What is Disseminated Tuberculosis?
Disseminated tuberculosis, also known as widespread tuberculosis, is a contagious infection in which a tuberculosis infection has spread from the lungs to other parts of the body, with multiple organs affected. Disseminated tuberculosis can occur within weeks of infection with tuberculosis or years afterward.
The diagnosis of this form of TB involves taking a sample from the organ, that is believed to be affected, to prove the presence of an infection.
The treatment of disseminated tuberculosis usually involves taking a combination of antibiotics for 6 to 12 months. Most people recover well, although it does take time for the symptoms to improve. People who may be experiencing symptoms linked to disseminated tuberculosis can use List of Doctors to carry out a symptom assessment.
Good to know: The term miliary TB is used interchangeably with disseminated TB. However, military TB in fact refers more specifically to disseminated TB which presents with a millet-seed-like appearance on a chest x-ray, when the disease is spread by the blood throughout the lungs (see FAQs).[1]
Symptoms of disseminated tuberculosis
Symptoms depend upon the organ system infected with the bacteria. Common general symptoms of tuberculosis include:[2]
- Fever
- Chills
- Night sweats
- Malaise, i.e. feeling generally unwell
- Joint pain
- Weight loss
- Fatigue
- Pale skin due to anemia
- Swollen glands
- A cough and shortness of breath
- Skin rashes
Less common symptoms that may be related to disseminated tuberculosis include:[3]
- Bone pain
- Diarrhea
- Abdominal pain
- Swelling
- Blood in the urine
- Rigors
People who may be experiencing symptoms linked to disseminated tuberculosis can use List of Doctors to carry out a symptom assessment.
Causes
Tuberculosis (TB) is very infectious. The bacterium that causes tuberculosis, Mycobacterium tuberculosis, is spread through the air and via droplets from the mouth or throat of person infected with the pathogen. Infectious patients cough up large numbers of mycobacteria, which can survive on objects outside of the body for a long time.[2]
Tuberculosis is usually contained in the lung by the formation of small granulomas, a mass of tissue that forms in response to infection or inflammation. These are structures created by the body to contain the mycobacterium. In such a case, the condition is known as primary or pulmonary tuberculosis.
Occasionally, normally in people with a severely damaged immune system, granuloma formation is impaired, and mycobacteria can spread through the blood or lymph system[4] and infect other parts of the body. When this occurs, it is called disseminated tuberculosis.
Common locations for this to occur include:[3]
- Central nervous system
- Liver
- Spleen
- Kidneys
- Adrenal glands
- Choroid, a structure within the eye
- Skin
Risk factors for disseminated tuberculosis
Risk factors for catching primary TB include:[5]
- Being around people who have the condition
- Living in crowded or unclean conditions
- Having poor nutrition
Most people with tuberculosis in the US will not develop disseminated tuberculosis, as the immune system is often able to contain the primary infection. Risk factors that may increase the risk of developing disseminated tuberculosis may include:[6]
- Living in areas where there is not good access to health care
- Not being well nourished
- Living in crowded conditions
- Having a weakened immune system, especially among people with HIV
- Being older than 65 or an infant
Disseminated tubercilosis diagnosis
The diagnosis of disseminated tuberculosis can be difficult. Although the diagnosis may be suspected based on the symptoms, especially in a person who is at high risk of tuberculosis, it can only be confirmed with tests. Often, several tests are needed. These may include:[7][8]
- A computerized tomography (CT) scan, magnetic resonance imaging (MRI) scan or ultrasound to look for TB in internal organs
- Taking a sample of the affected part of the body and testing it for the presence of the bacteria, such as from urine, the lymph glands near the skin, spinal fluid or the lung.
- An examination of the inside of the body with an endoscope – a long, thin, flexible tube with a light and camera at one end – which is inserted through a natural opening, such as the mouth, or through a small cut made in the skin
- A lumbar puncture, in which a small sample of cerebrospinal fluid is taken from the base of the spine
- A chest X-ray to look for tuberculosis infection in the lungs
- A skin, urine or blood test for the presence of antibodies to TB bacteria, which indicates exposure to it in the past
Good to know: People with suspected disseminated TB may be offered an HIV test because people with HIV are much more likely to develop disseminated TB. Treatment may be needed for both conditions.
Treatment
Disseminated tuberculosis is treated with a combination of antibiotics. This is the same treatment for tuberculosis in the lungs, but disseminated TB usually needs a longer course of antibiotics. It may take 6 to 12 months to completely treat the infection.
It is very important to take TB medicines as instructed, otherwise, the infection can become much more difficult to treat, as the bacteria become antibiotic-resistant, meaning the medicines no longer work.[7]
A hospital stay may be needed to prevent spreading the disease to others until a person is no longer contagious.[5] This will depend upon the policies of the country, in which the person is recovering and the strain of tuberculosis contracted.
FAQs
Are military TB and disseminated TB the same thing?
