Tuberculosis is a disease caused by a bacterium called Mycobacterium tuberculosis. said pathology It has multiple forms of presentation as well one of the least frequent is miliary tuberculosis. Want to know what the symptoms, causes and treatment are? We will clarify this for you below.
This type of presentation gets its name from the formation of small circular lesions on the affected tissue, very similar to millet seeds. It occurs when the infection reaches a blood or lymph vessel and spreads to both lung fields, as well as other organs.
Symptoms of miliary tuberculosis
First of all, it is important to clarify that being a disseminated infection it can affect any organ. As, usually has no specific symptoms. Although the disease begins in the lungs, it affects the spleen, liver, meninges, and pericardium.
In this way, the symptoms may vary according to each patient and the organs harvested. However, as this is a long-standing infection, it is common to experience the following symptoms:
- Fever of unknown origin.
- Unintentional weight loss.
- Chills that make you tremble.
- Muscle weakness and fatigue.
- respiratory distress or dyspnea
- Cough with expectoration.
Also, miliary tuberculosis is the extrapulmonary form Most frequently of this disease, with an incidence of approximately 11%. In this way, when it reaches other organs it can manifest itself through the following pathologies:
- Pyelonephritis: upon arrival in the genitourinary system.
- Meningitis: when it takes the layers covering the brain and spinal cord.
- pericarditis: It occurs when it affects the tissue covering the heart.
- Peritonitis and lymphadenitis: when the abdominal and pelvic lymph nodes are infected.
- Pott’s disease: when it settles in the bone marrow of the vertebrae.
Causes of miliary tuberculosis
Before explaining the causes of this form of presentation, we need to talk a little about the disease itself. This infection is characterized by having 2 phases: a primary and a post-primary or secondary.
In the primary stage the infection occurs for the first time and with the appropriate treatment it can be resolved. However, when the immune system responds partially and the disease has not completely healed, the bacteria will remain encapsulated in the body without causing harm.
Once the bacterium is encapsulated, if the patient is re-exposed to the disease or some condition suppresses his or her immune system, it will reactivate causing post-primary or secondary tuberculosis. In this case there is a dissemination that generates cavitations or holes.
On the other hand, miliary tuberculosis occurs when the defense system does not respond adequately to infection. In this way it can be generated from the primary or post-primary stage of the disease.
While there are no specific causes of miliary tuberculosis, there are various predisposing factors. The main one is immunosuppression, especially due to HIV and AIDS.
However, various conditions and diseases can cause a failure in the immune system. Therefore, it is common to find this disease in the elderly, children under 4, malnourished, diabetics, chronic alcoholics, and people with kidney failure or cancer.
Treatment of miliary tuberculosis
Treatment of miliary tuberculosis is complex and It will depend on the degree of affection that the patient has.. In general terms, there are 3 treatment options ranging from the use of antibiotics and corticosteroids to surgery.
antibiotics
When it comes to antibiotic treatment of miliary tuberculosis, it does not differ much from that used in the classic pulmonary form. In this sense, a prolonged approach should be started which can last from 6 to 9 months. However, if the meninges are affected, it can last up to 12 months.
The protocol will include the use of those drugs that prevent bacterial proliferation and destroy it. In this way, the doctor should advise, in the first instance, the use of ethambutolas well as isoniazid, rifampin, pyrazinamide and streptomycin.
corticosteroids
The use of corticosteroids is not included in routine treatment. It will only be recommended if there is a meningeal or pericardial condition. In such cases, it decreases mortality 22 and 18%, respectively. On rare occasions, they may be used when the infection is very extensive.
Due to the large number of side effects these have on the body, their use will not be prolonged. The treatment will last for 1 month and will be progressively interrupted for 2 months.
Surgery
However, surgery will not be a treatment for the infection itself It is used to resolve various complications of miliary tuberculosis. In this way, among the cases in which an intervention will be necessary, we include the following:
- Correct vertebral malformations.
- drain a empyemawhich is the accumulation of pus.
- Closed fistulas, which are pathways that carry pus out.
- Remove any affected sections of intestine.
The risks of this disease
Miliary tuberculosis is a very dangerous disease that puts the patient’s life at risk. While rare, it’s important to pay attention to any symptoms, especially if you have a predisposing factor for immunosuppression.
On the other hand, when this pathology is diagnosed, the most important thing is to strictly follow the treatment. This will be the only way to prevent antibiotic resistance and future complications.
Post miliary tuberculosis: symptoms, causes and treatment first appeared in research-school.