Miliary tuberculosis and HIV

This chest x-ray shows reticulonodular shadowing. The pattern is more patchy and less fine than is shown in image number W0045323. In addition, the horizontal fissure is clearly visible and there is a small right-sided lamellar effusion (fluid between lung and visceral pleura). This patient was co-infected with HIV and Mycobacterium tuberculosis. Tuberculous pleural effusions occasionally occur with pulmonary tuberculosis. However, the combination of pulmonary and pleural disease is more in common with HIV co-infection. A lamellar effusion often suggests fluid overload.