Miliary TB vs. Open Pulmonary TB: Key Clinical Differences

Feature	Miliary TB	Open (Cavitary) Pulmonary TB
Spread	Hematogenous → diffuse micronodules in lungs, liver, spleen, brain, etc.	Localized to lungs with cavitation; airways communicate with cavities.
Transmissibility	Not directly person-to-person.	Highly infectious—aerosolizes bacilli via cough.
Symptoms	Fever, weight loss, night sweats, hepatosplenomegaly; organ-specific signs later.	Chronic cough, hemoptysis, fever, weight loss.
Diagnosis	CXR: diffuse 1–2 mm nodules; biopsy often needed.	Sputum AFB/NAAT positive; CXR shows upper lobe cavities.
Treatment Duration	9–12 months (4-drug intensive phase).	Standard 6-month regimen (2HRZE/4HR) for drug-sensitive.

Both are serious conditions. Miliary TB is a medical emergency requiring prompt multidrug therapy. Open pulmonary TB drives community transmission and requires aggressive infection control.