Mycobacterium tuberculosis infection can lead to different disease outcomes, we analyze a with-in host tuberculosis infection model considering interactions between macrophages, T lymphocytes, and tuberculosis bacteria to understand the dynamics of disease progression. Four coexisting equilibria that reflect TB disease dynamics are present: clearance, latency, and primary disease, with low and high pathogen loads. We also derive the conditions for backward and forward bifurcations and for global stable disease free equilibrium, which affect how the disease progresses. Numerical bifurcation analysis and simulations elucidate the dynamics of fast and slow disease progression.