A clinical study of miliary tuberculosis in adults

Abstract

A retrospective clinical study was done on 85 cases of miliary tuberculosis admitted to Pusan National University Hospital and Pusan Medical Center from Jan. 1978 to Dec. 1983. The following results were obtained. 1) The patients were most common in the age group between 20 and 29 and the ratio of male to female was 1.5 : 1. 2) The major symptoms & signs on admission were fever with chillness (58.8%), dyspnea (45.9%), tachycardia (42.4%) and coughing (40.4%). 3) The possible predisposing factors were steroid therapy (5.9%), pregnancy (4.7%), alcoholics (3.5%), diabetes mellitus (2.4%), and malignancy (1.2%). 4) The chest X-ray findings on admission were miliary shadow only (61.2%), and in addition pneumonic infiltration (12.9%), pleurisy (10.5%) and pleural thickening with adhesion (4.7%) were observed. 5) Sputum smear for tubercle bacilli was positive in 30.3%, and sputum culture was positive in 42.9%. 6) The extrapulmonary tuberculosis associated with miliary tuberculosis were tuberculous meningitis (22.4%), pleurisy (11.8%), tuberculous cervical adenitis (8.2%). in order. 7) Among the important laboratory findings on admission, anemia less than 12 gm% of hemoglobin was 59 cases (69.5%), leukopenia less than 4,000/mm3 3 cases (3.5%), leukocytosis more than 10,000/mm3 33 cases (38.9%), abnormal SGOT 22 cases (25.9%), SGPT 11 cases (12.9%), hyponatremia 5 cases (5.9%). 8) The duration required for roentgenologic clearing was less than 3 months in 2 cases, 3~6 months in 7 cases, 6~12 months in 16 cases, more than 12 months in 27 cases. 9) The treatment regimens were INH, steroid in 45 cases (52.9%) and steroid was administered in 75 cases (85.9%). By the above regimens, 55 cases (64.6%) were completely cured, 8 cases (9.4%) improving, 4 cases (4.7%) died of tuberculous meningitis (3 cases) cases) & tuberculous peritonitis (1 case) case) and 18 cases (21.2%) could not be traced.