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: penicillins attending: chief complaint: febrile neutropenia major surgical or invasive procedure: none history of present illness: ms. is a 63 yo woman with metastatic breast cancer with hepatic, pulmonary and bone mets who presented to the ed yesterday evening fever (100.8f) following therapeutic paracentesis (2.5l). prior to thursday ms. had noted fatigue since sunday, but denied cough, sob, changes in bowel habits or urination. fevers/chills were absent until thursday post-procedure she is currently recieving 4th line chemotherapy with navelbine with ascites following 4 rounds. also with leukopenia (wbc 2.3) and neutropenia (483). ascites has been therapeutically tapped in w/ 3l removed but with interval worsening of ascites. in the ed, initial vitals were t 99.0, hr 138, bp 118/69, rr 18, o2 100% on ra. she triggered for tachycardia and received a total of 4l ivf with minimal improvement. she had a clear cxr and negative u/a. she also received 1 g iv vanco and 2 g iv cefepime for febrile neutropenia and acetaminophen and motrin for fever. the oncology fellow was consulted and recommended against diagnostic paracentesis. vitals on transfer were t 99.6 (tmax in ed 100.4), hr 128, bp 122/88, rr 15, o2 sat 100% ra. on the floor, patient endorses abdominal pain, dyspnea, and malaise. she is somnolent and requests many questions be referred to her daughter. past medical history: -stage i breast cancer, diagnosed by biopsy , (negative mammogram in ), on she had a right partial mastectomy with sentinel node biopsy for invasive carcinoma of the right breast (diagnosed by core biopsy) at hospital. the pathology report showed that one of five radioactive lymph nodes contain a neoplastic cell in peripheral sinus, pn0 (i+). era 40%, pra 2%, her2 1+ out of 3+, ki67 25%. -dm -hypercholesterolemia social history: she denies the use of tobacco, alcohol, or illicit drug use ever. she lives with her husband and 2 of her 5 daughters in . she is a homemaker. family history: the patient's sister had a suprasellar epidermoid cyst diagnosed s/p right craniotomy . ct brain showed it was a suprasellar based mass extending into the sella measuring 1.8x1.4x2.2 cm which may represent dermoid or teratoma. mri showed suprasellar mass with fat and calcifications exerting some mass effect on the optic chiasm which is likely dermoid or teratoma. her mother had breast cancer at 37, and also had crohn's disease and a stroke, she died in her 70s. her father had lymphoma and died in his early 70s. her sister has dm. physical exam: exam on admission: general: tired but oriented x3, heent: dry mm, oropharynx w/ mucosal bleeding neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi cv: sinus tachycardia, normal s1 + s2, no murmurs, rubs, gallops abdomen: grossly distended abdomen w/ tenderness to palpation gu: ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema exam on discharge: vitals: tmax 97.7, tcurrent 96.8, bp 100/60, hr 88, rr 20, so2 97 on ra gen: nad, aox3 heent: perrl cards: rrr, no mrg pulm: lungs ctab (poor effort), no dullness to percussion gi: abdomen is distended and mildly tender to palpation in all 4 quadrants, no guarding or rebound tenderness extremities: mild non-pitting edema in le's bilaterally pertinent results: admission labs: 11:20pm pt-16.4* ptt-24.9 inr(pt)-1.4* 11:20pm plt smr-normal plt count-204 11:20pm hypochrom-normal anisocyt-1+ poikilocy-normal macrocyt-1+ microcyt-1+ polychrom-1+ 11:20pm neuts-21* bands-0 lymphs-45* monos-31* eos-0 basos-0 atyps-0 metas-2* myelos-1* 11:20pm wbc-2.3*# rbc-3.70* hgb-10.8* hct-32.7* mcv-89 mch-29.3 mchc-33.1 rdw-19.5* 11:20pm albumin-2.6* 11:20pm lipase-32 11:20pm alt(sgpt)-46* ast(sgot)-225* alk phos-396* tot bili-1.2 11:20pm glucose-139* urea n-13 creat-0.4 sodium-135 potassium-3.9 chloride-99 total co2-25 anion gap-15 11:28pm lactate-3.1* k+-3.7 11:28pm comments-green top 01:40am urine color-yellow appear-clear sp -1.005 03:23am lactate-3.2* 07:14am gran ct-1140* 07:14am pt-17.9* ptt-26.3 inr(pt)-1.6* 07:14am plt smr-normal plt count-184 07:14am hypochrom-normal anisocyt-2+ poikilocy-1+ macrocyt-1+ microcyt-normal polychrom-occasional ovalocyt-occasional schistocy-1+ 07:14am neuts-41* bands-0 lymphs-33 monos-19* eos-1 basos-0 atyps-0 metas-4* myelos-2* nuc rbcs-2* 07:14am wbc-2.8* rbc-3.67* hgb-10.7* hct-32.9* mcv-90 mch-29.2 mchc-32.6 rdw-19.1* 07:14am calcium-8.6 phosphate-2.5* magnesium-1.5* 07:14am alt(sgpt)-43* ast(sgot)-199* ld(ldh)-996* alk phos-405* tot bili-1.8* 07:14am glucose-115* urea n-13 creat-0.5 sodium-139 potassium-3.7 chloride-105 total co2-24 anion gap-14 imaging: cxr : findings: there is no pneumonia. there is no pleural effusion or pneumothorax. hilar, mediastinal, and cardiac silhouette within normal limits. there is a port-a-catheter with tip at the cavoatrial junction. impression: no pneumonia. ecg : sinus tachycardia. since the previous tracing no significant change on previously noted findings. sinus tachycardia. since the previous tracing no significant change on previously noted findings. micro: - bcx - ngtd - bcx - ngtd - mrsa nasal swab screen - negative discharge labs: 06:29am blood wbc-4.3 rbc-3.06* hgb-8.9* hct-28.0* mcv-92 mch-28.9 mchc-31.6 rdw-18.4* plt ct-100* 06:29am blood neuts-52 bands-0 lymphs-16* monos-30* eos-0 