Sequential Radiographic Changes of Nodules in Patients with Miliary Pulmonary Tuberculosis

ABSTRACT

PURPOSE: To evaluate sequential changes in miliary nodules, as seen on chest radiographs in patients withmiliary tuberculosis. MATERIALS AND METHODS: We retrospectively analyzed sequential changes in miliary nodules,as seen on the chest radiographs of 13 patients with miliary tuberculosis who recovered completely ofterantituberculous medication. Two were children and 11 were adults, and their ages ranged from 2 monts to 73years(mean, 38 years). In cases in which miliary tuberculosis had been diagnosed from initial chest radiographs,follow-up chest radiographs were obtained 5 to 15(mean, 10) months later. After complete resolution of miliarynodules, as seen on chest radiographs, high-resolution CT scanning was performed in three patients. RESULTS: Asseen on follow-up chest radiographs obtained at one week, the number and size of miliary nodules had decreased ineight of nine patients (89%), and on those obtained at one month, these decreases were seen in all 13 patients.The mean duration of complete resolution of miliary nodules was 6.3 months ; in children, this was 3.5(range, 2-5)months, and in adults, 6.8 (range, 3-10) months. In all three patients involed, high-resolution CT scans obtainedafter complete radiographic resolution of miliary nodules showed no recurrence. CONCLUSION: In patients withmiliary tuberculosis, the size and number of nodules had decreased within one month of adequate chemotherapy andon chest radiographs, complete resolution was seen at 6.3 months, on average.