Ariel, a 25-year-old woman who works in the lab with you has severe rheumatoid arthritis and is receiving anti-TNF

Ariel, a 25-year-old woman who works in the lab with you has severe rheumatoid arthritis and is receiving anti-TNF monoclonal antibody therapy to immunosuppress her autoimmune response. Unfortunately, this therapy causes generalized immunosuppression. Ariel was gardening on Saturday and cleaned up the very back part of her yard that contained rotting apples and leaves that had been raked there the previous fall. She has developed a fever, cough, chest pain, and difficulty breathing. Her chest x-ray reveals patchy dense areas. 1. What disease do you think Ariel may have? Support your answer. 2. Can you test for antibody to diagnose Ariel’s illness? 3. How can Ariel be treated? (hint: think deeply…)

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