# Anti-Tubercular-Therapy-Induced Severe Thrombocytopenia Presenting as a Vocal Cord Bleed With Massive Hemoptysis Causing Mortality: A Catastrophic Combination

## TL;DR

A rare case shows that anti-tuberculosis drugs can cause severe blood platelet drop, leading to fatal bleeding from the vocal cords.

## Contribution

Highlights a rare and fatal complication of anti-tubercular therapy-induced thrombocytopenia causing massive hemoptysis.

## Key findings

- Anti-tubercular therapy can induce severe thrombocytopenia leading to fatal hemoptysis.
- Vocal cord bleeding can be a source of massive hemoptysis in thrombocytopenic patients.
- Thorough airway evaluation is crucial in patients with unexplained massive hemoptysis.

## Abstract

Severe thrombocytopenia induced by anti-tubercular therapy (ATT) is a rare but potentially life-threatening complication. Severe thrombocytopenia is a known adverse effect of ATT, but its association with fatal hemoptysis is rare. Hematemesis and hemoptysis are two serious symptoms that indicate bleeding from the upper gastrointestinal and the lower respiratory tract, respectively. We report a rare case of a 65-year-old man, a diagnosed case of tuberculosis on ATT, who presented with massive hemoptysis. On navigating the bleed, the source was found to be a vocal cord bleed, which further led to massive clot formation in the left bronchus, leading to the collapse of the subsequent lung, leading to mortality. This case emphasizes the importance of recognizing ATT as a potential cause of bleeding and considering causes of massive hematemesis that are not gastrointestinal. It also highlights the need for a thorough evaluation of the airway in such patients.