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: plaquenil / daypro / atenolol / keppra attending: chief complaint: left leg pain major surgical or invasive procedure: left hemiarthroplasty history of present illness: ms. is an 82-year-old female with severe diastolic heart failure, moderate pulmonary hypertension, afib on anticoagulation, rheumatoid arthritis, and chronic anemia who was admitted to the orthopedics service for a left femoral neck transverse fracture which occured in the setting of a mechanical fall while cleaning her house on . she denied any chest pain, palpitations, pre-syncopal, or syncopal episodes prior to the fall. she denied any loc or any head trauma. . after ortho surgery she was extubated. she was intitially satting well on 4lnc. she became progressively more hypoxic, hypertensive, tachycardic (a fib to 130s) and tachypneic. she was placed on nrb and an abg was obtained which showed hypercarbic and hypoxic respiratory failure. a cxr showed pulmonary edema. she was given lasix and nitropaste and put out 300 ccs of urine. she was then placed on bipap. while on bipap, she was noted to have a focal motor (arm) seizure which was new to her which resolved prior to receiving any medications. she developed a second right arm focal motor seizure post-operatively and was given 2 mg of ativan iv. she was hypoxic during the event and was bagged by anesthesia. she was then placed back on bipap. patient was transferred to the micu. . patient was diuresed in the micu. she had a head ct due to seizure activity that was negative. she had an echo that showed diastolic hf and moderate pulmonary hypertension. also post op was given 1 unit rbcs. patient was transferred to the floor and she has been stable past medical history: 1. non-ischemic cardiomyopathy -tte : ef 50-55%, lvh, with now more mod-severe diastolic chf compared to prior echos -cardiac cath with 40% lad stenosis -difficult to manage, is hospitalized for exacerbations often 2. moderate pulmonary htn -3+ tr on echo 3. hypertension 4. paroxysmal atrial fibrillation on coumadin 5. rheumatoid arthritis on methotrexate 6. macrocytic anemia 7. osteoarthritis 8. gout 9. osteoporosis 10. pancreatic cyst: already worked up by heme-onc, and adressed by pcp and gi, no further work up at this time recommended. 11. failure to thrive: decreased appetite, managed currently with ensure. social history: she is married and lives in a house with her husband, son, and daughter in law. retired from stores this year. her husband is well. she denies drugs and alcohol. 50-pack year smoking history, occasionally smokes now. family history: mom - dm, arthritis dad - no health problems family history of premature cad or scd. physical exam: vs: hr 80, bp 104/48, 98% on bipap, rr 20, gen: somnolent, opens eyes to voice/sternal rub, follows simple commands heent: bipap in place cv: rrr, no m/r/g pulm: crackles way up bilaterally, no wheezes/crackles abd: soft, nt, nd, bowel sounds present ext: lle with bandage with small amount of blood, mild edema, cool extremities neuro: somnolent, follows simple comands pertinent results: 11:52pm urine color-straw appear-clear sp -1.007 11:52pm urine blood-lg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 11:52pm urine rbc-0-2 wbc-0 bacteria-none yeast-none epi-<1 09:45pm type-art temp-37.0 o2-80 po2-218* pco2-47* ph-7.33* total co2-26 base xs--1 aado2-318 req o2-57 intubated-not intuba 07:20pm type-art po2-152* pco2-50* ph-7.29* total co2-25 base xs--2 07:20pm lactate-4.3* 06:42pm glucose-171* urea n-23* creat-1.3* sodium-134 potassium-4.5 chloride-101 total co2-20* anion gap-18 06:42pm ck(cpk)-191* 06:42pm ck-mb-10 mb indx-5.2 ctropnt-0.03* 06:42pm calcium-7.8* phosphate-3.8 magnesium-1.6 06:42pm wbc-9.7 rbc-3.05* hgb-11.1* hct-36.0 mcv-118* mch-36.3* mchc-30.8* rdw-14.9 06:42pm neuts-94.1* lymphs-4.6* monos-1.1* eos-0.1 basos-0.1 06:42pm plt count-140* 06:42pm pt-15.2* ptt-24.7 inr(pt)-1.3* 05:56pm type-art temp-36.9 po2-77* pco2-51* ph-7.32* total co2-27 base xs-0 intubated-not intuba 05:56pm glucose-173* lactate-2.1* na+-139 k+-4.6 03:18pm glucose-131* urea n-24* creat-1.4* sodium-139 potassium-5.4* chloride-104 total co2-22 anion gap-18 03:18pm ck(cpk)-165* 03:18pm ck-mb-8 ctropnt-0.03* 03:18pm calcium-8.8 phosphate-4.1 magnesium-2.0 03:09pm wbc-13.5* rbc-3.29* hgb-12.0 hct-38.3 mcv-116* mch-36.5* mchc-31.4 rdw-14.9 03:09pm plt count-138* 03:09pm pt-22.7* inr(pt)-2.1* 06:15am glucose-99 urea n-23* creat-1.3* sodium-142 potassium-4.7 chloride-104 total co2-27 anion gap-16 06:15am calcium-8.4 phosphate-4.5# magnesium-2.0 