Miliary tuberculosis (TB) is a severe form of disseminated TB that could be fatal without treatment. It remains a significant health problem in endemic countries such as Indonesia. A-3-month-old child was admitted to the hospital with chief complain of shortness of breath, cough, and intermittent low-grade fever. Significant clinical findings were lack of weight gain, previous contact with confirmed cases of TB, and severe malnutrition. Significant laboratory findings were anemia, elevated CRP, and hypoalbuminemia. Radiological findings were suggestive of miliary TB with bilateral diffuse reticulonodular lung lesion on chest CT-scan. Diagnosis of miliary TB is difficult because of nonspecific, atypical symptoms and varied clinical signs. It is needed multiple diagnostic approach, especially for children. Miliary TB remain to be a difficult case that require an early intervention despite difficulties in its diagnosis, to prevent morbidity and mortality of patient.

Tuberculous pericarditis (TBP) is a rare case of extrapulmonary TB (EPTB) especially in the developed countries. This may cause serious and deadly impact if not diagnosed and treated properly. A-15-year-old girl was admitted with tightness of breath, weight loss, a productive cough and fatigue. Severe malnutrition, bronchial rales and anemia are present in patient. Chest x-ray showed pleural effusion with cardiomegaly. On three days later, Thoracic multi-slice spiral (MSCT) confirmed pericardial effusion, following pericardiocentesis on the fifth day. Tuberculous was confirmed by analysis of pericardial fluid. This patient was diagnosed as tuberculosis pericardial effusion showed complete recovery after pericardiocentesis and anti-tuberculosis drugs administration. Tuberculous is an endemic disease and its extrapulmonary forms should be included as a differential diagnosis. Early and adequate treatment decreases the risk of developing into a potentially fatal disease.