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In miliary tuberculosis, Koch’s invading bacilli can metastasize throughout the body from an initial lesion in the lungs. But since Mycobacteria can sometimes enter the body via the different pathways of ingestion, inoculation, or vertical transmission, they can establish the original infection in a locus other than the lungs. This multiplicity of possible sites of infection makes tuberculosis one of the most polymorphous of all diseases, capable of attacking any tissue or organ—skin, heart, central nervous system, meninges of the brain, intestines, bone marrow, joints, larynx, spleen, kidney, liver, thyroid, and genitals. Potentially, therefore, TB can appear in a wide array of guises, enabling it to mimic other diseases and making physical diagnosis notoriously difficult.
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Frank M. Snowden III (Epidemics and Society: From the Black Death to the Present)