Question

Identify the infection from the chest X-ray of a patient with low-grade fever?

• A. ILD
• B. Bronchopneumonia
• C. Miliary TB
• D. Consolidation

Hint:

Uniform 1-2 mm millet-seed nodules across both lungs with low-grade fever.

Answer 1

The Correct Option is C

Step 1: The chest radiograph in a patient with low-grade fever shows small, discrete nodules about 1-2 mm in diameter evenly distributed throughout both lung fields - the classic millet-seed pattern of miliary tuberculosis.
Step 2: Miliary TB results from haematogenous dissemination of tubercle bacilli. This haematogenous spread may be seen in both primary and post-primary disease.
Step 3: Early on, the chest radiograph may be normal, but then the numerous tiny uniform nodules become apparent throughout both lungs. With adequate anti-tubercular treatment they slowly resolve; untreated, they may enlarge and coalesce.
Step 4: Interstitial lung disease gives reticular or honeycomb changes, bronchopneumonia gives patchy peribronchial opacities, and consolidation gives a lobar opacity with air bronchograms. The uniform, bilateral, tiny nodular shower with low-grade fever is diagnostic of miliary TB.