Acute Miliary Tuberculosis
Acute miliary tuberculosis is a serious post-primary complication due to massive invasion of the blood stream by the tubercle bacilli.
This condition is common among malnourished children, infants and untreated cases of meningitis.
Clinically, the detection of miliary tb is difficult since symptoms like anorexia, weight loss, cough and low grade fever are nonspecific symptoms of any respiratory infections.
There may be an abrupt rise of body temperature that has a tendency to persist. Miliary Tb may present as:
– typhoidal
– pulmonary
– and or meningeal
In the typhoidal form, abdominal manifestations like tender abdomen, enlarged liver and spleen, toxic looking child. In the pulmonary form, respiratory symptoms are common and in the meningeal form, symptoms of meningitis may prevail. Thus, an early spinal tap should be considered.
The tuberculin test is positive in the early stage of miliary TB and reverts to negative as the disease progresses.
And this is ominous of impending death. However, if the disease will respond to treatment and the tuberculin reaction returns to positive, this is a good omen.
With early detection, proper management and effective antimicrobial therapy, most of the better nourished children survive miliary tuberculosis.