Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: patient recorded as having no known allergies to drugs attending: chief complaint: shortness of breath major surgical or invasive procedure: none history of present illness: 71 yo f with h/o cad, a. fib, copd, recent diagnosis of hepatocellular carcinoma presents with one day of worsening shortness of breath. she reports that within the last week, she developed productive cough and shortness of breath which worsened so that she was feeling short of breath at rest this morning and albuterol nebs, combivent mdi were not providing any relief. she was seen at on and her steroids were increased to 20mg daily and she was started on azithromycin, but she says this did not provide any relief either. she denies subjective fevers with her worsening respiratory status, but says she transiently had low grade fevers on wednesday in the setting of diarrhea which has since resolved. she denies chest pain/palpitations. she does report chronic low right lateral rib pain in the setting of her hepatic malignancy. . pfts reveal fev1 of 1.05 (66% predicted) and fev1/fvc of 99% predicted. dlco was reduced at 54% predicted. . in the ed, vitals were t 98.4 hr 82 bp 127/99 rr 22 o2 sat 100% by written documentation although by verbal report o2 sats were in the low 90s and she was diffusely wheezy on exam. cxr did not reveal e/o chf nor infiltrates and ct chest did not show consolidation. she had a ct head for her headache in the setting of known malignancy which has not yet been read. ct abdomen showed liver mass causing mass effect on ivc, but no evidence of ivc thrombosis. it also showed diverticulosis/no diverticulitis. cta chest showed second order left lower lobe pe of doubtful clinical significance. she has been requiring continuous nebs and, thus, was transferred to the for continued respiratory care. . ros: she has had left occipital to left frontal headache x 2days. she has blurry vision in left eye at baseline ? cataracts. she denies numbness/tingling/weakness. she had diarrhea upon return from a recent cruise, but c. diff and stool studies were negative. she has not had diarrhea x several days. she denies melena/hematochezia. no dysuria/hematuria. she reports poor uop x 2 days and decreased po food and fluid poor appetite. she feels thirsty currently. past medical history: 1. cad/mi/cabg() 2. atrial fibrillation 3. pe transiently on warfarin, now s/p ivc filter (developed rpb while on coumadin previously) 4. rheumatoid arthritis 5. oa 6. mild copd 7. htn 8. depression 9. right adrenal adenoma 10. b/l rotator cuff repairs 11. hepatocellular carcinoma followed by dr. of transplant and dr. of hem/onc 12. chf, diastolic dysfunction 13. psoriasis 14. recurrent utis 15. herpes zoster 16. s/p b/l caratact surgery social history: social history: lives with her husband at home and has 4 children, 2 daughters who are very involved in her care and medical history. she quit smoking 2 years ago--smoked 1 ppd x 40 years. she never used etoh or illicit drugs. family history: family history: lung ca and chf. physical exam: vitals: t 97.3 axillary bp 113/63 hr 96 a. fib rr 20 o2 sat 95% ra (100% 4l nc) gen: nad, pleasant, interactive, appears mildly sob, not using accessory resp. muscles currently heent: perrl, dry mm neck: no jvd appreciated, but difficult given body habitus, supple, no lad appreciated cv: tachycardic, irreg. irreg, no mrg resp: diffuse wheezes anteriorly and posteriorly. no crackles nor rhonchi. abd: soft, nt, nd +bs ext: no c/c/e, 1+ b/l dp pulses neuro: alert and oriented x3. sensation and strength intact throughout. pertinent results: echo: lvef 70%, but lv cavity size small. rv function appears depressed with dilated rv cavity and hypertrophied free wall. 2+ tr. moderate pulmonary artery systolic hypertension. . ekg: a. fib 82 bpm, no acute st, t wave changes. . cxr: there is unchanged cardiomegaly. there is tortuosity of the thoracic aorta. median sternotomy wires are seen. lungs are clear without focal infiltrates, pleural effusions, or signs of pulmonary edema. . cta chest/abdomen: 1. second order pe in the left lower lobe. 2. somewhat limited comparison of liver masses due to difference in modality but approximate stability of largest mass. 3. liver mass causes mass effect on ivc, but no evidence of ivc thrombosis. severe atherosclerotic disease involving coronary arteries, great vessels, abdominal aorta, and major tributaries. focal aneurysmatic dilatation of the mid abdominal aorta. 4. diverticulosis without evidence of diverticulitis. 