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Cryptic Disseminated Tuberculosis

Robert E. Carlson, MD
JAMA. 1981;245(23):2394. doi:10.1001/jama.1981.03310480014012.
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To the Editor.—  Regarding the two articles dealing with tuberculosis (TB), Harvey Katzen, MD, and Samuel V. Spagnolo, MD (1980;244:2438), described a patient with bone marrow necrosis from what they termed "miliary TB," and Brandstetter et al (1980;244:2440) reported on a patient with tubercular meningitis in the postpartum period. Both articles are certainly timely, considering that the incidence of TB, both new primary infection and reactivation of the old disease, appears to be on the rise. Contrary to some of the publicity that accompanied the closing of many of the TB sanatoriums, TB is by no means a dead disease. Indeed, it is alive and well in the community, irrespective of the socioeconomic classification of that community. Both of the aforementioned reports described patients with disseminated TB who had normal chest films. It is for this reason that I would disagree with the term "miliary TB" as used by Katzen


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