High-Resolution Computed Tomography in the Diagnosis of Miliary Tuberculosis

The diagnosis of miliary tuberculosis can be difficult for a variety of reasons. First, the symptoms may be relatively subacute. Second, the classic plain-film appearance of miliary nodules occurs relatively late in the disease. Third, the early interstitial pattern can be nonspecific, a particularly difficult problem in the population of patients with acquired immunodeficiency syndrome (AIDS), in whom other etiologies, such as Pneumocystis carinii infection, are more common. High-resolution computed tomography (CT) may help suggest a more specific diagnosis. The potential benefits are illustrated by the following two cases.