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February 1924


Author Affiliations

From the Department of Pediatrics, Johns Hopkins University.

Am J Dis Child. 1924;27(2):110-112. doi:10.1001/archpedi.1924.01920080017003

The pathologic examination in a case of generalized miliary tuberculosis in childhood shows why this disease is nearly always fatal. There is a softened focus of tuberculosis, usually in a lymph node, which has discharged into a blood vessel, not once, but several times, the cavity having undoubtedly filled. Evidence of repeated infection is found in the size of the resultant tubercles. There are crops of different sizes, but the tubercles that belong to one crop are of approximately the same size. This indicates an eruption of tubercle bacilli into the blood stream at different intervals. The discharge of tubercle bacilli may be so overwhelming and produce so extensive and generalized an infection as to prove fatal in a short time. But if it does not, successive discharges of tubercle bacilli can hardly be borne; and, from the nature of the lesion in the tuberculosis focus, successive discharges are the

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