Can you get miliary TB without getting Primary TB?

Can you get miliary TB without getting Primary TB?

• A. No, it always follows obvious primary TB
• B. Yes, it can occur without prior symptomatic primary TB
• C. Only in children
• D. Only if HIV present

Answer: (B)

Miliary TB can result from hematogenous spread of Mycobacterium tuberculosis even when the initial primary infection did not cause noticeable illness. The primary infection can be subclinical or become latent, and dissemination to multiple organs can occur without a preceding, obvious pulmonary TB presentation. So, you can have widespread, tiny nodules (miliary pattern) and systemic symptoms without a recognized or symptomatic primary TB episode. In practice, this means miliary TB is not tied to a prior obvious primary lung illness. It can occur in otherwise healthy adults as well as in children, and while HIV infection increases risk, it is not a prerequisite for developing miliary TB.

Miliary TB can result from hematogenous spread of Mycobacterium tuberculosis even when the initial primary infection did not cause noticeable illness. The primary infection can be subclinical or become latent, and dissemination to multiple organs can occur without a preceding, obvious pulmonary TB presentation. So, you can have widespread, tiny nodules (miliary pattern) and systemic symptoms without a recognized or symptomatic primary TB episode.

In practice, this means miliary TB is not tied to a prior obvious primary lung illness. It can occur in otherwise healthy adults as well as in children, and while HIV infection increases risk, it is not a prerequisite for developing miliary TB.