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A 36-year-old man is required to attend a Pulmonary clinic as part of a contact ...

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A 36-year-old man is required to attend a

Pulmonary clinic as part of a contact investigation for a person who tested positive for tuberculosis. He works in a factory where he encounters a large number of

unvaccinated persons among whom the disease has begun to spread. Since the man

is properly vaccinated and his results are negative, this check is performed only a

once.

Mycobacterium tuberculosis

is a specific bacterium that is

able to survive after phagocytosis inside macrophages. Once it is engulfed by

macrophages, it starts to produce a protein called PtpA (protein tyrosine

phosphatase A). These molecules knock out two different mechanisms that the

macrophage needs to create the acidic environment necessary for bacteria to

break down. As a result, the tuberculosis bacteria hide inside the macrophages

and completely escape the attention of the immune system. When they multiply

sufficiently, they escape the cell and invade other parts of the body. What

should properly occur after phagocytosis and destruction of these bacteria

inside the macrophage?

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