They are used by some interchangeably. However, they refer to slightly different things. The term miliary TB originally referred to the appearance of the involved lung: on a chest x-ray, the small, firm white nodules on the surface of the lung resembled millet seeds. It now means disseminated TB that is spread through the bloodstream, i.e. when a tuberculosis lesion erodes into a blood vessel, disseminating millions of tubercle bacilli into the bloodstream and throughout the body. Some use military incorrectly, to describe any disseminated TB, whether or not it has the classic millet-like appearance associated with spread through the bloodstream.[1][9]
What is the difference between pulmonary TB and disseminated TB?
Tuberculosis is usually contained in the lungs when it is known as pulmonary tuberculosis. Tuberculosis that has spread to other organs is known as disseminated tuberculosis.
Can disseminated tuberculosis be fatal?
With treatment, most people will recover from disseminated tuberculosis. However, without treatment, such as may be the case for people living in developing countries, fatality may be likely.[5]
Other names used for disseminated tuberculosis
- Disseminated TB
- Extrapulmonary tuberculosis
- Widespread tuberculosis
- Tuberculosis outside the lungs
- Miliary tuberculosis or tuberculosis cutis miliaris disseminata (disseminated tuberculosis that is spread by the blood)
- Tuberculosis acuta generalisata (a rare form of cutaneous tuberculosis)
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“Clinical manifestations, diagnosis, and treatment of miliary tuberculosis.” UpToDate. 2 October 2018. Date Accessed: 9 January 2019. ↩ ↩
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“Tuberculosis | Doctor.” Patient.info. 21 May 2014. Date Accessed 9 January 2019. ↩ ↩
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“Tuberculosis. Amboss. Date Accessed: 21 November 2018. ↩ ↩
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The lymph system is a network that makes and moves lymph – a fluid that helps the body fight infection – from tissues to the bloodstream. ↩
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“Disseminated tuberculosis.” MedlinePlus Medical Encyclopedia. 13 December 2017. Date Accessed: 9 January 2019. ↩ ↩ ↩
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“Disseminated Tuberculosis.” DoveMed. 3 September 2018. Date Accessed: 9 January 2019. ↩
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“Tuberculosis (TB). Patient.info. 5 July 2017. Date Accessed: 9 January 2019. ↩ ↩
-
“Tuberculosis (TB) – Diagnosis.” NHS. Date Accessed: 21 January 2019. ↩
-
“Extrapulmonary Tuberculosis (TB).” MSD Manual. Date Accessed: 9 January 2019. ↩
**Q: What is Disseminated Tuberculosis?**
**A: Disseminated Tuberculosis (DTB)**, also known as miliary tuberculosis, is a severe and potentially life-threatening condition in which Mycobacterium tuberculosis (TB) bacteria spread throughout the body, leading to widespread infection.
**Key Symptoms of Disseminated Tuberculosis**
* Fever
* Chills
* Night sweats
* Weakness and fatigue
* Weight loss
* Loss of appetite
* Confusion
* Abdominal pain
* Chest pain
* Shortness of breath
**Causes of Disseminated Tuberculosis**
* Weakened immune system (e.g., due to HIV/AIDS, diabetes, cancer)
* Uncontrolled or untreated primary tuberculosis infection
* Infected blood or body fluids entering systemic circulation
**Diagnosis of Disseminated Tuberculosis**
* Medical history and physical examination
* Imaging tests (e.g., chest X-ray, CT scan) to detect lesions in various organs
* Blood tests to identify TB antibodies or bacteria
* Sputum or fluid samples for culture and staining
**Treatment for Disseminated Tuberculosis**
* Long-term antibiotic therapy (usually four anti-tuberculosis drugs for 9-12 months or more)
* Hospitalization and isolation in severe cases
* Close monitoring and follow-up to ensure effective treatment and prevent complications
**Risk Factors for Disseminated Tuberculosis**
* Immunocompromised individuals
* Diabetes
* Chronic kidney disease
* End-stage liver disease
* Diabetes
* HIV/AIDS
* Recent immigrants from TB-endemic countries
**Complications of Disseminated Tuberculosis**
* Lung damage
* Liver damage
* Kidney damage
* Bone and joint infections
* Meningitis (inflammation of the brain and spinal cord membranes)
* Death
**Prevention of Disseminated Tuberculosis**
* Prompt and effective treatment of primary TB infection
* Immunization with the Bacille Calmette-Guérin (BCG) vaccine in high-risk areas
**Other Relevant Keywords:**
* Tuberculosis
* Miliary tuberculosis
* Systemic tuberculosis
* Mycobacterium tuberculosis
* Immunosuppression
* Anti-tuberculosis drugs
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Disseminated tuberculosis (also called miliary tuberculosis) is a rare but serious form of tuberculosis (TB) that occurs when the bacteria that cause TB spread through the bloodstream and affect other parts of the body.
Disseminated tuberculosis (also called miliary tuberculosis) is a rare but serious form of tuberculosis (TB) that occurs when the bacteria that cause TB spread through the bloodstream and affect other parts of the body.