{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T06:08:58Z","timestamp":1779170938505,"version":"3.51.4"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the clinical and Imaging characteristics between children with pediatric pulmonary tuberculosis (PTB) and children with pneumonia who were initially suspected of PTB, and to explore valuable indicators for differential diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study enrolled pediatric inpatients initially suspected of PTB at Guangzhou Chest Hospital from March 2020 to May 2021. All participants were divided into the PTB group and the control group. Clinical characteristics, laboratory results, and chest computed tomography (CT) imaging findings were compared between the two groups. On the basis of univariate analysis, variables were further screened via the least absolute shrinkage and selection operator (LASSO) regression with reference to clinical significance. A stable and reliable predictive model was finally established using Firth penalized logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 63 children were enrolled in this study. Among them, 48 were finally diagnosed with PTB, including 23 cases with etiological confirmation and 25 cases with clinical diagnosis, which constituted the PTB group. The remaining 15 children were diagnosed with pneumonia and assigned to the control group. Compared with the control group, the PTB group had a significantly higher rate of tuberculosis contact history, longer pre-hospital symptom duration, and higher rates of pre-hospital antibiotic and systemic glucocorticoid use. In terms of chest CT manifestations, multiple pulmonary nodules, hilar\/mediastinal\/axillary lymphadenopathy, calcification, and fine linear or reticular opacities were significantly more common in the PTB group. The final predictive model was constructed based on the two most differentiating imaging features, namely multiple pulmonary nodules and hilar\/mediastinal\/axillary lymphadenopathy, and presented excellent diagnostic efficacy. The area under the receiver operating characteristic curve was 0.99. The corresponding sensitivity, specificity and overall accuracy were 93.75%, 100% and 95.24%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study preliminarily developed an imaging model based on multiple pulmonary nodules and hilar\/mediastinal\/axillary lymphadenopathy, which may assist in distinguishing pediatric PTB from pneumonia. However, given the single-center, specialized-hospital setting of this study and the exclusion of certain patient subgroups, the generalizability of these findings is limited. Therefore, the conclusions require validation through future multicenter, large-scale prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1812951","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:40:29Z","timestamp":1779169229000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and imaging features in the differentiation of pediatric pulmonary tuberculosis and pneumonia"],"prefix":"10.3389","volume":"14","author":[{"given":"Xiaoxia","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Guangzhou Chest Hospital","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaomei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Guangzhou Chest Hospital","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nontuberculous Mycobacteria, Guangzhou Chest Hospital","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"B1","volume-title":"WHO Consolidated Guidelines on Tuberculosis: Module 5: Management of Tuberculosis in Children and Adolescents","year":"2022"},{"key":"B2","first-page":"486","article-title":"Problems and thoughts on diagnosis and treatment of pediatric tuberculosis","volume":"37","author":"Liu","year":"2022","journal-title":"Chin J Appl Clin Pediatr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1016\/S0140-6736(24)02479-6","article-title":"Tuberculosis","volume":"405","author":"Trajman","year":"2025","journal-title":"Lancet"},{"key":"B4","first-page":"642","article-title":"Diagnosis of pulmonary tuberculosis WS288-2017","volume":"17","year":"2018","journal-title":"Chin J Infect Control"},{"key":"B5","first-page":"6","article-title":"Diagnostic criteria for community-acquired pneumonia in children (2019 edition)","volume":"12","year":"2019","journal-title":"Chin J Clin Infect Dis"},{"key":"B6","volume-title":"Global Tuberculosis Report 2025","year":"2025"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e202410498","DOI":"10.5546\/aap.2024-10498","article-title":"Tuberculosis in children and adolescents: diagnostic criteria and treatment","volume":"122","author":"Gonz\u00e1lez","year":"2024","journal-title":"Arch Argent Pediatr"},{"key":"B8","first-page":"224","article-title":"Clinical analysis of 467 cases of pediatric tuberculosis","volume":"30","author":"Xu","year":"2020","journal-title":"Zhejiang J Integr Tradit Chin West Med"},{"key":"B9","first-page":"490","article-title":"Expert consensus on the diagnosis of pulmonary tuberculosis in children","volume":"37","year":"2022","journal-title":"Chin J Appl Clin Pediatr"},{"key":"B10","first-page":"491","article-title":"Clinical feature analysis of 473 cases of pediatric extrapulmonary tuberculosis","volume":"42","author":"Ma","year":"2024","journal-title":"J Clin Pediatr"},{"key":"B11","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1016\/j.pcl.2017.03.010","article-title":"Tuberculosis in children","volume":"64","author":"Thomas","year":"2017","journal-title":"Pediatr Clin North Am"},{"key":"B12","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1186\/s12879-016-1617-9","article-title":"Smear positivity in paediatric and adult tuberculosis: systematic review and meta-analysis","volume":"16","author":"Kunkel","year":"2016","journal-title":"BMC Infect Dis"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2094","DOI":"10.3390\/medicina61122094","article-title":"CT imaging features of pulmonary sarcoidosis: typical and atypical radiological features and their differential diagnosis","volume":"61","author":"Baratella","year":"2025","journal-title":"Medicina (B Aires)"},{"key":"B14","doi-asserted-by":"publisher","first-page":"306","DOI":"10.3390\/diagnostics12020306","article-title":"The diagnostic deceiver: radiological pictorial review of tuberculosis","volume":"12","author":"Alshoabi","year":"2022","journal-title":"Diagnostics"},{"key":"B15","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1007\/s11547-016-0683-9","article-title":"Radiological patterns of childhood thoracic tuberculosis in a developed country: a single institution\u2019s experience on 217\/255 cases","volume":"122","author":"Tom\u00e0","year":"2017","journal-title":"Radiol Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/s12880-019-0355-z","article-title":"Computed tomography-based predictive nomogram for differentiating primary progressive pulmonary tuberculosis from community-acquired pneumonia in children","volume":"19","author":"Wang","year":"2019","journal-title":"BMC Med Imaging"},{"key":"B17","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1016\/j.ijmyco.2016.06.015","article-title":"Determining the lymphadenopathy characteristics of the mediastinum in lung CT scan of children with tuberculosis","volume":"5","author":"Mehrian","year":"2016","journal-title":"Int J Mycobacteriol"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1812951\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:40:31Z","timestamp":1779169231000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1812951\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":17,"alternative-id":["10.3389\/fped.2026.1812951"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1812951","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]},"article-number":"1812951"}}