How to distinguish between pulmonary tuberculosis and pneumonia in children?

When the children with fever, cough, chest to cast a shadow perspective, it should be carefully considered by pneumonia or tuberculosis, if not seriously careful analysis, can result in misdiagnosis and delayed treatment, causing great loss to the patient. Children with pneumonia and tuberculosis in children, the same pulmonary disease. The pediatric pneumonia is the Department of Pediatric Clinical lung diseases the most common syndromes. How to identify the two are set out below:

(1) bronchial pneumonia in the X ray showed hilar texture weight gain, should be identified with the hilar lymph node tuberculosis. ① start with the identification of the symptoms: bronchial pneumonia, most of the rapid onset, high fever, cough, expectoration, Chuancu. Nuclear generally asymptomatic hilar lymph nodes, when the lymph nodes to a certain degree of repression occurs when the bronchial cough. ② the important signs of bronchial pneumonia, is the lungs are wet and dry sex rale, while the lack of pulmonary hilar lymph nodes were signs of nuclear. ③ hemogram characteristics: the total number of bacterial pneumonia in high white blood cells, neutrophils, increased; viral pneumonia, the total number of white blood cells is not high, not high neutrophils and lymphocytes increased. And when infected with TB, the mononuclear cells increased, relative lymphopenia. ④ chest weight gain during both lung markings. Bronchial pneumonia, inflammation by bronchial proliferation, therefore, weight gain and lung markings will soon appear patchy lung field shadows, spread outward from the hilum. Hilar lymph node tuberculosis, the hilar lymph nodes and lymph node swelling near the peri-hilar shadow formed by the deep, but the lung fields without lesions. It is timely to chest review helpful to differentiate.

(2) infiltration of pulmonary tuberculosis and identification of mycoplasma pneumonia. Mycoplasma pneumonia caused by mycoplasma, symptoms, malaise, most asymptomatic. Mycoplasma pneumonia when only slight fever, dry cough and pulmonary shadow flakes easily be confused with the invasive pulmonary tuberculosis, should be identified. ① X-ray examination: Mycoplasma pneumonia and pulmonary infiltration extended from the hilar lung fields, sometimes very light and sometimes they diffuse a wider, particularly in the lung lower lobe is a common, a small number of large leaf shadow. Tend to disperse and it has been a new invasion took place at another. Infiltrative pulmonary tuberculosis occurred within the two apex or upper edge of ambiguity was ground-glass shadows. ② mycoplasma pneumonia symptoms are often mild and X-significant lesions, which is one of the characteristics of its. ③ course of mycoplasma pneumonia about 2 ~ 3 weeks, self-healing may be dead, but often relapse. The infiltration of tuberculous lesions more slowly absorbed, must be promptly treated with anti-TB drugs. ④ agglutination, in the pathogenesis of mycoplasma pneumonia 2 weeks after positive (1:32 or above), tuberculosis was negative. When necessary, subject to the tuberculin test to be identified.

Children with pneumonia and tuberculosis, although the Department are of lung disease, pneumonia, acute onset and short duration; TB mostly slow onset and long course. Often prone to misdiagnosis in the early, in addition to careful observation and grasp the history, symptoms, signs, the time to do chest and blood as the inspection will help both the differential diagnosis.