Sputum cultures are usually negative. When we consider the epidemiological importance, it is not mainly associated with those cases which discharge AFB and useful for control purposes. Therefore, the priority in case findings should be for cases to be identified by direct microscopy. These patients could conceivably represent primary tuberculosis with a very minute focus of infection, or they may represent reactivation TB with subradiographic pulmonary lesions. Even if, in the majority of the cases, AFB is negative, finding a miliary pattern on CXR should be taken as a consideration for the diagnosis of TB in addition to clinical findings.
Miliary lesions vary from one to four mms and are fairly discrete.
The lesions are distributed uniformly throughout the lung, including apices. In some cases pleural effusion or the presence of chronic fibrocavitary apical lesions may be noted. Even though the study was limited to the analysis of records, it showed that CXR was used for all suspects of tuberculosis that ended up in an increased cost for routine diagnosis. From the CXR presentation, cavity, interstitial shadowing and the presence of more than one findings were found to be positively associated with positive sputum smear. We are grateful to the Hossana Hospital TB Clinic staffs for their continuous support in collecting the data for the study.