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(Chest. 1970;58:586-589.)
© 1970 American College of Chest Physicians

Miliary Tuberculosis: Diagnostic Methods with Emphasis on the Chest Roentgenogram

Herbert W. Berger M.D., F.C.C.P.1 and Teresita G. Samortin M.D.2

1 Chief, Pulmonary Disease Service, Mount Sinai Hospital Services—City Hospital Center at Elmhurst; Associate Professor of Clinical Medicine, Mount Sinai School of Medicine, The City University of New York
2 Resident in Medicine, Mount Sinai Hospital Services—City Hospital Center at Elmhurst

The initial chest roentgenogram was reported to be normal in 12 of 14 episodes of miliary tuberculosis. On review, miliary lesions were seen on ten films. The four normal roentgenograms exhibited miliary infiltrations after periods of seven days to one month. Liver and bone marrow biopsies were more reliable diagnostic methods than sputum cultures. The initial chest roentgenograms may frequently be interpreted as normal in miliary tuberculosis, particularly when the radiologist does not have detailed clinical information, but with careful review of initial and follow-up films miliary lesions will become apparent in almost all cases. The early roentgenographic detection of miliary tuberculosis depends upon clinical suspicion, technically adequate films, and close cooperation between clinician and radiologist.




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