In the present study,our results demonstrated accurate diagnosis and early therapeutic management were crucial to optimizing outcome and DM, ALT, AST, D-dimer, hemoglobin, and albumin are independent predictors of ARDS development in patients with miliary TB. Tuberculosis remains a major cause of morbidity and mortality around the world, especially in developing countries [13, 14] . According to the 13th annual tuberculosis report of the World Health Organization (WHO), there were an estimated 9.27 million new cases worldwide in 2007, an increase from 9.24 million in 2006 [1] . Further, miliary TB is an uncommon cause of ARDS with a high mortality [4, 15] . The current study was performed in Chongqing, the fourth central municipality of China, which has a prevalence rate of 0.54%, higher than the national average. In our study, the average age of patients with ARDS caused by miliary TB was younger than that previously reported due to the possible reason of host factors including region, race, and environment [3, 4] . Mechanical ventilation is an important treatment for miliary TB complicated by ARDS. Prompt mechanical ventilation from the day of diagnosis can effectively improve outcome, which benefits for the management of ARDS caused by miliary TB. Also, accurate diagnosis and early anti-tuberculosis therapy are crucial to the treatment of miliary TB with ARDS. However, the high overall mortality is attributed to case mix, misdiagnosis, and severity of illness, which ultimately lead to the delay in the initiation of anti-tuberculosis therapy or mechanical ventilation.