Asthma, a prevalent chronic respiratory condition affecting millions of children globally, presents a significant health challenge. This review critically examines the developmental pathways of asthma in children, focusing on genetic, environmental, and early-life determinants. Specifically, we explore the impact of prenatal and postnatal factors such as maternal smoking, nutrition, respiratory infections, and allergen exposure on asthma development. Our analysis highlights the intricate interplay of these influences and their contribution to childhood asthma. Moreover, we emphasize targeted strategies and interventions to mitigate its burden, including genetic counseling for at-risk families, environmental modifications to reduce triggers, and early-life immunomodulation. By delving into these preventive measures and interventions, our review aims to provide actionable insights for healthcare professionals in developing tailored strategies to address the complexities of childhood asthma. In summary, this article offers a detailed examination of asthma development in children, aiming to enhance understanding and inform efforts to reduce its burden through targeted interventions.

Pediatric tuberculosis (TB) remains diagnostically challenging because of nonspecific presentations and the frequent absence of microbiological confirmation. We aimed to characterize pediatric TB patients presenting to a non-specialized tertiary hospital in Romania and to explore factors associated with bacteriological confirmation. We retrospectively analyzed children diagnosed with TB between 2017 and 2025 at a tertiary pediatric hospital in Bucharest. Clinical, epidemiological, laboratory, radiological, microbiological, and follow-up data were evaluated. Factors associated with bacteriological confirmation were assessed using univariate and exploratory multivariable analyses. Among 48 patients, the median age was 14 years (IQR 8.25–16), and 37.5% of cases were bacteriologically confirmed. Initial presentations were pleural effusion (47.9%), pneumonia (41.7%), and cavitary disease (10.4%). No patient with pleural effusion had a documented TB contact, compared with 45.0% with pneumonia and 40.0% with cavitary disease (p < 0.001). Bacteriologically confirmed patients were older and more frequently had cavitary lesions. In exploratory Firth penalized logistic regression, older age and the presence of cavitary lesions remained associated with bacteriological confirmation. Pediatric TB may mimic common respiratory diseases even without known TB contact. In exploratory Firth penalized logistic regression, older age and cavitary lesions were associated with bacteriological confirmation, although the estimates, particularly for cavitary lesions, were imprecise and should be interpreted cautiously, while the substantial proportion of clinically diagnosed cases highlights the importance of integrating clinical, radiological, immunological, and microbiological findings.