Clinical, hematological and biochemical alterations in pulmonary tuberculosis with coexisting skin infections

Pulmonary tuberculosis (PTB), caused by Mycobacterium tuberculosis, remains a major global health challenge, with Pakistan ranking among the countries with the highest disease burden. Coexisting skin infections may further complicate the clinical profile of patients with PTB, yet their clinical, hematological, and biochemical characteristics remain poorly understood. This study aimed to characterize the clinical, hematological, and biochemical alterations in patients with PTB with and without coexisting skin infections. In this cross-sectional comparative study, 128 participants were enrolled and allocated into four groups: patients with PTB, patients with PTB and coexisting skin infections (PTB + SI), patients with skin infections (SI) without PTB, and healthy individuals (H). Demographic, anthropometric, clinical, and hematological data were collected, and serum biochemical analyses were performed to assess lipid profile, liver function, renal function, serum electrolytes, calcium, and vitamin D levels. Compared with the SI and H groups, patients with PTB and PTB + SI had poorer nutritional status, greater clinical burden, and prevalence of comorbidities. Hematological findings were characterized by anemia and inflammatory changes, whereas biochemical alterations involved liver function, renal function, electrolyte balance, lipid metabolism, and vitamin D status. Compared with PTB alone, the PTB + SI group showed greater clinical, hematological, and biochemical alterations. Multinomial logistic regression identified BMI (aOR = 9.20) and hypertension (aOR = 12.96) as factors independently associated with the PTB + SI group. Correlation analysis showed differences in the patterns of associations among hematological and biochemical parameters across the study groups. These findings support integrated clinical assessment of patients with PTB and coexisting skin infections, including consideration of dermatological evaluation as part of comprehensive patient management. In high TB-burden settings such as Pakistan, routine assessment for coexisting skin infections may contribute to improved clinical care.