An unusual presentation of miliary tuberculosis with medullary nephrocalcinosis in an infant

Miliary tuberculosis (MTB) is a rare and potentially fatal manifestation of <i>Mycobacterium tuberculosis</i> infection, resulting from hematogenous dissemination of the primary infection. Although more commonly seen in immunocompromised individuals, infants are also susceptible due to their immature immune systems. We present the case of an 88-day-old female with MTB and extrapulmonary disease involving the liver, spleen, kidneys, and retina. Imaging demonstrated diffuse pulmonary nodules, hepatic and splenic granulomas, and nephrocalcinosis. This case highlights the hallmark radiologic features seen in MTB and extrapulmonary disease, along with imaging of medullary nephrocalcinosis, a rare extrapulmonary manifestation.