Review Question - QID 214281

A 40-year-old woman is brought by her family to the emergency department after they found her confused this morning at home. The day prior, the patient had been complaining of feeling tired and feverish and had noticed that she was developing a rash. Her family reports that she had not complained of any other symptoms prior to today. In the emergency department, the patient has a temperature of 101.7°F (38.7°C), blood pressure is 110/76 mmHg, pulse is 92/min, and respirations are 14/min. The patient is currently alert and oriented only to person, but not to place or time. Her dermatological exam is noted in Figure A. A urine toxicology screen is negative, and the patient is not pregnant. The urine is dark, however, and the dipstick is positive for blood. The patient’s blood smear is shown in Figure B. Which of the following is the most likely mechanism of the patient’s disease?