All of the following statements about Miliary Tuberculosis are true Except:
Correct Answer: Montoux is always positive
Description: Answer is D (Monotoux is always positive): 120. Montoux test is not always positive in cases of Miliary Tuberculosis. It may be negative /non reactive as a result of anergy. Miliary Tuberculosis max' occur following primary infection and secondary reactivation Miliary tuberculosis is due to hematogenous dissemination of tubercle bacilli. 'Classically miliary tuberculosis develops following hematogenous dissemination at the time ofprimary infection' -Harrisons 1 lth/629 In adults it/diary tuberculosis may be due to reactivation of old disseminated foci (secondary reactivation)' - Harrisons 17th/1013 Sputum microscopy is usually negative (Harrisons 17th/1013) 'Sputum smear microscopy is negative in 80% of cases' - Harrison 17th/1013 Montoux test is negative in 20-30% of patients with Miliary Tuberculosis `The Tuberculn skin Test (montoux) may be non reactive due to anergy' -Nelson 5th/567 `Tubercular anergy is common in Miliary Tuberculosis and a negative skin test should not be a deterrant to the consideration of this diagnosis' - Harrison 11th/629 'Upto 30% of children have a negative tuberculin skin test' - 'Tuberculosis : Current concepts and Treatment' 2nd/201 Liver, kidney and spleen are common sites of involvement along with other sites Almost every organ in the body may be involved. Mihaly tuberculosis is most prominent in Liver, spleen, kidney and other organs including bone marrow, adrenals, meninges, fallopian tubes and epididymis - Robbins 7th/386
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