baso-0 atyps-0 metas-2* myelos-0 06:29am blood hypochr-normal anisocy-1+ poiklo-2+ macrocy-1+ microcy-normal polychr-1+ ovalocy-2+ schisto-1+ macroov-occasional 06:29am blood plt smr-low plt ct-100* 06:29am blood gran ct-2484 06:29am blood glucose-116* urean-12 creat-0.5 na-137 k-4.0 cl-105 hco3-26 angap-10 06:29am blood alt-24 ast-95* ld(ldh)-310* alkphos-357* totbili-1.5 06:29am blood calcium-8.6 phos-2.3* mg-1.8 brief hospital course: ms. presented with febrile neutropenia following therapeutic paracentesis and was admitted to the medical icu for tachycardia unresponsive to fluids in the ed. # febrile neutropenia. on arrival, the patient's anc was < 500 and she was febrile to tmax 100.4 in the ed. she was therefore started on broad-spectrum antibiotic coverage with vancomycin and cefepime. u/a and cxr were unremarkable, and blood cultures obtained at admission showed no growth at this time. diagnostic paracentesis was considered to rule out the possibility of sbp, but no suitable fluid pocket could be identified for safe bedside paracentesis. her fever resolved within 24 hours of admission and she remained afebrile throughout the remainder of her hospital stay. #tachycardia: the patient was noted to be tachycardic to 130s-140s on arrival to the ed; after 4l of ivf, her hr remained in the 130s. 12-lead ekg was obtained which showed sinus tachycardia. this was felt likely secondary to fever/infection, as when her fevers resolved her heart rate decreased to 90s-100s. on review of her most recent clinic notes, her heart rate was nearly always > 90 bpm, so hr in 90s to 100s was felt to be her recent baseline. #abnormal lfts: patient was noted to have a transaminitis as above. this was felt possibly secondary to known liver metastases vs. toxicity from recent chemotherapy. transaminases trended down over the course of this admission. #metastatic breast cancer: ms. has undergone significant functional decline over the past few weeks. prior to this admission, she had planned to visit for a second opinion on treatment options and discussion of her prospects for involvement in a clinical trial. her oupatient oncologist dr. was called to consult during this admission, and was involved with her plan of care. at this juncture, it was felt that the patient has a relatively poor prognosis with life expectancy on the order of a few months. ms. went out of the icu to the oncology (omed) service on hospital day #2, where she remained afebrile and normotensive and was discharged to home with services. #dmii: metformin held while inpatient. humalog iss was implemented during this stay. transitional issues: - follow up blood cultures. - patient at higher risk for readmission due to reaccumulating ascites and ongoing issues with pain (although under better control than admission). medications on admission: diazepam 2mg 1-2x daily for insomnia/anxiety, simvastatin 40mg once daily, paroxetine 20mg once daily, docusate 100mg twice daily, oxycontin 30 mg prn pain, metformin 1000 mg discharge medications: 1. oxycontin 30 mg tablet extended release 12 hr sig: one (1) tablet extended release 12 hr po twice a day as needed for pain: hold for sedation or respiratory rate < 12/min. disp:*60 tablet extended release 12 hr(s)* refills:*0* 2. diazepam 2 mg tablet sig: 1-2 tablets po once a day as needed for anxiety. 3. simvastatin 40 mg tablet sig: one (1) tablet po once a day. 4. paroxetine hcl 20 mg tablet sig: one (1) tablet po once a day. 5. docusate sodium 100 mg capsule sig: one (1) capsule po twice a day. 6. metformin 1,000 mg tablet sig: one (1) tablet po twice a day. tablet(s) 7. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. discharge disposition: home with service facility: all care vna of greater discharge diagnosis: febrile neutropenia hypotension tachycardia metastatic breast cancer pancytopenia type ii diabetes mellitus discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear ms. , you were admitted with fever and low blood pressure. you were put on antibiotics, given fluids and given some medicines to help with your blood pressure. we also found that your white blood cell counts were low, but these have improved since the day of your admission. during your stay your blood pressure stabilized, you stopped having fevers and your pain came under better control. no changes were made to your medications. followup instructions: pcp :wednesday at 10:15am name: dr. tiba, an associate of your pcp, . since your pcp is unavailable next week. location: family health center address: , , phone: department: hematology/oncology when: wednesday at 3:00 pm with: , md building: sc clinical ctr campus: east best parking: garage department: hematology/oncology when: wednesday at 3:00 pm with: . , pa building: sc clinical ctr campus: east best parking: garage md procedure: percutaneous abdominal drainage diagnoses: pure hypercholesterolemia malignant neoplasm of liver, secondary diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled personal history of malignant neoplasm of breast antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use other ascites secondary malignant neoplasm of lung secondary malignant neoplasm of bone and bone marrow neutropenia, unspecified other specified aplastic anemias 

Answer: The patient is high likely exposed to