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Case Reports
December 1930

SUBACUTE MILIARY TUBERCULOSIS: FATAL CASE IN AN INFANT, WITH ROENTGENOLOGIC EVIDENCE OF HEALING

Am J Dis Child. 1930;40(6):1269-1275. doi:10.1001/archpedi.1930.01940060109010
Abstract

While the literature on acute miliary tuberculosis in children in the United States is extensive, the reports on the subacute and chronic forms are rather meager. Greengard reported fifty-four cases of miliary tuberculosis in children from the Cook County Hospital in 1925, all of them fatal, only 9 per cent of the children surviving from three to four months.

The pathologic explanation for the almost invariable fatality of miliary tuberculosis is as follows: At successive times, there occur discharges of tubercle bacilli into the blood stream from some primary focus, usually a lymph node. This is borne out by the resultant crops of tubercles, the tubercles of each crop being of approximately the same size. Successively repeated discharges of tubercle bacilli into the blood stream are almost invariably the rule, which accounts for the generalized infection that rapidly overwhelms the organism.

It is conceivable that if the primary focus is

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