Affiliation:
1. Associate Professor MD Department of Respiratory Medicine SRMS IMS Bareilly UP.
2. Junior Resident Department of Respiratory Medicine SRMS IMS Bareilly UP
3. Assistant Professor Department of Respiratory Medicine SRMS IMS Bareilly UP.
4. Senior Resident Department of Respiratory Medicine SRMS IMS Bareilly UP.
Abstract
Objectives: This study aimed to evaluate the clinical prole and outcome of the patients with miliary tuberculosis (TB).
Methods: This was a retrospective observational study which involved evaluation of medical records of 44 patients with miliary TB in the
department of respiratory medicine and internal medicine from 2016-2019. Miliary TB in these patients had been diagnosed on the basis of clinical
symptoms, radiology and microbiology. The clinical prole of the patients in terms of age, gender, clinical presentations were recorded. Time
duration for resolution of symptoms was noted. Radiological outcome was also studied. Final outcome was treatment success and mortality.
Results: The mean age of the patients were 37.07 years with 27 males. Most common complaints were fever (86.36%), cough (72.73%),
expectoration (65.91%) and anorexia (45.45%). Laboratory ndings showed hypertransaminasemia, anemia, and hyponatremia in 75.00%,
70.45%, and 43.18% patients, respectively. Standardized treatment (RHEZ) was given in 70.45% patients, and non-standardized treatment in
29.55% patients. Median duration of fever was relieved in 15 days. Mortality rate was 11.36% and drug induced liver injury (DILI) was seen in
4(9.09%) patients. Radiological resolution was seen in almost all of the patients except in 3 and in majority of patients clearing was seen within the
rst two months of initiation of treatment. Among all variables, hyperbilirubinemia showed signicant association with mortality (OR=14.6, 95%
CI 1.86 to 114.615, P=0.013).
Conclusion: In conclusion, in our series miliary TB presents most commonly in the third decade of life and is predominant among males. The
clinical features were similar to pulmonary tuberculosis. There was frequent association with derangements in liver function, electrolyte, and
hemoglobin. Hyperbilirubinemia was associated with signicantly increased the odds of mortality. Non-standardized treatment regimens were
associated with poorer outcome. Mortality rate in miliary TB was as high as 11.3% in our series.