What's the most likely diagnosis?

• 63 year-old male with fever

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

Answer:

 

3. Miliary tuberculosis

 

 

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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

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