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: dilaudid / ketorolac attending: chief complaint: chest pain major surgical or invasive procedure: none history of present illness: this is a 23 y/o female with cell ss disease who presents with chest pain and knee pain characteristic of her pain crises. of note, she was recently discharged from on and was here for pain crisis with unknown trigger. she was given iv pain medications, ivf, restarted on hydroxyurea and sent home with follow-up. patient reports that today she developed severe pain and came to the emergency room. in the ed, she received 46 mg iv morphine, 2 mg iv ativan and 2 liters ns. her initial vs were: t 97.8, hr 84, bp 128/78, 22-32, 97% ra. ekg non-ischemic. cxr negative for consolidation. . on presentation to the floor, patient reported severe pain but then immediately fell asleep in bed and was sleeping during vitals. initial vs were t 97.5, bp 156/82, 82, 26, 95% ra. she was sleeping when i went in and when awakened was complaining of severe pain and writhing in bed. while asking her questions, she occaisionally fell asleep while talking but appeared in significant distress at other times. she could not really give me much history except to say that this was a very severe pain crisis and that she has had episodes like this before. the pain is mostly in her chest and knees and denies pain elsewhere. denies headache, cough, sob, sputum production, nausea, vomiting, diarrhea, dysuria. reportedly has been taking her medications and eating and drinking ok. past medical history: cell ss disease avn of both hips s/p right hip replacement s/p cholecystectomy social history: student at . has a young daughter. alcohol, drugs, or tobacco. family history: no immediate family members with cell disease, both parents had the trait. no sibilings with disease. family history of dm, htn. physical exam: general: alternating between sleeping and writhing in bed vitals: t 97.5, bp 156/82, 82, 26, 95% ra skin: no rashes, no lesions heent: nc/at, anicteric, pupils 2 mm and reactive, mm very dry neck: no stiffness, no masses, no lad chest: no supraclavicular or axillary lad, lungs clear to asculation, no wheezes/rhonchi/crackles heart: rrr, s1s2 no mgr back: no cva tenderness, no spinal tenderness abdomen: obese, lap chol scar, nabs, soft, no guarding, no rebound. ext: no clubbing/cyanosis/edema. good pulses. tender sternum, and knee joints pertinent results: 08:00pm blood wbc-14.4* rbc-2.53* hgb-8.1* hct-23.2* mcv-92 mch-31.9 mchc-34.8 rdw-20.8* plt ct-428 01:00am blood wbc-18.1* rbc-2.33* hgb-7.5* hct-21.6* mcv-93 mch-32.1* mchc-34.6 rdw-21.2* plt ct-350 08:05am blood wbc-25.6* rbc-2.10* hgb-6.8* hct-19.2* mcv-91 mch-32.6* mchc-35.6* rdw-21.2* plt ct-260 03:20pm blood hct-21.0* 03:38am blood wbc-26.4* rbc-2.99*# hgb-9.3*# hct-26.5*# mcv-89 mch-31.0 mchc-34.9 rdw-20.5* plt ct-248 02:19pm blood hct-25.5* 03:09am blood wbc-24.5* rbc-2.74* hgb-8.7* hct-24.8* mcv-91 mch-31.6 mchc-34.9 rdw-20.6* plt ct-197 12:40am blood wbc-31.1* rbc-2.41* hgb-7.9* hct-21.8* mcv-90 mch-32.9* mchc-36.4* rdw-19.7* plt ct-147* 06:33pm blood wbc-47.0*# rbc-2.37* hgb-8.0* hct-21.2* mcv-89 mch-33.7* mchc-37.7* rdw-19.5* plt ct-170 04:39am blood wbc-22.9*# rbc-2.30* hgb-7.6* hct-20.8* mcv-90 mch-33.0* mchc-36.6* rdw-19.4* plt ct-170 04:11am blood wbc-16.9* rbc-2.14* hgb-7.2* hct-19.8* mcv-93 mch-33.6* mchc-36.3* rdw-20.6* plt ct-186 . 08:00pm blood ret man-14.8* 08:05am blood ret man-10.4* 03:38am blood ret man-6.7* 02:19pm blood ret man-8.6* 03:09am blood ret man-13.9* 12:40am blood ret aut-8.7* . 08:00pm blood alt-31 ast-65* ld(ldh)-671* alkphos-115 totbili-4.8* 08:05am blood alt-51* ast-130* ld(ldh)-1111* alkphos-144* totbili-7.0* 03:20pm blood ld(ldh)-1314* totbili-5.4* 03:38am blood alt-45* ast-149* ld(ldh)-* ck(cpk)-89 alkphos-210* totbili-6.7* 02:19pm blood ld(ldh)-2490* totbili-7.8* 03:09am blood alt-37 ast-109* ld(ldh)-2448* alkphos-342* totbili-11.2* 12:40am blood alt-39 ast-88* ld(ldh)-2156* totbili-26.5* dirbili-15.8* indbili-10.7 04:39am blood alt-30 ast-57* ld(ldh)-1591* alkphos-282* totbili-21.8* 04:11am blood alt-25 ast-45* ld(ldh)-1427* alkphos-271* totbili-15.5* . brief hospital course: 23-year-old woman with cell presents with pain crisis and hypoxia. . # cell anemia with acute chest syndrome: the patient's hematocrit on