06:15am wbc-9.5# rbc-3.02* hgb-11.0* hct-35.5* mcv-118* mch-36.5* mchc-31.0 rdw-14.9 06:15am plt count-146* 06:15am pt-18.4* ptt-25.7 inr(pt)-1.7* 10:20pm urine hours-random 10:20pm urine gr hold-hold 10:20pm urine color-yellow appear-clear sp -1.021 10:20pm urine blood-sm nitrite-neg protein-100 glucose-neg ketone-tr bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 10:20pm urine rbc-0-2 wbc- bacteria-mod yeast-none epi-0 10:20pm urine hyaline-0-2 08:15pm glucose-143* urea n-19 creat-1.3* sodium-138 potassium-4.7 chloride-100 total co2-27 anion gap-16 08:15pm estgfr-using this 08:15pm ctropnt-0.02* 08:15pm digoxin-0.7* 08:15pm wbc-6.3 rbc-3.02* hgb-11.6* hct-34.4* mcv-114* mch-38.5* mchc-33.8 rdw-15.2 08:15pm neuts-81.6* lymphs-12.9* monos-4.9 eos-0.5 basos-0.2 08:15pm plt count-188 08:15pm pt-21.5* ptt-25.0 inr(pt)-2.0* following labs from white blood cells 6.8 red blood cells 2.50* hemoglobin 9.0* hematocrit 27.9* mcv 112* mch 36.1* mchc 32.4 % rdw 17.5* platelet count 140* glucose 88 urea nitrogen 32* creatinine 1.0 sodium 138 potassium 4.5 meq/l chloride 100 meq/l bicarbonate 32 pt 18.6* ptt 27.1 inr(pt) 1.7* ct head: unchanged appearance of the brain without evidence of acute intracranial abnormalities. mri would be more sensitive for evaluation of new seizures, if clinically indicated. brief hospital course: ms. is an 82 yo female with severe chronic diastolic hf, afib on coumadin, htn, moderate pulmonary hypertension, rheumatoid arthritis, chronic anemia who is s/p hip replacement for mechanical fall complicated by post-op hypoxia. . shortness of breath: sob is likely secondary to diastolic chf given that she is known to have significant diastolic chf and has had several admissions for chf exacerbations. she reportedly got only 1l ns in the or and 2 units of ffp. additionally her post-op pain may have contributed to tachycardia and worsening diastolic dysfunction. patient was transferred to the micu post-op and diuresed with lasix. a dilt drip was started for hr control and blood pressure was controlled with nitropast/drip. an a-line was placed in the micu for frequent abgs. home digoxin and spironolactone were continued. patient was stablized and transferred to the floor on . on the floor she has not complained of shortness of breath. she was on oxygen upon transfer, but has not required o2 for the past 2 days; she is satting well on room air. . seizure: family denies history of seizure though patient has a keppra allergy suggesting seizure at some point. patient states that her doctor thought she had a seizure a few years back but then changed his mind. ct head was negative for any acute change. she should seek neuro follow-up and eeg as an outpatient. . hip replacement: patient post-op for hip replacement. per neuro, able to weight bear fully on both legs now. patient started lovenox 40units every night for dvt prophylaxis after ortho surgery. her coumadin was also started and her inr is climbing up. it was 1.7 on day of discharge. she is also receiving tylenol round the clock and morphine 7.5mg every 4 hours as needed. her fosamax, calcium, and vitamin d should be continued as an outpatient for osteoporosis. . afib with rvr: with rvr. patient with a. fib with rvr post-operatively leading to diastolic chf exacerbation. she is now on digoxin, metoprolol 25mg and comadin. her inr is 1.7 on discharge. she has had no episodes of rvr on the floor. please continue with current treatment. . cad. cardiac enzymes mildly elevated post-operatively without ischemic changes on ekg. this was likely secondary to demand ischemia. we continued aspirin and statin. beta-blocker was discontinued at first but restarted upon transfer to the floor. patient came in on toprol xl but has done well with metorolol 25mg in house. we will continue with metoprolol 25mg upon discharge. . hypertension: patient was hypertensive in the micu and was controlled with dilt drip and nitro paste/drip. she has done well on the floor without any episodes of hypertension. please continue her current anti-hypertensive regimen including metoprolol 12.5mg twice a day, furosemide 10mg 4x/week, lisinopril 2.5mg at night, spironolactone 12.5mg every day. . rheumatoid arthritis: patient is chronically on methotrexate and 5 mg of prednisone. she did not receive methotrexate in hospital. please continue methotrexate 5mg every thursday. please continue prednisone 5mg daily. . osteoporosis: continue calcium, vitamin d, alendronate. . gout: continue allopurinol. . constipation: patient states that she has not had a bowel movement in a week nor passed gas in 4 