For the most part, patients with tuberculosis are given a treatment regimen of antibiotics. It is seen both in primary and post-primary tuberculosis and may be associated with tuberculous infection in numerous other tissues and organs. Numerous calcified nodules are virtually diagnostic of histoplasmosis, especially when associated with hilar lymph node or splenic calcifications. Hematologic investigations are similar to those found in tuberculous pneumonia but a neutrophilia may be seen and should not put the diagnosis in doubt or cause empiric therapy to be restricted to antibacterials. Antibiotics are given usually given for 6 to 9 months, unless the meninges are affected. Such histories also suggest that the nodules are not always the result of hematogenous dissemination, such as in miliary tuberculosis, but may also be due to an inhaled organism. Disseminated TB usually develops insidiously with systemic symptoms such as fever, weakness, weight loss, fatigue, and anorexia. Autopsy series have shown the liver, lungs, bone marrow, kidneys, adrenal glands, and spleen to be the organs most frequently involved in miliary tuberculosis, but any organ can be the site of disease.303 Because of the multiplicity of sites involved, there are many potential sources of material to provide a diagnosis. Miliary TB is seen more commonly in infants, children less than 4 years old, and in immunocompromised people. The role of rapid nucleic acid amplification tests for identification of M. tuberculosis in patients with miliary tuberculosis has not been defined, and neither of the two tests licensed by the U.S. Food and Drug Administration is approved for nonrespiratory specimens, although Xpert MTB/RIF is recommended for use with specimens from extrapulmonary sites by WHO.308 The reported data are difficult to interpret because, often, the results of specimens from different sites are combined, patients are selected by a variety of criteria, and test performance varies.309-311 In contrast, several studies have shown that Xpert MTB/RIF can provide rapid molecular diagnostic assessment when extrapulmonary tuberculosis is suspected. As with histoplasmosis, the small nodules caused by varicella pneumonia may heal with the development of multiple, calcified nodules. The yield of sputum AFB microscopy and culture is low, averaging 30% and 50%, respectively, with variations across the reported series. 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