system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 55-year-old woman comes to the physician because of fevers for 2 weeks. She works as a nurse and recently returned from a charity work trip to India, where she worked in a medically-underserved rural community. A tuberculin skin test 3 months ago prior to her trip showed an induration of 3 mm. Physical examination is unremarkable. An x-ray of the chest shows right-sided hilar lymphadenopathy. A sputum culture shows acid-fast bacilli. Which of the following immunologic processes most likely occurred first?
assistant
Replication of bacteria within alveolar macrophages