The Value of Neutrophil-to-Monocyte-Plus-Lymphocyte Ratio as a Marker for Discriminating Pulmonary Tuberculosis from Pneumonia

Abstract

Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body. Most infections do not have symptoms, in which case it is known as latent tuberculosis. About 10% of latent infections progress to active disease which, if left untreated, kills about half of those affected (WHO, 2016). Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs ¬known as alveoli. Typically, symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing. Severity is variable (Roudsari et al., 2020). Immune system status plays an important role in tuberculosis infection. Monocytes cells have been considered as the target cells of Mycobacterium tuberculosis, and lymphocytes are the main effector cells of TB immunity (Naranbhai et al., 2015). Neutrophils are typically the earliest immune cells recruited to a site of inflammation, and are an essential component of innate immune resistance to respiratory pathogens (Grommes and Soehnlein, 2011). We aimed in this study to evaluate the Neutrophil-to-Monocyte-Plus-Lymphocyte ratio as a diagnostic marker to