<prompt> All of the following statements about Miliary Tuberculosis are true Except -May occur following primar in fectionMay occur follwoing secondary reactivationSputum microscopy is usually negativeMontoux is always positive  <response>: Ans. is d i.e., Montoux is always positive o Montoux test is not always positive in cases of miliary tuberculosis.o It may be regative non reactive as result of energy.Miliary Tuberculosis may occur foil only primary infection and secondary reactivationo Miliary tuberculosis is due to hematogenous dissemination of tubercle bacilli.y Classically miliary tuberculosis develops following hematogenous disseminaton at the time of primary infection.In adults miliary tuberculosis may be due to reactivation of old disseminated foci secondary- reactivation.o Sputum microscopy is usually negative Harrisons 17th1013Sputum smear microsocopy is negative in 80 of cases.o Montoux test is negative in 20-30 of patients with miliary tuberculosisThe Tuberculn skin test montoux be non reactive due to anergy-;Tubercular anergy is common in miliry tuberculosis and a negative skin test should not be a deterrant to the consideration of this diagnosis.Upto 30 of children have a negative tuberculin skin test.o Liver, kidney and spleen are common sites of involvement alone with other sitesAlmost every organ in the body may be involved. Miliary tuberculosis is most prominent in liver, spleen, kidney and other organs including bone marrow, adrenals, meninges, fallopian tubes and epididymis. 