5. severe degenerative changes involving the bony structures. . pfts: fev1 of 1.05 (66% predicted) and fev1/fvc of 99% predicted. dlco was reduced at 54% predicted. brief hospital course: 71 yo f with h/o cad, a. fib, copd, hepatocellular carcinoma admitted for shortness of breath requiring continuous nebulizer treatments. . # shortness of breath/copd exacerbation: her shortness of breath was attributed to copd exacerbation as she remained diffusely bronchospastic on exam. in the ed she was requiring continuous nebulizers and was transferred to the for further management. although she was recently diagnosed with pe, cta chest upon admission did not reveal propagation, but rather showed stable second order chronic pe in the left lower lobe and this was thought unlikely to be contributing to her symptoms. additionally, there were no infiltrates on cxr nor ct chest. she was originally continued on azithromycin which had been started prior to admission, but when respiratory status worsened requiring intubation, she was started on zosyn and vancomycin. she was started on iv solumedrol and tolerated successful extubation. . # hepatocellular carcinoma: this was recently diagnosed. afp on was found to be and on was . recent ct abdomen showed liver mass causing mass effect on ivc, but no evidence of ivc thrombosis. followed by dr. of hem/onc and in discussion with dr. , patient, and family, given the rapid progression of her disease, it was established that there were few therapeutic options. thus, family decided on change in code status to dnr/dni and then to cmo. . # cad: s/p mi and cabg in . cardiac enzymes originally revealed mb index slightly elevated at 6.5 and troponin also up at 0.05, but with full cycling, troponin decreased to 0.02 and index was no longer significant. ekg did not reveal any ischemic changes and she denied any symptoms of chest pain. she was continued on aspirin, bb was restarted when blood pressure could tolerate and statin was held in the setting of her hepatic malignancy. . # a. fib: she remained in a. fib during her stay requiring beta blockade and then initiation of diltiazem with improved rate control. . # chf: although bnp was elevated to 8340, she had no evidence of fluid overload on exam nor on cxr. - holding lasix, spironolactone, acei, and beta blocker in the setting of currenct hypotension. . # htn: she remained hypotensive compared to her baseline and appeared dry on exam. thus her diuretics were held as was her bb transiently. . # arf: creatinine elevated to 1.2 from baseline 0.7-0.9. resolved with iv hydration and likely represented prerenal etiology given her dry appearance on exam and response to hydration. . # ra: she was continued on steroids, plaquenil, and methotrexate and oxycodone for breakthrough pain. . # depression: she was continued on her outpatient medication regimen. . # pulmonary embolism: h/o pe s/p ivc filter placement. inr was 4.5 in the ed on 3mg daily coumadin dose. cta in ed revealed small pe which was thought unlikely clinically significant given not hypoxic. . # anemia: c/w acd on previous laboratory evaluation. hct remained stable. . # code: as above, her code status was reevaluated in the setting of her rapidly progressing hepatocellular carcinoma and was changed to cmo. she was placed on morphine gtt for respiratory comfort. she died on respiratory failure. medications on admission: 1. albuterol sulfate 0.083 % solution q6h prn 2. aspirin 325 mg qdaily 3. albuterol-ipratropium 103-18 mcg/actuation aerosol 1-2 puffs q4h 4. cyclobenzaprine 10 mg po hs 5. folic acid 1 mg daily 6. furosemide 40 mg po tid 7. lisinopril 10 mg po daily 8. hydroxychloroquine 200 mg po bid 9. prednisone 5 mg po daily 10. pantoprazole 40 mg daily 11. quetiapine 25 mg po qhs 12. spironolactone 12.5mg daily 13. metoprolol 50 mg po bid 14. sertraline 50 mg po daily 15. docusate sodium 100 mg po bid prn 16. oxycodone 5 mg po q4-6h prn 17. coumadin 3mg daily 18. methotrexate 8 tabs qwednesday discharge disposition: expired discharge diagnosis: hepatocellular carcinoma respiratory failure copd exacerbation atrial fibrillation discharge condition: deceased procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube enteral infusion of concentrated nutritional substances diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified acute kidney failure, unspecified unspecified septicemia severe sepsis atrial fibrillation obstructive chronic bronchitis with (acute) exacerbation acute respiratory failure malignant neoplasm of liver, primary 

Answer: The patient is high likely exposed to