miliary tuberculosis, extensive dissemination by the bloodstream of tubercle bacilli. In children it is associated with high fever, night sweats, and often meningitis, pleural effusions, or peritonitis. A similar illness may occur in adults but with a less abrupt onset and occasionally with weeks or months of nonspecific symptoms, such as weight loss, weakness, and low-grade fever. Multiple small opacities resembling millet seeds may be evident on chest x-ray films. The liver, spleen, bone marrow, and meninges are often affected. The tuberculin test result may be negative, and diagnosis is made by biopsy of the infected tissue or organ. Combined drug therapy with isoniazid, rifampin, and pyrazinamide is usually successful if the diagnosis is not delayed. Concurrent tuberculous meningitis makes the prognosis less favorable. See also Mycobacterium, tuberculosis.
