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    zakariah kamal
    This document discusses miliary tuberculosis. It begins with an introduction that defines miliary TB and outlines the topics that will be covered. These include the history, risk factors, types, pathophysiology, clinical findings, diagnosis, treatment, complications and prevention. Miliary TB is a disseminated form of TB caused by bloodborne spread of the bacteria, forming small lesions that look like millet seeds. It most commonly affects children, the elderly and immunocompromised individuals. Symptoms may be nonspecific but include fever, weight loss and fatigue. Diagnosis involves cultures, imaging and lumbar puncture. Treatment requires a multi-drug regimen for 6-9 months.

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    Miliary TB New

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    zakariah kamal
    46 views23 pages
    This document discusses miliary tuberculosis. It begins with an introduction that defines miliary TB and outlines the topics that will be covered. These include the history, risk factors, types, pathophysiology, clinical findings, diagnosis, treatment, complications and prevention. Miliary TB is a disseminated form of TB caused by bloodborne spread of the bacteria, forming small lesions that look like millet seeds. It most commonly affects children, the elderly and immunocompromised individuals. Symptoms may be nonspecific but include fever, weight loss and fatigue. Diagnosis involves cultures, imaging and lumbar puncture. Treatment requires a multi-drug regimen for 6-9 months.

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    This document discusses miliary tuberculosis. It begins with an introduction that defines miliary TB and outlines the topics that will be covered. These include the history, risk factors, types, pathophysiology, clinical findings, diagnosis, treatment, complications and prevention. Miliary TB is a disseminated form of TB caused by bloodborne spread of the bacteria, forming small lesions that look like millet seeds. It most commonly affects children, the elderly and immunocompromised individuals. Symptoms may be nonspecific but include fever, weight loss and fatigue. Diagnosis involves cultures, imaging and lumbar puncture. Treatment requires a multi-drug regimen for 6-9 months.

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    46 views23 pages

    Miliary TB New

    Uploaded by

    zakariah kamal
    This document discusses miliary tuberculosis. It begins with an introduction that defines miliary TB and outlines the topics that will be covered. These include the history, risk factors, types, pathophysiology, clinical findings, diagnosis, treatment, complications and prevention. Miliary TB is a disseminated form of TB caused by bloodborne spread of the bacteria, forming small lesions that look like millet seeds. It most commonly affects children, the elderly and immunocompromised individuals. Symptoms may be nonspecific but include fever, weight loss and fatigue. Diagnosis involves cultures, imaging and lumbar puncture. Treatment requires a multi-drug regimen for 6-9 months.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 23

    AZERBAIJAN 1

    MEDICAL
    UNIVERSITY

     NAME: ZAKARYA KAMAL SATTOUF


     GROUP: 180B
     SUBJECT: MILIARY TUBERCULOSIS
     DATE; 12/7/2019
     INTRODUCTION

     Definition 2
     History
     Risk factors
     Types and forms
     Pathophysiology of miliary TB
     Clinical findings
     Diagnosis
     Differentiation
     Treatment
     Complication
     prevention
     References
     DEFINITION

     Miliary TB is an a form of disseminated TB 3


    or Extra pulmonary TB that is caused by
    sudden diffuse dissemination of tubercli
    bacili through the bloodstream
    ( hematogenous spread of TB )
     The foci are possible caseous - necrotic
    changes. Focal changes develop in the
    interstitial tissues

     In miliary TB foci formed small ( 1-2 mm )


    with productive tissue reaction

     Small foci look like millet grains


     Miliary Tuberculosis: mainly occurs in
    children and young adults but may also
    occur in older people and it is insidious in
    onset in this older age group

     Miliary TB : is can be difficult to diagnose


    especially in older age group in which case
    it is known as Cryptic Tuberculosis (because
    of its insidious onset
     HISTORY

     Miliary TB got its name in 1700 from John Jacob


    Manget based on how it appears on autopsy
    findings.
     The bodies would have a lot of very small spots
    similar to hundreds of tiny seeds about
     2 millimeters long scatted in various tissues.

