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Luis Horacio Gutiérrez-González,1 Esmeralda Juárez,2 Claudia Carranza,2 Laura E Carreto-Binaghi,2 Alejandro Alejandre,3 Carlos Cabello-Gutiérrrez,1 Yolanda Gonzalez2 1Virology and Mycology Department, National Institute for Respiratory Diseases Ismael Cosío Villegas, Mexico City, Mexico; 2Microbiology Department, National Institute for Respiratory Diseases Ismael Cosío Villegas, Mexico City, Mexico; 3Pediatric Clinic, National Institute for Respiratory Diseases Ismael Cosío Villegas, Mexico City, MexicoCorrespondence: Yolanda GonzalezMicrobiology Department, National Institute for Respiratory Diseases Ismael Cosío Villegas, Calzada de Tlalpan 4502, Sección XVI, Alcaldía de Tlalpan, 14080, Mexico City, MéxicoTel +52 55 5487 1700 Ext. 5117Email ygonzalezh@iner.gob.mxAbstract: The diagnosis of tuberculosis (TB) in children is difficult because of the low sensitivity and specificity of traditional microbiology techniques in this age group. Whereas in adults the culture of Mycobacterium tuberculosis (M. tuberculosis), the gold standard test, detects 80% of positive cases, it only detects around 30– 40% of cases in children. The new methods based on the immune response to M. tuberculosis infection could be affected by many factors. It is necessary to evaluate the medical record, clinical features, presence of drug-resistant M. tuberculosis strains, comorbidities, and BCG vaccination history for the diagnosis in children. There is no ideal biomarker for all TB cases in children. A new strategy based on personalized diagnosis could be used to evaluate specific molecules produced by the host immune response and make therapeutic decisions in each child, thereby changing standard immunological signatures to personalized signatures in TB. In this way, immune diagnosis, prognosis, and the use of potential immunomodulators as adjunct TB treatments wil