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 / percocet / neurontin / codeine attending: chief complaint: altered mental status major surgical or invasive procedure: pleurex placement history of present illness: 76 y/o female with h/o metastatic breast cancer p/w altered mental status (slurred speech, acting "funny" per daughter) after receiving two units of blood during scheduled visit. parametics noted fever to 101.8, and she developed hypoxia to the 70%'s on ra, which responded to 100% on a nrb. in ed noted to have large right pleural (has chronic right pleural , last 1.3 l on /6), with a question of underlying pna. given cefepime. head ct was negative for bleed or large mass. concern for pe, but given cr 2.5, and inability to tolerate mri in past, started on heparin empirically for pe. ros: has been getting aranesp q4 wks(last on ) and pamiodronate q8wks (last ). received falsodex (last ). she does report orthopnea, occasional leg swelling, decreased functional status. she denies, fever, chills, headache, light sensitivity, chest pain, shortness of breath, abdominal pain, diarrhea, arthralgias, or myalgias. she does reports nausea and vomiting over the last several weeks associted with a new cancer medication, which has stopped since stopping the medication. past medical history: metastatic right breast cancer with mets to l4/l5 htn hyperlipidemia dm depression anxiety social history: denies alcohol, drug use, smoked ppd x 20 yrs, quit 20 yrs ago lives at senior living facility. family history: nc physical exam: t 97.6 hr 60 bp 118/41 rr 12 o2 sat 99% on 4l nc comfortable, not tachypneic no scleral icterus, perrl, eomi, no nystagmus no cerviacl lad, jvp to mid neck left axillary lymph node palpable heart regular with systolic murmur at lusb, s2 present dullness and decreased breath sounds over right lower lung fields, no rales or wheezes abd nondistended, good bowel sounds, soft, nontender no peripheral edema, good pulses neuro exam with orientation to person, place, time. able to do simple calulations and counbt down from 20 by 4's. able to name objects without dificulty. strength 5/5 throughout. coordination intact. toes downgoing. pertinent results: wbc 6.2 n:80.5 l:14.5 m:3.4 e:1.0 bas:0.6 hgb 12.0 hct 34.4 plt 150 mcv 88 . na 141 k 4.8 cl 105 hco3 27 bun 56 creat 2.5 gluc 147 ca: 8.2 mg: 1.9 p: 5.1 d anion gap 9 . ck: 54 mb: notdone trop-*t*: 0.07 . alt: 17 ast: 28 tbili: 0.4 alb: 3.5 : 96 lip: 82 . pt: 13.0 ptt: 23.2 inr: 1.1 . urine benzos, barbs, opiates, cocaine, amphet, mthdne negative . u/a: spec 1.015, sm blood, 500 prot, 1 rbc, 1 wbc, few bact, 1 epi . urine cx: pending blood cx x 2: pending . lower extremity ultrasound ( ): no evidence for deep vein thrombosis in the bilateral lower extremities. . cxr: portable ap chest dated is compared to the prior . there has been interval development of a large right pleural , which obscures the right heart border. there is compressive atelectasis of the right lower lung lobe. the heart size remains enlarged. the aorta and hilar contours are stable. there is no pulmonary vascular congestion. the left lung is clear. impression: interval accumulation of a large right pleural with compressive atelectasis of the right lung. . head ct: no evidence for hemorrhage, mass effect, or acute ischemic changes. please note that mri is more sensitive in the detection of acute ischemia. discharge labs: wbc 4.1 hgb 11.1 hct 30.7 plt 82 137 103 55 -----------< 82 4.3 27 2.4 ldh 173 tbili 0.5 b12 407, folate 9.4, haptoglovin 101, ferritin 702, trf 167 brief hospital course: 76 y/o female with metastatic breast cancer presents with altered mental staus, fever, right pleural . . 1. altered mental status: now cleared. possibly related to medication effect (?premedication with blood products). resolved quickly while in icu. no evidence of infection. tox screen negative. ct head without bleed or mass. no significant metabolic alterations. could be hypoxia with pleural as well. we avoided benadryl and other sedating meds while she was in the hospital. . 2. fever: could have been due to blood tranfusion, though no documentation of fever after blood products. occurred several hours after transfusions. no evidence of infection and fever resolved the day after the blood transfusion without any antibiotics given except for cefepime in ed. all cultures negative. . 3.hypoxia: resolved after pleurex was done. this was thought to be due to malignant . pleurex in 50% of people will cause an auto-pleurodesis. daughter instructed how to drain the device. pe ruled out with ct with gadollinium. mi ruled out with 3 sets of ces and no changes on ekg. patient has anemia, but had just been given transfusion so this was probably not contributing. . 4. right pleural : chronic, related to breast ca. pleurex done. . 5. breast cancer: metastatic right breast cancer. was not due for pamidroate or arinesp at this time. we continued fentanyl patch for pain with bony mets. . 6. diabetes mellitus: not on oral meds or insulin at home. was on sliding scale here but only required minimal insulin. no sugars above 200. on diabetic diet. . 7. htn: well controlled in hospital. continued lisinopril and dozaxosin. . 8. depression/anxiety: - cont fluoxetine . 9. thrombocytopenia- plts trended down from 150-->82. heparin was stopped on the third day and heparin dep ab were sent. pneumoboots were used instead. was not on ppi or any other abx. scheduled appt in 2 days with dr. to have cbc checked. . 10. anemia- based on iron studies, this is most likely anemia of chronic disease breast cancer. not due for aranesp. hemolysis labs negative. guaic negative. not iron deficient and b12 and folate were normal. will have repeat cbc in 2 days with heme-onc doctor, dr. . medications on admission: lisinopril 40 mg qd doxazosin 8 mg qhs furosemide 10 mg qd fluoxetine 20 mg qd calcium and vit d fentanyl patch 50 mcg q72h discharge medications: 1. fentanyl 50 mcg/hr patch 72hr sig: one (1) patch 72hr transdermal q72h (every 72 hours). disp:*10 patch 72hr(s)* refills:*2* 2. fluoxetine 20 mg capsule sig: one (1) capsule po daily (daily). disp:*30 capsule(s)* refills:*2* 3. doxazosin 4 mg tablet sig: two (2) tablet po hs (at bedtime). disp:*60 tablet(s)* refills:*2* 4. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 5. furosemide 20 mg tablet sig: 0.5 tablet po daily (daily). disp:*15 tablet(s)* refills:*2* 6. calcium 500+d oral discharge disposition: home with service facility: homecare discharge diagnosis: primary 1. pleural 2. altered mental status medication secondary 1. metastatic breast ca discharge condition: hd stable and afebrile. discharge instructions: you were admitted to the hospital because of altered mental status and low o2 saturations. you were found to have a pleural . the pulmonary doctors this . please take all medications as directed. please follow-up with all outpatient appointments. please return to the ed or seek medical advice if you experience chest pain, fevers, shortness of breath or any other concerning symptoms. followup instructions: please follow-up with dr. to have your blood counts checked. you have an appointment with dr. on thursday at 1 pm. . please follow-up with your primary care doctor, dr. . you have an appointment with her nurse practioner on wednesday at 12:30 pm. procedure: insertion of intercostal catheter for drainage diagnoses: diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified secondary malignant neoplasm of pleura personal history of malignant neoplasm of breast chronic kidney disease, unspecified dysthymic disorder other and unspecified hyperlipidemia anticoagulants causing adverse effects in therapeutic use drug-induced delirium secondary malignant neoplasm of bone and bone marrow anemia in neoplastic disease antiallergic and antiemetic drugs causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to