     Since a millet seed is about that size,


     the condition became known as miliary TB
     Small foci like millet seed which is
    scatted in various tissues
     RISK FACTORS
    4
    • Age – Child & Elderly
    • Immunosuppression
    • Cancer
    • Transplantation
    • HIV
    • Malnutrition
    • Diabetes
    • Silicosis
    • End-stage renal disease
     TYPES

    The miliary TB can be develop in the

    1. Miliary pulmonary tuberculosis: occurs when the


    organisms draining through the lymphatic and
    pulmonary arterioles and enter to the venous blood
    and circulate back to the lung
    2. Systemic miliary tuberculosis ; occurs when bacteria
    disseminate through the systemic arterial system.
     THE MAIN CLINICAL FORMS
    OF MILIARY TB

    SEPSIS

    POLMONARY MILIARY TB TYPHOIDAL

    MENINGITIC
     PATHOPHYSIOLOGY OF
    MILIARY TB 5
    • Tuberculosis infection in the lungs results in
    erosion of the epithelial layer of alveolar cells
    and the spread of infection into a pulmonary vein

    • Bacteria reach the left side of the heart and


    enter the systemic circulation, they may multiply
    and infect extra pulmonary organs

    • Once infected, the cell mediated immune


    response is activated. The infected sites become
    surrounded by macrophages which form
    granuloma, giving the typical appearance of
    miliary tuberculosis
     CLINICAL FINDINGS
    6
    • Patients may not be acutely ill
    • Symptoms include
    • Weakness and fatigue (90%)
    • Fever and weight loss (80%)
    • Chills, night sweats are common
    • Cough,
    • Hemoptysis
    • Anorexia
    • Hepatomegaly and lymphadenopathy are
    common
     DIAGNOSIS

    • CBC
    7
    - Leukopenia/leukocytosis
    • ESR - elevated in approximately 50% of
    patients
    • Lumbar puncture - strongly considered
     Lymphocytic predominance (70%)
     Elevated protein levels (90%)
     Low glucose levels (90%)
     Acid-fast bacilli (≥40%)
    • Cultures for mycobacteria
    • PCR
     CHEST X-RAY
    8
    • Typical appearance only in 50% of cases
    • Bilateral pleural effusions indicate
    dissemination. This may be a useful clue.

    • Nodules characteristic of miliary TB may


    be better visualized on lateral chest
    radiography (especially in the retro cardiac
    space).

    • Nodules are the size of millet seeds


    (1-5mm, mean=2mm)
     CT SCAN
    9
     MILIARY  ABDOMINAL
    TUBERCULOSIS TYPHUS

    • Breathlessness • The typhus begins with


    • Cyanosis gradually developing of
    • Tachycardia weakness and increase of
    • irregular type fever temperature
    • absence of dyspeptic • Bradycardia
    disturbances  leucopenia
     leucocytes within the limits of  lymphocytosis
    norm or leucocytosis up to • Widal’s reaction can be
    15 000-18 000 positive just in typhus
      lymphopenia
     Monocytosis
    • Roentgenograms confirm
    suspicions on miliary lung
    tuberculosis
     TREATMENT
    10
    • Four-drug regimen to start
     Isoniazid
     Rifampin
     Pyrazinamide
     Ethambutol or streptomycin
    • Treatment may continue for 6-9 months
    • 9-12 months with meningeal involvement
    COMPLICATIONS
    11
    • Dissemination via bloodstream to
    I. Prostate
    II. Seminal vesicles
    III. Epididymis
    IV. Fallopian tubes
    V. Endometrium
    VI. Meninges
    VII.Lymph nodes
    VIII.Liver
    IX. Spleen
    X. Skeleton
    XI. Kidneys
    XII.Adrenals
     PREVENTION

    BCG vaccination
     Effective in reducing the incidence of miliary
    tuberculosis Not effective in individuals who are
    already infected
     Should not be administered to
    immunosuppressed hosts

     Targeted tuberculin testing


     Treatment of latent tuberculosis infection
    REFERENCES:
    12
    https://www.slideshare.net/chaudharymahesh/miliary-tuberculos
    is-dr-mahesh
    http://tuberkulez-forever.com/tuberkulez-likbez/eng
    https://
    www.slideshare.net/DeepakKumarGupta2/granulomatous-infla
    mmation-tuberculosis-syphillis
    https://
    www.slideshare.net/ghalan/pulmonary-tuberculosis-2941528
    https://slideplayer.com/slide/10787857/
    https://en.wikipedia.org/wiki/Jean-Jacques_Manget
    https://
    www.slideshare.net/chaudharymahesh/miliary-tuberculosis-dr-
    mahesh
    https://www.youtube.com/watch?v=9HUmsnp-nYg
    https://www.healthline.com/health/miliary-tuberculosis

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