CLINICAL PROFILE, LABORATORY CHARACTERISTICS AND OUTCOME IN MILIARY TUBERCULOSIS

We report a retrospective series of 100 non-HIV adult patients with mi liary tuberculosis (MTB) treated in a tertiary care centre. There were 51 males. Their mean age was 35 years. Predisposing conditions existe d in 34. Twelve patients had larger-than-miliary (>2mm) shadows in the ir chest roentgenograms. Five presented with acute respiratory failure , and early treatment cured four of them. Hyponatraemia occurred in 42 /60 patients (70%) for whom values were available. Twelve patients (12 %) died of MTB, Temperature greater than or equal to 39.3 degrees C (p <0.01), hypoalbuminaemia (p<0.01), hyponatraemia (p<0.001), history of vomiting (p<0.001) and presence of crepitations on auscultation (p<0. 001) were independent predictors of mortality. Diagnosis of MTB is dif ficult even in an endemic area, as the clinical symptoms are non-speci fic and the chest roentgenograms do not always reveal classical miliar y changes. A high index of clinical suspicion and diligent efforts in confirming the diagnosis are needed, as early therapy yields good resu lts.