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: epinephrine attending: chief complaint: difficulty breathing and increased weakness for several days major surgical or invasive procedure: none history of present illness: the patient is a 31 year old woman with a history of myasthenia diagnosed in now presenting with worsening weakness and difficulty breathing for the past few days. the patient has unfortunately experienced difficult to control myasthenia symptoms and has been tried on multiple treatment regimens including ivig, plasmapheresis, high-dose steroids, and more recently cellcept and rituximab with very limited success. she had a mild response with these last 2 treatments. 2 days ago she visited her outpatient neurologist and was found to have worsened symptoms: poor neck control, nasal speech, difficulty arising from a chair, worsening shortness of breath. the plan was to give her the 6th and last dose of the rituxan, arrange for ivig one week after this last dose, increase the mestanon to 120 mg 5x per day and continue her cellcept and prednisone at the current doses. the mother of the patient tells me her legs were very weak and last night at 3am, she was only able to count to 15 before taking a breath, which is a dramatic drop in her usual performance. she called me (and her outpt. neurologist) and we urged her to bring her daughter immediately into the for evaluation. upon arrival in the ed, the patient was found to be very lethargic and weak. a abg was done which revealed a pco2 of 119; she was then immediately intubated for hypercarbic respiratory failure. immediately following intubation, the patient went into svt with rates as high as 190's and dropped her systolic bp to the high 50s. her rapid rate broke after a couple rounds of adenosine and her blood pressure went up to the 130s systolic. past medical history: -10 weeks post-partum -h/o migraines -irritable bowel syndrome -iron def. anemia -sectio ces. social history: -lives with husband -no tobacco or alcohol use -worked as a social worker family history: -mother with auto-immune hepatitis -cousin with spinal muscular atrophy physical exam: physical exam vitals: 98.6 130/70 110 18 100% intubated general: thin woman lying intubated and in no acute distress neck: supple lungs: clear to auscultation cv: tachycardic but regular abdomen: non-tender, non-distended, bowel sounds present ext: warm, no edema neurologic examination (s/p versed for intubation): pt. very lethargic, not following simple commands, eyes open with some spontaneous eye movements; blinks to threat b/l, corneal reflex intact, gag reflex intact; decrease gastroc. bulk bilat; decreased tone throughout; dtrs about 1+ throughout; toes down- going pertinent results: 06:15am glucose-138* urea n-19 creat-0.5 sodium-141 potassium-3.9 chloride-93* total co2-40* anion gap-12 06:15am alt(sgpt)-41* ast(sgot)-28 ck(cpk)-36 alk phos-48 amylase-120* tot bili-0.3 06:15am lipase-42 06:15am albumin-4.2 phosphate-4.7*# magnesium-2.2 06:15am wbc-23.9*# rbc-5.05 hgb-14.5 hct-45.0 mcv-89 mch-28.7 mchc-32.2 rdw-14.2 06:15am neuts-79.8* lymphs-14.8* monos-4.9 eos-0.3 basos-0.3 06:15am plt count-413# 08:51pm urine blood-tr nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-9.0* leuk-neg . cxr: comparison is made to a chest ct scan from . the endotracheal tube tip is in satisfactory position in the mid trachea. heart size and pulmonary vessels are normal allowing for supine positioning. no pleural effusion. lungs are clear. no pneumothorax. brief hospital course: 31 year old woman with recently diagnozed with seronegative mg (during 2nd trimester of pregnancy). upon presentations she was 10 wks postpartum. she has not been responding well to treatment so far (including ivig, plasmapheresis, steroids, rituximab, mestinon). she now presented with increased weakness (proximal >distal), difficulties breathing and lethargy. abg in ed: pco2 119. she was intubated stat. upond admission she had a short episode of svt (190's) responding to adenosine. she was admitted to the n-icu. . respiratory: the patient was intubated upon admission for respiratory muscle support and rest. she was slowly weaned off the ventilator once her muscle strength improved. she was extubated . no complications occurred, but bipap was arranged for further support at night. this was to be continued at home. . neuro: prior to admission she had been taking prednisone. as she did not respond to this treatment and given the risks of this treatment peri-operatively (see below), it was decided to discontinue the prednisone. the steroids were slowly tapered as per endocrine recommendations. the patient was continued on cellcept and mestinon. ivig treatment (400mg/kg/day; 5 day course) was started . she tolerated