# Case Report: Management challenges of active tuberculosis complicated by thrombocytosis and squamous cell lung carcinoma

## TL;DR

This case report describes managing a complex patient with tuberculosis, high platelet levels, and lung cancer using a step-by-step treatment approach.

## Contribution

The paper introduces a sequential treatment strategy combining anti-TB therapy with aspirin to manage thrombocytosis before cancer treatment.

## Key findings

- Combining anti-TB therapy with aspirin normalized platelet levels in a patient with tuberculosis and thrombocytosis.
- Anticancer treatment could be safely initiated after stabilizing TB and platelet counts.
- This approach successfully managed multiple overlapping medical conditions in a single patient.

## Abstract

This report assesses the feasibility of a sequential treatment strategy for a patient with active tuberculosis (TB) complicated by thrombocytosis and squamous cell lung carcinoma, involving initial anti-TB therapy combined with aspirin, followed by anticancer treatment. It highlights the challenge of balancing infection control, hematologic stability, and oncologic management in this complex scenario.

A 55-year-old man with a 15-day history of cough, sputum, and fever was found to have markedly elevated platelet levels. Bronchoscopy confirmed active TB with concurrent lung cancer. Following anti-TB therapy combined with aspirin for antiplatelet management, platelet counts returned to normal. One month later, antitumor chemotherapy with nab-paclitaxel and carboplatin was initiated, leading to effective disease control.

Active TB complicated by thrombocytosis and squamous cell lung carcinoma poses diagnostic and therapeutic challenges. This case demonstrates that early anti-TB therapy combined with aspirin can effectively normalize platelet counts and facilitate the timely initiation of anticancer treatment.