Clinical, Radiological and Evolutionary Profile of Miliary Tuberculosis in Saint-Louis

Introduction: Miliary tuberculosis is a severe, acute form of tuberculosis caused by lymphohematogenous dissemination of tuberculosis bacilli from a focal lesion ruptured in the blood or lymphatic flow, and results from the lymphohematogenous dissemination of tuberculosis bacilli from a focal lesion ruptured in the blood or lymphatic flow and is manifested on the chest x-ray by a seedling of small puncture-shaped opacities the size of a “grain of millet” (1 to 2 mm).

Patients and Methods: We conducted a retrospective study of 55 cases of miliary tuberculosis collected at the Pneumology department of the Saint-Louis regional hospital between January 2014 and December 2020.

Results: Miliary tuberculosis represented 4.1% (n = 55) of all tuberculosis diagnosed. The sex ratio was 0.90. The average age of the patients is 37 years with extremes of 17 and 73 years. Tuberculosis contagion was found in 28 patients, i.e. 50.9%. The chest x-ray revealed a typical miliary aspect in all cases. The definitive diagnosis of tuberculosis infection was made in 65.4% of cases. The dissemination results showed associated extra thoracic involvement in 47.2%. Antituberculosis treatment was initiated in all patients combining rifampicin, isoniazid, pyrazinamide, ethambutol, for two months, followed by four months of rifampicin, isoniazid . The evolution in the hospital environment was marked by a case fatality rate of 9%.

Conclusion: Miliary tuberculosis is a severe, life-threatening form of tuberculosis, hence the need for early diagnosis and management.

Keywords: Tuberculous miliary; Chest x-ray; Saint-Louis; Senegal.