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Updated: Jun 28, 2025

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
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Paediatric pulmonary disease-are we diagnosing it right?

Priya Rajendran1, Silla Varghese Thomas1, Sarath Balaji2

  • 1ICMR-National Institute for Research in TB, Chennai, India.

Frontiers in Pediatrics
|April 25, 2024
PubMed

Insights

Diagnosing tuberculosis (TB) in children is challenging. A real-time multiplex PCR test can detect TB alongside other respiratory pathogens, aiding in accurate diagnosis of pediatric pneumonia.

Area of Science:

  • Pediatric infectious diseases
  • Microbiology
  • Molecular diagnostics

Background:

  • Differential diagnosis of bacterial/viral pneumonia and tuberculosis (TB) in children is complex due to difficulties in microbiological confirmation.
  • Pediatric pulmonary TB diagnosis requires improved methods for accurate identification of causative pathogens.

Purpose of the Study:

  • To evaluate the effectiveness of a real-time multiplex PCR assay for diagnosing respiratory pathogens in children with pulmonary TB.
  • To assess the utility of multiplex PCR in differentiating TB from other common respiratory infections in pediatric patients.

Main Methods:

  • 185 respiratory samples from children aged 3-12 years were analyzed.
  • Samples underwent N-acetyl L-cysteine (NALC) NaOH treatment for Mycobacterium tuberculosis (MTB) detection via smear microscopy, Xpert® MTB/RIF, and liquid culture.
  • Multiplex real-time PCR was performed on processed sputum for bacterial and fungal pathogens.

Main Results:

  • 20 out of 185 samples were positive for MTB.
  • Of the MTB-positive samples, 15 also showed co-infection with bacterial or fungal pathogens.
  • 145 (87%) of MTB-negative samples were positive for other bacterial or fungal pathogens.

Conclusions:

  • Tuberculosis can coexist with other respiratory pathogens in children.
  • Simultaneous detection methods like multiplex PCR are valuable for diagnosing pediatric TB and pneumonia.
  • Large-scale, multi-geographical studies are needed to confirm the utility of these rapid diagnostic tests.
Abstract

Keywords:
childrencoinfectiondiagnosismultiplex real-time PCRpneumoniatuberculosis

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