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Case of the Week 456



What is the most likely diagnosis?

  • 62 year-old with fever and cough



Axial CT Scan of Chest

  1. Silicosis
  2. Bronchoalveolar cell carcinoma
  3. Miliary tuberculosis
  4. Rheumatoid nodules
  5. Multiple arteriovenous malformations

Additional Image - Close-up of Axial CT Scan of Right Hemithorax

 

Additional Images

 

Close-up of Axial CT Scan of Right Hemithorax


Answer:

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3. Miliary Tuberculosis

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More (Click Discussion Tab)

 

 

Miliary Tuberculosis


General Considerations

  • Widespread hematogenous dissemination of Mycobacterium Tuberculosis
  • So named because the nodules are the size of millet seeds (1-5mm with a mean of 2 mm)
  • Miliary TB represents only 1-3% of all cases of TB
  • Older men, African Americans and pregnant women are susceptible
  • Considered to be a manifestation of primary TB–although clinical appearance of miliary TB may not occur for many years after initial infection
  • When treated, clearing is frequently rapid
    • Miliary TB seldom, if ever, produces calcification
  • Under age 5, there is an increased risk of meningitis

 

MORE . . .

 


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