| Abstract: | The clinical pattern of miliary tuberculosis has changed strikingly in the past two decades, with a decreased frequency, an increased incidence of undiagnosed cases and an increase in the mean age of affected patients. The clinical presentation is not specific; however, headache and abdominal pain are strongly suggestive of meningeal and peritoneal involvement. Skin testing, chest roentgenograms and specimens from extrapulmonic sources are all helpful in establishing a diagnosis. The potential role of brush biopsy and of percutaneous needle lung biopsy in the diagnosis of miliary tuberculosis is presented. Hematologic and hepatic abnormalities are common and diverse but nonspecific, whereas body cavity fluids, when involved with tuberculosis, have changes highly suggestive of this diagnosis. An overview of the supportive measures available in the acutely ill patient and the present drug armamentarium for tuberculosis are discussed. |
