Miliary tuberculosis in children. Clinical and laboratory manifestation in 19 patients.

The clinical course of 19 children with miliary tuberculosis was studied. Complaints were nonspecific and included fever, anorexia, weight loss, and night sweats. Although all but one child had a miliary infiltrate visible on the chest roentgenogram, only 13 had a positive reaction to the purified protein derivative of the tuberculin test at admission to the hospital. Outcome was excellent unless the child also had tuberculous meningitis or was in a far advanced state of the disease. Miliary tuberculosis continues to be a rare but important cause of illness in the pediatric population. Seriously ill children with undiagnosed conditions of febrile disease deserve an aggressive evaluation for miliary tuberculosis, including an epidemiological survey, serial chest roentgenograms, and extensive, repeated culturing.