All that seems to be miliary mottling is not always due to tuberculosis: A case report

Sneha, Latha M.; Karmegaraj, Balaganesh; Ravindran, Manipriya; Srikiran, Sarvepalli; Sai, Venkata; Scott, Julius Xavier

doi:10.1177/0049475515582326

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…Various metastatic cancers and other neoplastic processes are known causes of miliary disease [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Several interstitial lung diseases can present atypically with a miliary pattern, such as sarcoidosis [21], pulmonary alveolar microlithiasis [22], various pneumoconioses [23], hypersensitivity pneumonitis [24], lipoid pneumonia [25], vaping-associated lung injury [26], drug-induced pneumonitis [27], and organizing pneumonia [28].…”

Section: Introductionmentioning

confidence: 99%

Examining Miliary Disease Etiology in a Coccidioides-Endemic Center: A Retrospective Cohort Study

Scott,

Lim,

Randhawa

et al. 2023

JoF

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Background: A miliary pattern on chest imaging is often attributed to tuberculosis (TB) infection. However, a myriad of conditions can cause a miliary pattern, many of which are imminently life-threatening. Research Question: The primary aim of our study is to elucidate the potential causes of miliary chest imaging patterns to improve workup and empiric therapy selection. The secondary aims are to discern the predictors of miliary disease etiology and to determine whether appropriate empiric antimicrobial therapies were given. Study Design and Methods: In this retrospective cohort study, we searched a radiology database for patients with chest imaging studies described by the word “miliary”. Subjects were excluded if they were under 18 years of age and if there were insufficient objective data to support a miliary disease etiology. A radiologist independently reviewed all imaging studies, and studies that did not appear to have a true miliary pattern were excluded. The collected data include patient demographics, immunocompromising risk factors, conditions associated with miliary disease, β-D-glucan levels, serum eosinophil count, and empiric therapies received. Results: From our 41-patient cohort, 22 patients (53.7%) were clinically diagnosed with coccidioidomycosis, 8 (19.5%) with TB, 7 (17.1%) with metastatic solid cancer, 1 (2.4%) with lymphoma, 1 (2.4%) with other (Mycobacterium simiae), and 3 (7.3%) with unknown diseases (the sum equals 42 patients because one individual was diagnosed with both coccidioidomycosis and TB). All six patients with greater than 500 eosinophils/μL were diagnosed with coccidioidomycosis. Of the 22 patients diagnosed with coccidioidomycosis, 20 (90.91%) were empirically treated with an antifungal regimen. Of the eight patients with TB, six were empirically treated for TB. Interpretation: Based on our data from a Coccidioides-endemic region with close proximity to tuberculosis-endemic areas, the leading cause of miliary disease is coccidioidomycosis, although TB and cancer are also common etiologies. Serum eosinophilia and elevated β-D-glucan levels were strongly predictive of coccidioidomycosis in our patient cohort with a miliary chest imaging pattern.

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Section: Introductionmentioning

confidence: 99%

Examining Miliary Disease Etiology in a Coccidioides-Endemic Center: A Retrospective Cohort Study

Scott,

Lim,

Randhawa

et al. 2023

JoF

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“…It has been found associated with Mycobacterium Tuberculosis infection in the past (three case reports) [ [2] , [3] , [4] ].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Langerhans Cell Histiocytosis(PLCH) masquerading as Atypical Mycobacterial infection

Yazdani¹,

Bousamra

Yazdani

2018

Respiratory Medicine Case Reports

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Isolated Pulmonary Langerhans Cell Histiocytosis in a Child

Satapathy,

Padhi,

Gulla

et al. 2024

Research and Reviews in Pediatrics

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A 4-year-old boy presented with a history of chronic cough for the past 1 year that was progressing for the last 2 weeks. History of intermittent fever with breathlessness was there. The child had received antibiotics, nebulization, and oral steroids, but was never prescribed inhaled steroids, as no wheeze was documented. As the X-ray chest was not showing any significant findings, a computerized tomography chest was done that showed septal thickening, and reticulonodular pattern bilaterally without bronchiectasis or mediastinal lymphadenopathy. Bronchoscopy was done and the lavage fluid found CD1a and S-100-positive cells suggestive of pulmonary Langerhans cell histiocytosis. There was no other organ involvement.

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All that seems to be miliary mottling is not always due to tuberculosis: A case report

Cited by 3 publications

References 9 publications

Examining Miliary Disease Etiology in a Coccidioides-Endemic Center: A Retrospective Cohort Study

Examining Miliary Disease Etiology in a Coccidioides-Endemic Center: A Retrospective Cohort Study

Pulmonary Langerhans Cell Histiocytosis(PLCH) masquerading as Atypical Mycobacterial infection

Isolated Pulmonary Langerhans Cell Histiocytosis in a Child

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