Miliary Tuberculosis: Moroccan Series of 101 Cases

Abstract

Introduction: Miliary tuberculosis is an increasingly rare form (2% to 8%), defined by the hematogenous or lymphatic dissemination of the tubercle bacillus from a pulmonary or extra-pulmonary focus but which remains serious and can lead to acute respiratory failure due lesional pulmonary edema. Patients and Methods: This is a retrospective study of 101 cases of miliary tuberculosis hospitalized between January 1989 and July 2019 in the pneumology department of “20 Aout” in Casablanca. Results: The average age is 43 years with a predominance of men (64%), the history of tuberculosis is found in 8 cases and tuberculosis contagion in 10 cases. The common symptom in all cases (100%) is an alteration of the general condition, fever is present in 76% of cases, dry cough is found in 75.5% of cases and dyspnea is found in 38.3% of cases. Among the causes of immunosuppression, we noted: 3 cases of neoplasia, 5 cases of diabetes, 5 cases of pregnancy and 4 cases of system diseases. The chest X-ray (frontal view) found an aspect of pulmonary miliaria in all cases associated with pleurisy in 18 cases, an excavated opacity in 3 cases and pneumothorax in 1 case. Tuberculin intradermal reaction (tIDR) was positive in 35 cases. Antibacillary treatment was started urgently in all cases. The outcome was good in the majority of cases with 10 deaths. Further work-up allowed confirmation of the diagnosis either by direct isolation of the koch bacillus or by biopsy in 47.52% of cases.