Adalimumab (along with infliximab and etanercept) is a TNF inhibitor. As of 2008 adalimumab has been approved by the FDA for the treatment of rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, moderate to severe chronic psoriasis and juvenile idiopathic arthritis. 

Although most easily seen in the lungs, miliary TB is a systemic illness with solid organs also affected. In this case splenic and hepatic involvement is evident. 

This patient went on to receive appropriate systemic antibiotics.