Children with TB commonly have paucibacillary disease (low number of organisms) without evident lung cavitation but with involvement of intrathoracic lymph nodes.

Consequently, compared with adults, sputum smears from children are more likely to be negative and children are far less likely to be infectious.

Xpert MTB/RIF ideally would be used as the initial test while culture of sputum or other specimens, radiographic examination of the chest, and tests to detect TB infection are importance in diagnosis of pediatric TB.