Role of neutrophil-lymphocyte ratio as a potential marker to differentiate between pulmonary tuberculosis and community-acquired pneumonia in children

Abstract

Background: This is often creating challenge to differentiate pulmonary tuberculosis (TB) with community acquired pneumonia (CAP) particularly in children. The neutrophil-lymphocyte count ratio (NLR) as an indicator of inflammation has been used in various infectious diseases. The aim of this study was to investigate the role of NLR as a possible marker in differentiating pulmonary TB from CAP.Methods: In this retrospective record based analytic study, conducted from July 2020 to Dec 2021, patient aged 2 months to 18 years diagnosed as pulmonary TB or CAP were enrolled in this study i.e., 155 children after exclusion. The diagnostic ability of NLR in differentiating between pulmonary Tb and CAP were assessed.Results: Out of 155 children, 85 (54.8%) had CAP and 70 (45.1%) had pulmonary TB. Mean values of NLR were significantly lower in patients with TB than in pneumonia (3.16±1.9 vs 5.05±1.2, p<0.000). Total WBC, neutrophil, Hb and CRP were also significantly lower in patients with pulmonary TB. On the other hand, lymphocyte count was significantly higher in children with pulmonary TB in compare to children with pneumonia (p=0.04).Conclusions: The NLR can be used as a useful simple laboratory marker in differentiating children with Pulmonary TB from CAP, especially in resource limited high TB disease burden countries.