Rattazzi L C, Simmons R L, Spanos P K, Bradford D S, Najarian J S
Am J Surg. 1975 Sep;130(3):359-61. doi: 10.1016/0002-9610(75)90402-x.
Miliary tuberculosis is the most lethal form of tubercular disease. If dissemination of tubercle bacilli occurs without therapy, death is almost certain. The importance of establishing an etiologic diagnosis as promptly as possible in patients receiving immunosuppressive therapy is self-explanatory. The presence of a life-threatening infection in these patients requires aggressive antimicrobial therapy and discontinuation of the immunosuppressive drugs until the infectious process is under control; the presence of an impaired immunologic response is responsible for the life-threatening infection and the lack of an acute rejection reaction.
粟粒性肺结核是结核病最致命的形式。如果在未进行治疗的情况下发生结核杆菌播散，几乎肯定会死亡。对于接受免疫抑制治疗的患者，尽快确立病因诊断的重要性不言而喻。这些患者中存在危及生命的感染需要积极的抗菌治疗，并停用免疫抑制药物，直到感染过程得到控制；免疫反应受损是导致危及生命感染的原因，且缺乏急性排斥反应。
