Miliary tuberculosis is a dangerous condition in which the tuberculous bacillus (mycobacterium) is spread rapidly through every organ of the body when an infected lymph node discharges its contents into a blood vessel of the lung. The person is first infected by someone with TB, and the disease settles in lung tissue with a white area called a Ghon focus on the X-ray. It spreads to the lymph nodes which enlarge and form cheese-like pus known as caseous material. The node presses on the nearest blood vessel, eventually breaks down the wall and ejects a shower of material into the blood stream. A tsunami of mycobacteria sweeps through the body to the lung, liver, brain and elsewhere, there to work their mischief. If the condition is not diagnosed, and treated, the condition is nearly 100% fatal. Miliary TB is first visible on Chest X-ray as thousands of tiny white dots in all parts of the lungs.
The condition is so named because the little white dots in the lung are plentiful and small – the size and shape of millet seeds.
Fortunately it is uncommon complication of TB (1 – 2%) and people with AIDS are at higher risk for the condition.
My picture began with a man showing signs of miliary TB and it illustrates the condition with a central focus – a “hot” area and the explosion of tiny particles that extends outwards through every part of the picture. Where the mycobacteria have settled and are active shows as a heap of fiery embers .