new alternatives.Front Immunol. 2020;11. doi:10.3389/fimmu.2020.02006
Underwood J, Cresswell F, Salam AP, et al.Complications of miliary tuberculosis: low mortality and predictive biomarkers from a UK cohort.BMC Infect Dis. 2017;17(1):295. doi:10.1186/s12879-017-2397-6
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