The pathogenic capacity of the tubercle bacillus is related to:
A) Formation of a Ghon focus lesion
B) Its inherent destructive capabilities
C) Rapid viral replication in host cells
D) The initiation of a cell-mediated immune response
Ans: D
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The pathogenesis of tuberculosis, in previously unexposed immunocompetent people, is a cell-mediated immune response that confers resistance to the organism and development of hypersensitivity to the tubercular antigens. Pathologic manifestations of tuberculosis, such as caseating granuloma and cavitation, are the result of the hypersensitivity reaction rather than its inherent destructive capabilities. In persons with intact cell-mediated immunity, the cell-mediated immune response results in the development of a granulomatous lesion, called a Ghon focus, that contains the tubercle bacilli, modified macrophages, and other immune cells.
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