TNF-alpha inhibitors such as infliximab are a high-risk factor for reactivating latent TB, and she comes from an endemic area (Pakistan). Fever, weight loss, night sweats and an apical cavity are typical of reactivation pulmonary TB, which favours the oxygen-rich apices. Lung cancers and metastases do not explain the fever and night sweats after anti-TNF therapy, and sarcoidosis does not typically cause apical cavitation.