admission was 23, then trended down to 19. she received a total of 5 units of prbcs. she also required supplemental o2. bilirubin and ldh were initially elevated but were trending down at discharge. exchange transfusion was discussed in the presence of hematology and pathology (transfusion medicine) consultants, but no absolute indications were evident. she was given bronchodilators. she was initially started on vancomycin, azithromycin, and cefepime, but that regimen was soon changed to vancoymycin and levofloxacin. by discharge she was clinically stable enough that vancomycin was discontinued. she was to finish 3 more days of levofloxacin to finish a 7-day course. on day of discharge, she refused transfusion of 1 unit of prbc for hct 19.8. . # pain crisis: she was placed on the fentanyl and ketamine drips, mscontin, morphine po prn, and morphine iv prn. pain service was consulted. per patient's request, her morphine po was changed to oxycodone sr 20 mg po q8h and morphine iv prn. her ketamine and fentanyl continuous infusions were weaned right before discharge but may need to be restarted as patient has labile pain levels. before discharge prn short-acting oxycodone was added with goal of transitioning from prn iv morphine to oral regimen. . # leukocytosis: no left shift, no bandemia. negative cultures to date. likely stress response; however, still concerning for a pneumonia that triggered the cell crisis. levofloxacin was continued, while vancomycin discontinued. after discharge she is to take 3 more days of levofloxacin for a 7-day course. . # sinus tachycardia: likely from pain. she was given metoprolol, which was discontinued as the tachycardia resolved. . # ppx: subq heparin, standing and prn bowel regimen given narcotics (no bowel movement during this admission) . # access: 2 pivs . # code: full . # contacts: mom in -5956 (now in ), (sister) medications on admission: hydroxyurea 500 mg percocet q6 prn pain ibuprofen 8oo mg q6 prn pain cyanocobalamin 100 mcg qd folic acid 1 mg qd benadryl 25 mg q8 prn discharge medications: 1. hydroxyurea 500 mg capsule sig: one (1) capsule po bid (2 times a day). 2. cyanocobalamin 100 mcg tablet sig: one (1) tablet po daily (daily). 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) unit injection tid (3 times a day). 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 7. ibuprofen 400 mg tablet sig: two (2) tablet po q6h (every 6 hours). 8. acetaminophen 500 mg tablet sig: two (2) tablet po qid (4 times a day). 9. albuterol sulfate 2.5 mg/3 ml solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours). 10. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). 11. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). 12. levofloxacin 250 mg tablet sig: three (3) tablet po q24h (every 24 hours) for 3 days. 13. diphenhydramine hcl 25 mg capsule sig: one (1) capsule po q3h (every 3 hours) as needed. 14. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 15. ondansetron 2 mg iv q8h:prn nausea 16. oxycontin 20 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po three times a day. 17. morphine 10 mg/ml solution sig: 4-10 mg intravenous q2h (every 2 hours) as needed for pain: hold for oversedation. 18. oxycodone 10 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. discharge disposition: extended care discharge diagnosis: primary diagnosis: cell crisis with acute chest syndrome secondary diagnoses: avascular necrosis of both hips status post right hip replacement, status post cholecystectomy discharge condition: still in significant pain on ketamine and fentanyl iv infusions. slowly driftng down hematocrit, patient refused offer to transfuse 1 unit before discharge. oriented x 3. discharge instructions: you presented to with a cell pain crisis. you were given pain medications and transfused for low blood counts. you are now being transferred to , where you have received care in the past, for continuity of care. followup instructions: please follow up with your hematologist, dr. , at . md procedure: transfusion of packed cells diagnoses: pneumonia, organism unspecified other specified cardiac dysrhythmias pain in joint, lower leg aseptic necrosis of head and neck of femur leukocytosis, unspecified hip joint replacement hb-ss disease with crisis acute chest syndrome 

Answer: The patient is high likely exposed to