<prompt> All of the following statements about Miliary Tuberculosis are true Except:May occur following primary infectionMay occur following secondary reactivationSputum microscopy is usually negativeMontoux is always positive  <response>: Answer is D Monotoux is always positive: 120. Montoux test is not always positive in cases of Miliary Tuberculosis. It may be negative non reactive as a result of anergy. Miliary Tuberculosis max occur following primary infection and secondary reactivation Miliary tuberculosis is due to hematogenous dissemination of tubercle bacilli. Classically miliary tuberculosis develops following hematogenous dissemination at the time ofprimary infection -Harrisons 1 lth629 In adults itdiary tuberculosis may be due to reactivation of old disseminated foci secondary reactivation - Harrisons 17th1013 Sputum microscopy is usually negative Harrisons 17th1013 Sputum smear microscopy is negative in 80 of cases - Harrison 17th1013 Montoux test is negative in 20-30 of patients with Miliary Tuberculosis The Tuberculn skin Test montoux may be non reactive due to anergy -Nelson 5th567 Tubercular anergy is common in Miliary Tuberculosis and a negative skin test should not be a deterrant to the consideration of this diagnosis - Harrison 11th629 Upto 30 of children have a negative tuberculin skin test - Tuberculosis : Current concepts and Treatment 2nd201 Liver, kidney and spleen are common sites of involvement along with other sites Almost every organ in the body may be involved. Mihaly tuberculosis is most prominent in Liver, spleen, kidney and other organs including bone marrow, adrenals, meninges, fallopian tubes and epididymis - Robbins 7th386 