What happens in the 1st phase of Miliary (Disseminated) TB?

What happens in the 1st phase of Miliary (Disseminated) TB?

• A. It forms granulomas to contain bacteria
• B. It remains dormant with no symptoms
• C. Mycobacterium tuberculosis escapes initial lung infection site and enters the bloodstream through the lymphatics
• D. It causes cavitation in upper lobes

Answer: (C)

In miliary TB, the initial event is the bacteria breaking away from the primary lung lesion and entering the bloodstream via the lymphatic route, leading to hematogenous dissemination to many organs. This early spread seeds distant sites such as the liver, spleen, bone marrow, and others, creating the tiny nodules that characterize the miliary pattern. Cavitation in the upper lobes is more typical of reactivation localized pulmonary TB, and latent infection involves dormant bacteria without active dissemination. So the first phase centers on the escape from the primary site and entry into the bloodstream to seed widespread disease.

In miliary TB, the initial event is the bacteria breaking away from the primary lung lesion and entering the bloodstream via the lymphatic route, leading to hematogenous dissemination to many organs. This early spread seeds distant sites such as the liver, spleen, bone marrow, and others, creating the tiny nodules that characterize the miliary pattern. Cavitation in the upper lobes is more typical of reactivation localized pulmonary TB, and latent infection involves dormant bacteria without active dissemination. So the first phase centers on the escape from the primary site and entry into the bloodstream to seed widespread disease.