Differential diagnosis

The differential diagnosis includes the following: the syndrome of HIV wasting disease (sometimes referred to as "slim disease"), bacteraemia (including typhoid fever), disseminated carcinoma, disseminated infection with "atypical" mycobacteria, trypanosomiasis (in endemic regions) and connective tissue diseases.

The typical diffuse CXR abnormalities can be confused with those of LIP in children. The table below lists features that help to differentiate miliary TB from LIP. However, there is clinical overlap as LIP presents with a broad range of clinical and radiographic features, which vary depending on the stage of HIV disease.

Clinical differentiation of miliary TB from LIP in children

Miliary TB

LIP

Clinical features:

Respiratory symptoms

-/+

+++

Persistent fever

++

++

Wasting

+++

-/+

Generalized lymphadenopathy

-/+

+++

Parotid enlargement

-

++

Clubbing

-

+

Hepatomegaly

++

++

CXR features:

Diffuse micronodular

++

+

Diffuse reticular

-

++

Lymphadenopathy

-/+

++

Was this article helpful?

0 0

Post a comment