Concurrent Lepromatous Leprosy and Active Tuberculosis in A Young Male: A Complex Diagnostic and Therapeutic Challenge with Hematologic Manifestations

This report details the clinical evolution of a 23-year-old male presenting with the exceptionally rare co-occurrence of active lepromatous lerosy and tuberculous lymphadenitis, complicated by severe immune thrombocytopenia. The patient’s presentation—spanning chronic dermatological findings, acute systemic symptoms, and profound hematological disturbance—required a multifaceted diagnostic approach culminating in histopathological and microbiological confirmation of both mycobacterial infections. Management was successfully integrated, utilizing a single rifampin-based antitubercular regimen to simultaneously address both diseases, resulting in resolution of thrombocytopenia and significant clinical improvement. This case highlights the diagnostic complexity in co-endemic regions, the potential for tuberculosis to drive significant parainfectious hematologic complications, and the feasibility of a unified pharmacological strategy for dual mycobacterial disease.