Touraine R, Romestaing P
Nouv Presse Med. 1981;10(30):2483-7.
Seventy-five cases of disseminated tuberculosis of the lung were observed between 1960 and 1978. On radiology, they presented as fine or coarse miliary nodules or diffuse infiltrates. The disease occurred at all ages and were afebrile in 25% of the cases. It was frequently haemategenous, as shown by the presence of extrathoracic foci (Pott's disease, tuberculosis of the urinary or genital tracts), or, more often, by associated lesions indicating bacteraemia, such as meningitis, granulations on the fundus oculi, miliary tuberculosis of the liver and positive urine culture with normal urographic findings. Positive urine cultures, which were encountered in 32% of the patients, appeared to be reliable criterion of dissemination through the blood stream. Disseminated pulmonary tuberculosis usually responded to modern combined antibiotic therapy, but 8 patients over 60 years of age died during the first six weeks of treatment. Relapses were rare with prolonged therapy including isoniazid and streptomycin and did not occur after rifampicin was introduced into the therapeutic regimen.
1960年至1978年间观察到75例播散性肺结核。在放射学上，它们表现为细或粗的粟粒状结节或弥漫性浸润。该疾病在各年龄段均可发生，25%的病例无发热。它常通过血行传播，表现为胸外病灶（波特病、泌尿生殖道结核），或更常见的是伴有提示菌血症的相关病变，如脑膜炎、眼底肉芽肿、肝粟粒性结核以及尿培养阳性且尿路造影结果正常。32%的患者尿培养呈阳性，这似乎是血行播散的可靠标准。播散性肺结核通常对现代联合抗生素治疗有反应，但8例60岁以上患者在治疗的前六周内死亡。采用包括异烟肼和链霉素的长期治疗时复发很少见，在治疗方案中引入利福平后未再发生复发。
