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Miliary tuberculosis in British Columbia.

The case records were studied of all 48 patients with miliary tuberculosis registered by the British Columbia Division of Tuberculosis Control between 1967 and 1971. Two groups of patients were found, one group of 30 in whom the diagnosis was made during life and antituberculous therapy instituted, and a second group of 18 patients in whom the diagnosis was made only at autopsy and who had received no antituberculous therapy. In the latter group there was a particularly high incidence of concomitant disease; additionally, tuberculin testing, bacteriological search for acid-fast bacilli and chest radiography were frequently neglected. This group consisted mainly of elderly male Caucasians. The disease was characteristically insidious in onset, frequently with non-specific symptoms and physical findings. Fever was a common presenting symptom. Several patients presented with a fulminant illness which, although diagnosed, was not affected by antituberculous therapy and was rapidly fatal. North American Indians showed a high incidence of disease but a low mortality rate, probably owing to their younger age.