Clinical Characteristics and Etiologies of Miliary Nodules in the US: A Single-Center Study.
Aspergillosis
/ diagnosis
Cross-Sectional Studies
Female
HIV Infections
/ complications
Histoplasmosis
/ complications
Humans
Male
Middle Aged
Neoplasms
/ diagnosis
Pneumonia
/ diagnosis
Retrospective Studies
Sarcoidosis
/ diagnosis
Silicosis
/ diagnosis
Sputum
/ microbiology
Tuberculosis, Miliary
/ diagnosis
Tuberculosis, Pulmonary
/ diagnosis
United States
/ epidemiology
Bronchoscopy
Imaging
Miliary nodules
Sarcoidosis
Tuberculosis
Journal
The American journal of medicine
ISSN: 1555-7162
Titre abrégé: Am J Med
Pays: United States
ID NLM: 0267200
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
22
11
2018
revised:
02
12
2018
accepted:
19
12
2018
pubmed:
20
1
2019
medline:
10
1
2020
entrez:
20
1
2019
Statut:
ppublish
Résumé
Miliary nodules have been typically described as a radiological manifestation of disseminated tuberculosis. However, miliary nodules are known to occur in a wide variety of conditions. The primary objective of the study was to identify clinical characteristics and etiologies of miliary nodules within our institution. Using International Classification of Diseases, Ninth and Tenth Revision codes, electronic medical records were used to retrospectively identify 53 patients who fulfilled criteria of miliary nodules over the last 10 years. Demographic and clinical data were extracted for all the patients in this cross-sectional study. The diagnosis of tuberculosis was made in 15 (28.3%) patients, sarcoidosis in 12 (22.6%), silicosis in 7 (13.2%), extrathoracic malignancy in 5 (9.4%), and histoplasmosis in 4 (7.6%) patients. Four of 9 HIV patients had histoplasmosis. There was 1 case each of hypersensitivity pneumonitis, Pneumocystis jiroveci pneumonia, Mycobacterium-avium complex, Epstein-Barr virus pneumonia, cryptococcosis, aspergillosis, and primary lung cancer. Sputum was positive for acid fast bacilli in 4 cases (28%), and bronchoscopy had a 57% successful yield in miliary tuberculosis. Our study is the largest single-center data review evaluating the etiology of miliary nodules within the United States; most of the data exist in case reports.
Sections du résumé
BACKGROUND
Miliary nodules have been typically described as a radiological manifestation of disseminated tuberculosis. However, miliary nodules are known to occur in a wide variety of conditions. The primary objective of the study was to identify clinical characteristics and etiologies of miliary nodules within our institution.
METHODS
Using International Classification of Diseases, Ninth and Tenth Revision codes, electronic medical records were used to retrospectively identify 53 patients who fulfilled criteria of miliary nodules over the last 10 years. Demographic and clinical data were extracted for all the patients in this cross-sectional study.
RESULTS
The diagnosis of tuberculosis was made in 15 (28.3%) patients, sarcoidosis in 12 (22.6%), silicosis in 7 (13.2%), extrathoracic malignancy in 5 (9.4%), and histoplasmosis in 4 (7.6%) patients. Four of 9 HIV patients had histoplasmosis. There was 1 case each of hypersensitivity pneumonitis, Pneumocystis jiroveci pneumonia, Mycobacterium-avium complex, Epstein-Barr virus pneumonia, cryptococcosis, aspergillosis, and primary lung cancer. Sputum was positive for acid fast bacilli in 4 cases (28%), and bronchoscopy had a 57% successful yield in miliary tuberculosis.
CONCLUSION
Our study is the largest single-center data review evaluating the etiology of miliary nodules within the United States; most of the data exist in case reports.
Identifiants
pubmed: 30659816
pii: S0002-9343(19)30058-0
doi: 10.1016/j.amjmed.2018.12.030
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
767-769Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.