PRIME: Planning and Retrieval-Integrated Memory for Enhanced Reasoning.

Tuberculosis (TB) remains a major global health problem, with an estimated 10.6 million people falling ill and 1.6 million deaths in 2021 alone., The World Health Organization (WHO) Global Tuberculosis Report 2023 indicated that approximately 7.5 million people were diagnosed with TB in 2022—the highest number since WHO began global monitoring in 1995—and an estimated 10 million new cases occurred in 2023. The COVID-19 pandemic has caused unprecedented disruption to TB services worldwide, leading to increased TB incidence and mortality for three consecutive years (2020–2023), reversing the previous downward trend and consequently setting back decades of efforts in the global fight against TB. TB has once again become the leading cause of death from a single infectious agent, with mortality more than twice that of HIV/AIDS. An estimated 1.26 million TB deaths occurred in 2023, with nearly 700,000 excess TB-related deaths during 2020–2023. Among the various forms of TB, miliary tuberculosis represents one of the most severe and potentially lethal manifestations, resulting from the massive lymphohematogenous dissemination of  from a primary focus., The term “miliary,” derived from the Latin word  meaning related to millet seed, was first coined by John Jacob Manget in 1700 to describe the resemblance of gross pathological findings to innumerable millet seeds in size and appearance., Historically considered predominantly a disease of infants and children in the pre-antibiotic era, miliary TB has undergone a significant epidemiological shift over the past three decades and is now increasingly recognized in adults as well., This changing demographic pattern reflects several factors, including the global HIV/AIDS pandemic, increased use of immunosuppressive therapies, organ transplantation, chronic hemodialysis programs, and the introduction of biological agents such as anti-tumor necrosis factor-α (anti-TNF-α) therapies. The COVID-19 pandemic has further exacerbated the TB burden through healthcare disruptions, delayed diagnoses, and increased vulnerability in affected populations.,