Pulmonary tuberculosis versus Mycoplasma pneumoniae pneumonia in children: A retrospective analysis of clinical and imaging characteristics

This study aims to examine the differences in clinical and imaging characteristics between pulmonary tuberculosis and Mycoplasma pneumoniae pneumonia in pediatric patients. A retrospective analysis was conducted on the clinical data of 37 cases of pulmonary tuberculosis and 34 cases of M pneumoniae pneumonia diagnosed at the Guiyang Public Health Treatment Center between January 2023 and October 2024. The analysis focused on comparing the epidemiological characteristics, clinical presentations, laboratory findings, and imaging features of the 2 groups. The age range of the pulmonary tuberculosis group was 10 to 15 years, which was higher compared to the 5 to 10 years age range of the M pneumoniae pneumonia group. The incidence rates of fever (50.00% vs 10.81%), cough (91.18% vs 64.86%), and expectoration (52.94% vs 29.73%) were greater in the M pneumoniae pneumonia group than in the pulmonary tuberculosis group. Conversely, the pulmonary tuberculosis group exhibited significantly higher positive rates for the γ-interferon release test (86.49% vs 20.59%) and the tuberculin skin test (75.68% vs 26.47%), as well as a greater incidence of hypoalbuminemia (13.51% vs 0). A 4-fold increase in the titer of mycoplasma antibody was observed in 32.43% of cases. Pulmonary tuberculosis was more frequently associated with cavity formation (10.8% vs 0) and calcification (16.2% vs 0), whereas M pneumoniae pneumonia was primarily characterized by lung consolidation (17.6% vs 2.7%) and bilateral upper lobe involvement (29.4% vs 10.3%). Significant differences were observed in age distribution, immunological markers, and imaging characteristics between children with tuberculosis and those with M pneumoniae pneumonia. However, there is a substantial overlap in clinical symptoms. It is recommended to implement immunological screening for tuberculosis in children diagnosed with M pneumoniae pneumonia.