Miliary tuberculosis (TB) is the widespread dissemination of Mycobacterium tuberculosis via

hematogenous spread.

Risk factors for miliary tuberculosis involve immunosuppression and the only risk facotr that is
applicable to the client is malnutrition.

Following exposure and inhalation of TB bacilli in the lung, a primary pulmonary complex is established,
followed by development of pulmonary lymphangitis and hilar lymphadenopathy. Mycobacteremia and
hematogenous seeding occur after the primary infection. After initial inhalation of TB bacilli, miliary
tuberculosis may occur as primary TB or may develop years after the initial infection. The disseminated
nodules consist of central caseating necrosis and peripheral epithelioid and fibrous tissue.

Childhood TB is usually acquired from an infectious adult contact. High rates of transmission are
sustained in TB-endemic areas due to high case density and prolonged diagnostic delay (Marais, et al.,
2005). In addition, childhood TB remains neglected for various reasons, mainly the difficulty in
diagnosing pulmonary TB, the lack of scientific studies on childhood TB, the largely unknown outcomes
of children with TB, and the belief that childhood TB is not important for TB control (Nelson & Wells,
2004). To top of it, the risk factor that is present in the client for disseminated TB is malnutrition. It is
noted that

G6PD is one of many enzymes that help the body process carbohydrates and turn them into energy.
G6PD also protects red blood cells from potentially harmful byproducts that can accumulate when a
person takes certain medications or when the body is fighting an infection.

In people with G6PD deficiency, either the RBCs do not make enough G6PD or what is produced cannot
properly function. Without enough G6PD to protect them, RBCs can be damaged or destroyed.
Hemolytic anemia occurs when the bone marrow (the soft, spongy part of the bone that produces new
blood cells) cannot compensate for this destruction by increasing its production of RBCs.

risk factors -> Contact with TB --||

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G6PD Deficiency ||

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Malnutrition -> Immunosuppression -> Acquired TB -> Hematogenous spread -> blood stream infection

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Susceptibility to infection -> HAP ---- TB Meningitis