A 48-Year-Old Man Who Recently Immigrated to the United States

A 48-year-old man who recently immigrated to the United States comes to the physician with multiple skin lesions.  Physical examination shows a few well-defined, hypopigmented lesions on the skin of his lower extremities that have diminished sensation.  After confirming the diagnosis of leprosy, the patient undergoes further testing to help classify the severity of his disease.  Intradermal injection of heat-killed Mycobacterium leprae causes the development of a large indurated nodule.  The patient is most likely to demonstrate which of the following additional findings?

A) Blood smears positive for mycobacteria
B) High serum level of protective antimycobacterial antibodies
C) Inactivated macrophages
D) Increased interleukin-2 and interferon-γ in skin lesions
E) Numerous acid-fast bacteria in skin lesions

Correct Answer:

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