Pathogenesis of paratuberculosis.

Paratuberculosis in ruminants is characterized by oral ingestion of Mycobacterium avium subsp. paratuberculosis (MAP), followed by a long incubation period during which time MAP is able to survive within the host’s macrophages. Initially the infection is held in check by the host’s cell-mediated immune response, but gradually the host loses control of the infection. The infection incites a granulomatous inflammatory response in intestinal tissue and mesenteric lymph nodes, resulting in protein-losing enteropathy, malabsorption, diarrhea, weight loss, and edema.