Miliary tuberculosis in children: a review of 94 cases

Pediatr Infect Dis J. 1991 Nov;10(11):832-6. doi: 10.1097/00006454-199111000-00008.


This is a retrospective review of the clinical, radiologic and laboratory features of 94 cases of childhood miliary tuberculosis seen during a 5-year period, 1985 to 1989. A history of Bacillus Calmette-Guérin vaccination was documented in 88% of children. The median age at presentation was 10.5 months, 52% of cases occurring in those younger than 1 year. The presenting symptoms were nonspecific: cough (72%); fever (61%); loss of appetite and weight (40%); and diarrhea and vomiting (33%). The main presenting signs were hepatomegaly (82%), splenomegaly (54%), lymphadenopathy (46%) and pyrexia (39%). Most of the patients were malnourished and anergic. Meningitis occurred in 19% of patients and this was the only significant risk factor identified for mortality, the overall case fatality rate being 14%. The diagnosis in the vast majority was made on the clinical presentation supported by a classic miliary pattern on chest roentgenogram (91% of cases). Mycobacterium tuberculosis was cultured in 33% of cases. In addition a review of hospital admissions from 1981 to 1989 revealed that annually miliary tuberculosis in children and adults accounted for 8.3 and 1.3%, respectively, of all tuberculosis admissions. This study confirms that miliary tuberculosis is a relatively common complication of tuberculosis in young children.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • BCG Vaccine
  • Child
  • Child, Preschool
  • Epidemiologic Factors
  • Female
  • Humans
  • Infant
  • Liver Function Tests
  • Male
  • Middle Aged
  • Retrospective Studies
  • South Africa / epidemiology
  • Survival Analysis
  • Tuberculosis, Meningeal / epidemiology
  • Tuberculosis, Miliary / diagnosis
  • Tuberculosis, Miliary / drug therapy
  • Tuberculosis, Miliary / epidemiology*


  • BCG Vaccine