Pediatric pneumonia and tuberculosis, but pneumonia has a rapid onset and short course; tuberculosis mostly has a slow onset and long course. Misdiagnosis often occurs at an early stage, so in addition to careful observation and grasp of history, symptoms and signs, timely chest X-ray and blood tests can help in the differential diagnosis of the two. Pediatric pulmonary disorders include both pediatric pneumonia and pediatric tuberculosis. Pediatric pneumonia as the most common evidence of clinical pulmonary disorders in pediatrics. However, when a child has fever, cough, or shadow on chest fluoroscopy, careful consideration needs to be given to whether it is pneumonia or tuberculosis; if not carefully analyzed, misdiagnosis and delayed treatment can result, causing great damage to the child. The differential diagnosis of pediatric tuberculosis and pneumonia is divided as follows: 1. Bronchopneumonia should be differentiated from hilar lymph node tuberculosis when the X-ray shows increased hilar texture. (1) Differentiation by symptoms: Most bronchopneumonia has an acute onset with high fever, cough, sputum, and wheezing. Pulmonary hilar lymph node tuberculosis is usually asymptomatic, and coughing symptoms occur when the lymph nodes become enlarged to a certain extent and compress the bronchi. (2) The important sign of bronchopneumonia is dry moist rales in both lungs, while hilar lymphatic tuberculosis lacks pulmonary signs. (3) Blood features: bacterial pneumonia has high total leukocyte count and elevated neutrophils; viral pneumonia does not have high total leukocyte count, neutrophils are not elevated, and lymphocytes are elevated. In contrast, when infected with tuberculosis, monocytes increase and relative lymphocytes decrease. (4) Both have increased lung texture on chest X-ray. In bronchopneumonia, the inflammation spreads from the bronchi, so the lung texture is heavier and soon there are speckled shadows in the lung fields, spreading outward from the hilum. In hilar lymph node tuberculosis, enlarged lymph nodes and perilymph node inflammation near the hilum form a deepened hilar shadow, but there is no lesion in the lung field. Therefore, timely review of chest X-ray can help to differentiate. 2, infiltrative tuberculosis and mycoplasma pneumonia Mycoplasma pneumonia is caused by mycoplasma, the symptoms vary in severity, and most of them are asymptomatic. When mycoplasma pneumonia only has low fever, dry cough and lamellar shadows in the lungs, it is easily confused with infiltrative tuberculosis, so it should be differentiated. (1) X-ray examination: The pulmonary infiltrate of mycoplasma pneumonia extends from the pulmonary hilum to the lung fields, sometimes very lightly and sometimes diffusely, especially in the middle and lower lobes of the lung, with a few lobar shadows. Often, one infiltrate has dissipated and a new infiltrate has developed elsewhere. Infiltrative pulmonary tuberculosis mostly occurs in the apical or upper part of both lungs with blurred marginal shadows of a hairy glass type. (2) Mycoplasma pneumonia is characterized by mild signs and often significant lesions on x-ray. (3) The duration of mycoplasma pneumonia is about 2 to 3 weeks and may not heal spontaneously, but there are often recurrences. In contrast, tuberculous infiltrative lesions are absorbed more slowly and must be treated promptly with antituberculous drugs. (4) Condensation set test, 2 weeks after the onset of mycoplasma pneumonia is positive (1:32 or more), while tuberculosis is negative. A tuberculin test is required for differentiation if necessary. Although both pneumonia and tuberculosis are pulmonary diseases, the difference is that pneumonia has a rapid onset and a short course, whereas tuberculosis mostly has a slow onset and a long course. Misdiagnosis between the two often occurs at an early stage, so in addition to careful observation and knowledge of medical history, symptoms and signs, timely chest X-ray and blood tests can help in the differential diagnosis of the two.