“ Due to inhaled Mycobacteria tuberculosis. This is very common worldwide. Initial infection in the naive host is known as primary TB; sec...
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Due to inhaled Mycobacteria tuberculosis. This is very common worldwide. Initial infection in the naive host is known as primary TB; secondary/reactivation TB occurs due to immunocompromised status or reinfection. Miliary disease may occur with primary or secondary TB.
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• Classic acute appearance is middle/lower lobe consolidation with ipsilateral lymph node enlargement and effusion.
• Apical consolidation is typical of post-primary TB (i.e. healed primary TB).
• Miliary nodules
CT
• Classically, lobar consolidation with ipsilateral hilar lymph node enlargement.
• Lymph nodes have central low density and peripheral enhancement with intravenous contrast (i.e. lymph node necrosis, fairly specific for TB).
• Look for ‘tree in bud’, suggesting endobronchial dissemination (i.e. bronchiolitis)—this is relatively specific for active TB.
Miliary tuberculosis. Chest x-ray and CT image demonstrating multiple miliary nodules due to pulmonary tuberculosis.
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