Background

Tuberculosis(TB) remains a major and global health dis-ease[1,2]. Recent studies have shown the link between acute respiratory distress syndrome (ARDS) and pulmon-ary TB[3,4]. Pulmonary TB complicated by ARDS is often found in the setting of miliary TB[3-6]. Most reports on ARDS caused by miliary TB are small numbers of patients in the case reports. Compared with miliary TB alone, mil-iary TB with ARDS portends a higher mortality of 33-90% [7-9]. Duration of miliary TB beyond 20 days tends to markedly increase the risk of ARDS [10]. It is very import-ant for recognition of ARDS caused by miliary TB. Despite being a well-documented entity, miliary TB complicated by ARDS remains a challenging diagnosis due to its variable clinical manifestations and low morbidity. Some predictors such as AST, and ALT[4,10] in miliary TB with ARDS have drawn our attention. Numerous cas