[Pathogenesis of tuberculosis].

Abstract

1. Infection with M. Tuberculosis and primary complex-formation. Infection begins with entry of M. Tuberculosis into the human pulmonary airspace and phagocytosis by alveolar macrophage (AM). M. Tuberculosis proliferates in the AM and another phagocytosis repeats until coagulation necrosis and epithelioid cell granuloma formation takes place several weeks after infection. Primary focus and corresponding lymph nodes were affected by necrotizing epithelioid cell granuloma, which is characterized with exudative typed necrosis. Usually proliferation of M. Tuberculosis ceases after necrotizing granuloma formation. 2. Development of Tuberculosis. Limited person became tuberculosis after infection. There are two types of tuberculosis; primary (following infection) and secondary (internal reactivation months to years after infection). When M. Tuberculosis does not confined in the primary complex, then primary tuberculosis begins. Secondary tuberculosis begins if primary complex or minor disseminated lesions worsened by unknown cause such as cavity formation following softening or new productive typed necrosis formation based on the original lesion. Recently reinfection tuberculosis was seen among old aged persons.