Maartens et al listed predisposing factors for miliary tuberculosis in addition to listing risk factors for mortality (see above). Miliary tuberculosis should be considered in a patient with predisposing factors and a systemic febrile illness if at risk for tuberculosis. The authors are from Groote Schuur Hospital and University of Cape Town, South Africa.
Factors that may predispose a patient to miliary tuberculosis:
(1) alcoholism
(2) pregnancy or postpartum
(3) diabetes mellitus
(4) immunosuppressive therapy (corticosteroid therapy, immunosuppression for organ transplant, etc)
(5) iron overload
(6) immunocompromising conditions (hematologic malignancy, other)
(7) connective tissue disorder
where:
• The study was performed while AIDS was uncommon.
• The presence of dietary iron overload is common in South Africa.
• Treatment with targeted immunosuppressants would also be a predisposing factor.