the treatment well without complications and her exam improved gradually, as measured by sustained upgaze, vital capacity, and ability to lift her arms and legs off the bed. prior to discharge she was ambulatory. the patient would likely benefit from a thymectomy, especially given her age. thoracic surgery was consulted as to which procudure (vats versus sternotomy) would be most appropriate and as what the best timing would be for the surgery. given the patient's recovery, it was decided to plan for surgery months after discharge. upon discharge, repeated courses of ivig had been scheduled. cyclosporin may be added to this regimen after discharge. from a surgical point of view, cyclosporin would pose no problems. . id: her wbc were elevated upon admission. a cxr was negative for pna, and ua and blood culture was negative as well. . cv: the patient was continued on lisinopril for htn. metoprolol was avoided to manage tachycardia as this aggravates mg. diltiazem was used prn. . endo: she was maintained on a iss and fsbs were checked while she was receiving steroids. . haematology: her hct was low upon admission. she received prbc. hct upon discharge was stable and no active bleeding was noted. her anaemia is most likely related to her recent pregnancy and delivery. . fen: while intubated, the patient received tube feeds through an ngt. after extubation, she tolerated a regular diet. . prophylaxis included ppi, heparin sc, vd boots, tylenol for fever. . the patient was followed by pt and discharged with home services. medications on admission: 60mg--one by mouth twice a day amitriptyline hcl 10mg--one by mouth every day cervical soft collar --wear during the day as tolerated effexor 50mg--3 by mouth every day flonase 50mcg--two sprays/nostril every day klonopin 0.5mg--as directed lisinopril 10mg--one by mouth every day prednisone 20mg--take 3 pills (60 mg) in in the morning --------------- --------------- --------------- --------- discharge medications: 1. bipap machine bipap machine indication: myasthenia with respiratory failure settings: 8 over 5, room air 2. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 3. pyridostigmine bromide 60 mg tablet sig: two (2) tablet po 5x/d (5 times a day). 4. escitalopram oxalate 10 mg tablet sig: one (1) tablet po daily (daily). 5. mestinon timespan 180 mg tablet sustained release sig: one (1) tablet sustained release po qhs (). disp:*30 tablet sustained release(s)* refills:*2* 6. hyoscyamine sulfate 0.125 mg tablet sig: two (2) tablet po qid (4 times a day). disp:*240 tablet(s)* refills:*2* 7. prednisone 10 mg tablet sig: as instructed below tablet po daily (daily) for 40 days: please take 3.5 tablets on then take 3 tablets on the take 5 tablets qod starting on x 2 days then take 4.5 tablets qod x 2 days then take 4 tablets qod x 2 days then take 3.5 tablets qod x 2 days then take 3.0 tablets qod x 2 days then take 2.5 tablets qod x 2 days then take 2.0 tablets qod x 2 days thesn take 1.5 tablets qod x 2 days then take 1.0 tablets qod x 2 days then take 0.5 tablets qod x 2 day then stop. disp:*80 tablet(s)* refills:*0* 8. mycophenolate mofetil 500 mg tablet sig: four (4) tablet po bid (2 times a day). disp:*240 tablet(s)* refills:*2* 9. lansoprazole 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily) for 40 days: please stop when prednsione has finished. disp:*40 capsule, delayed release(e.c.)(s)* refills:*0* 10. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day). 11. trimethoprim-sulfamethoxazole 80-400 mg tablet sig: one (1) tablet po daily (daily) for 40 days: please stop when prednisone has finished. disp:*40 tablet(s)* refills:*0* discharge disposition: home with service facility: centrus home care discharge diagnosis: myasthenic crisis discharge condition: fair discharge instructions: please come to the emergency room or return to the emergency room if you experience shortness of breath, increasing weakness, worsened double vision, chest pain, heart palpitations, cough with sputum production. . please take your medications as instructed. please hold your lisinopril for five days since your blood pressure has been low . use bipap at night followup instructions: please follow up with dr. on to arrange your ivig therapy and to discuss your medications and bipap. . please call dr. of thoracic surgery in the next week to discuss a thymectomy. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances non-invasive mechanical ventilation transfusion of packed cells injection or infusion of immunoglobulin diagnoses: unspecified essential hypertension acute respiratory failure other specified cardiac dysrhythmias iron deficiency anemia, unspecified diarrhea myasthenia gravis with (acute) exacerbation 

Answer: The patient is high likely exposed to