TB is characterized by granulomatous inflammation and caseous necrosis, with neutrophils playing a significant role in its pathogenesis.6–9 Activated macrophages release tumor necrosis factor (TNF) and chemokines, recruiting more monocytes and ultimately leading to the death of the mycobacterium.10 Hematological parameters such as neutrophils, lymphocytes, and monocytes exhibit variations in TB patients.11–13 In recent years, ratios derived from various hematological parameters have been explored as markers of inflammation in multiple diseases. Here, TNF is linked to inflammatory response.