Correct!

3. Influenza

All are causes of a miliary pattern with tuberculosis, fungal disease or metastatic disease making up over 95% of the cases. Sarcoidosis and pneumoconioses are rarer causes. Influenza has not been reported to cause a miliary pattern to our knowledge.

What should be done at this point?

1. Three sputum specimens on separate days for acid-fast bacilli and tuberculosis culture.
2. Biopsy of left axilla
3. Bronchoscopy with bronchoalveolar lavage
4. Open lung biopsy
5. Empiric treatment with amphotericin B

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