Introduction

Germination of the organism results in transformation to vegetative bacteria with subsequent exotoxin production which results in hemorrhage and edema in the lymph nodes and mediastinum.

Pleural effusions and thickening of the bronchovascular bundles result from lymphatic stasis and edema related to extensive lymph node involvement. Ultimately, the bacteria enter the blood stream via the thoracic duct, resulting in severe septicemia and often death.

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