days. a radiograph of her abdomen was performed, which showed a large amount of stool and was negative for obstruction. she was given a ducolax suppository today, a fleets enema, and lactulose. upon discharge she had not had a bm. rehab made aware. . patient stated that she wanted to be full code. she had peripheral iv access while on the floor. her contact is her husband, daughter, or daughter-in-law. ( - hcp) medications on admission: alendronate 35 mg allopurinol 150 mg daily digoxin 125 mcg 4/week (tues/thurs/sat/sun) folic acid 1 mg daily furosemide 10 mg 4x/wk (tues/thurs/sat/sun) lisinopril 2.5 mg qhs methotrexate 5 mg every thursday toprol xl 25 mg qhs pravastatin 10 mg qhs prednisone 5 mg daily spironolactone 12.5 mg daily trazadone 25 mg qhs warfarin 2.5 mg 6x/week, 5 mg on thurs acetaminophen 650 mg prn pain citracal + d 1500 mg/200 units ensure 1 can qhs guar gum qhs multivitamin 1 tab daily ocuvite 1 tab discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. multivitamin sig: one (1) cap po daily (daily). 3. calcium carbonate 500 mg , chewable sig: one (1) , chewable po tid (3 times a day). 4. cholecalciferol (vitamin d3) 400 unit sig: one (1) po daily (daily). 5. allopurinol 100 mg sig: one (1) po daily (daily). 6. folic acid 1 mg sig: one (1) po daily (daily). 7. pravastatin 10 mg sig: one (1) po hs (at bedtime). 8. prednisone 5 mg sig: one (1) po daily (daily). 9. spironolactone 25 mg sig: 0.5 po daily (daily). 10. digoxin 125 mcg sig: one (1) po daily (daily). 11. enoxaparin 40 mg/0.4 ml syringe sig: one (1) subcutaneous qpm (once a day (in the evening)). 12. warfarin 2.5 mg sig: one (1) po qpm (once a day (in the evening)). 13. aspirin 81 mg , chewable sig: one (1) , chewable po daily (daily). 14. metoprolol tartrate 25 mg sig: one (1) po bid (2 times a day). 15. acetaminophen 500 mg sig: one (1) po q6h (every 6 hours). 16. furosemide 20 mg sig: 0.5 po qtues, thurs, sat, sun (). 17. morphine 15 mg sig: 0.5 po q4h (every 4 hours) as needed for pain. 18. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily): until patient has a bowel movement. 19. senna 8.6 mg sig: 1-2 tablets po bid (2 times a day) as needed for constipation: until patient has a bowel movement. 20. cephalexin 500 mg capsule sig: one (1) capsule po q8h (every 8 hours) for 7 days. discharge disposition: extended care facility: - discharge diagnosis: primary diagnosis: left femoral neck fracture acute on chronic diastolic heart failure atrial fibrillation with rapid ventricular response discharge condition: stable discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: 1.5 liters you were admitted with a femoral fracture. you were taking to the operating room where they fixed your fracture, but afterwards you developed shortness of breath and were taken to the micu where you had fluid taken off of your lungs. you improved, and were taken to the medical floor where you were seen by physical therapy, and you were cleared for rehabilitation. you will need to complete a short course of antibiotics as listed below. you will need follow up with dr. as scheduled below. the following changes were made to your medications: cephalexin 500 mg three times a day for 7 days please keep all scheduled appointments if you develop any of the following concerning symptoms, please call your pcp or go to the ed: chest pains, fevers, chills, shortness of breath, nausea, vomiting, diarrhea, or pain/swelling/redness or discharge from your leg wound. followup instructions: please follow up with dr. on 10:00 am- please schedule a followup appt with your pcp . for followup in weeks. provider: , - medicine (sb) phone: date/time: 2:00 provider: , md phone: date/time: 3:00 provider: , m.d. phone: date/time: 2:40 md procedure: non-invasive mechanical ventilation partial hip replacement diagnoses: other primary cardiomyopathies anemia of other chronic disease tobacco use disorder congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified gout, unspecified atrial fibrillation acute on chronic diastolic heart failure other chronic pulmonary heart diseases osteoporosis, unspecified long-term (current) use of anticoagulants osteoarthrosis, unspecified whether generalized or localized, site unspecified other constipation rheumatoid arthritis fall from other slipping, tripping, or stumbling localization-related (focal) (partial) epilepsy and epileptic syndromes with simple partial seizures, without mention of intractable epilepsy cyst and pseudocyst of pancreas closed fracture of unspecified part of neck of femur 

Answer: The patient is high likely exposed to