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: history of present illness: ms. is a 46-year-old female with no significant past medical history who presented to the emergency department on complaining of the acute onset of chest pain. the patient was driving at the time of the onset and described onset of tightness along the left sternal border radiating to the right breast area then up over the left shoulder. this was associated with a general feeling of uneasiness and anxiety but no shortness of breath, diaphoresis, nausea, or vomiting. the pain was not effected by movement but was slightly alleviated by sitting forward. there was no cough, fevers, or chills. the pain persisted for several hours with worsening in intensity and effecting a large of the chest. she then called her primary care physician who directed her to go to the emergency department. she has no history of hypertension, diabetes, coronary artery disease, hypercholesterolemia, or smoking. she had no extended plane flight or car rides, but the patient leads a sedentary lifestyle spending long hours at a desk writing. she denies any leg swelling or pain. she also denied any recent viral illnesses, and her review of systems was remarkable only for some right ear drainage which she suffers from on a chronic intermittent basis. past medical history: 1. psoriasis. 2. intermittent right ear drainage and congestion. 3. anemia. medications on admission: the only medication she takes is an over-the-counter medication. allergies: no known drug allergies. social history: she denies any alcohol, drug, or tobacco use. family history: her mother with coronary artery disease at an early age. physical examination on presentation: on presentation, the patient's temperature was 99.4, blood pressure was 106/78, heart rate was 93, respiratory rate was 18, and oxygen saturation was 100% on 2 liters. she had a pulsus paradoxus of 8. in general, a thin young-appearing african-american female who was calm. alert and oriented times three. in no acute distress. head, eyes, ears, nose, and throat examination revealed normocephalic and atraumatic. pupils were equal, round, and reactive to light. the oropharynx was clear. the mucous membranes were moist. no facial wrinkles. the neck was supple. there were mobile nontender lymph nodes in the right neck in right submandibular region; per the patient these were stable since chronic otitis media as a child. there was jugular venous distention. no thyromegaly or nodules appreciated. cardiovascular examination revealed she was tachycardic but regular. there was a rub at the mid upper sternal border, the left sternal border, increased with expiration, best heard in the left lateral decubitus position. there was no radiation. there were no gallops appreciated. there was increased right ventricular impulse, but the patient was very thin. there was no increased p2 or prominent pulsation over the pulmonic valve area. the lungs were clear to auscultation bilaterally. chest wall revealed no there no lesions or tenderness to palpation. the abdomen was soft, nontender, and nondistended. no hepatosplenomegaly. normal bowel sounds. extremities revealed no clubbing, cyanosis, or edema. no calf tenderness to palpation. pertinent laboratory values on presentation: (in the emergency department, the patient had the following) she had a white blood cell count of 7.5 (91% polys, 1 band, and 6% lymphocytes), hematocrit was 38.8, and platelets were 318. her chemistry-7 was unremarkable; save for a glucose of 140. she had three negative cks and troponin levels. she had an initial chest x-ray which showed moderate cardiomegaly. no infiltrates or effusions. she had an ekg which showed a normal sinus rhythm at 89, borderline left atrial enlargement, and normal intervals. she had a rsr prime in v1 and v2. low voltage across the leads in the precordium. she had peaked t waves in ii suggesting a mitral equivalent. she had a flat t wave in v2. there were slightly diffuse pr depressions and pr elevations in avr. the patient subsequently had many other laboratories including the following: on hematocrit was 30.4 (after dropping to a nadir of 25.2). she had normal coagulations. she had an erythrocyte sedimentation rate of 34 and a c-reactive protein of 9.9. reticulocyte count was 2.1. she had pericardial fluid which had a hematocrit of 9% and 900 white blood cells, 41 polys, 54% lymphocytes, and 2% mesothelial cells. she had normal liver function tests. she had normal cholesterol studies. she had a total iron-binding capacity of 3042 and an iron that was low in the 20s. she had normal thyroid studies. she had a hemoglobin a1c of 5.5 and a normal cholesterol panel. she had a positive anti-smooth muscle antibody at a titer of 1:40 and then another of 1:80. her rheumatoid factor was negative. her double-stranded dna was negative. her antinuclear antibody was negative. human immunodeficiency virus antibody was negative. fluid chemistry from her pericardial fluid showed a total protein of 4.8, glucose of 69, lactate dehydrogenase of 1533, amylase of 43, albumin of 2.9, and cholesterol of 106. viral culture from the pleural fluid was no growth to . pleural fluid gram stain showed no polys and no microorganisms (this was pleural fluid). the culture was no growth. anaerobic culture was no growth. afb was negative. alpha-fetoprotein culture was pending. fungal culture was negative. pericardial tissue showed 1+ polys, no microorganisms, no growth on the tissue culture. no growth in the anaerobic culture. acid-fast bacillus smear was negative. acid-fast culture was pending. fungal culture was negative to date. pericardial fluid showed 2+ polys, no microorganisms. no growth in the fluid culture. no growth in the anaerobic culture. no acid-fast bacilli seen. acid-fast culture pending. fungal culture negative. blood cultures times two on were pending. lyme serology was negative. monospot was negative. anticardiolipin antibody pending. adenosine deaminase pending. pertinent radiology/imaging: she had multiple radiologic studies. she had a thyroid ultrasound which demonstrated a heterogenous nodule in the lower pole of the left thyroid with increased vascularity. she a computed tomography angiogram of her chest which showed cardiomegaly and a pericardial effusion. she had multiple chest x-rays which showed pleural effusions and pericardial effusions at various stages. please see the dictation of the images for further details. she had multiple echocardiograms; the first of which was on which demonstrated an ejection fraction of 55%. normal left ventricular wall thickness, cavity size, and systolic function. right ventricular chamber size and free wall motion was normal. moderate-to-large pericardial effusion, circumferential. no signs of tamponade. on she had one which showed a large pericardial effusion and a left pleural effusion; unchanged in size of the effusion but partial collapse of the right ventricle. she had a cardiac catheterization during this time which demonstrated a cardiac output of 3.6, and an index of 2.4, and equalization of right and left-sided pressures; consistent with tamponade; at which point she had a pericardiocentesis with about 600 cc of serosanguineous fluid removed. she then had a follow-up echocardiogram on which demonstrated resolution of the effusion, status post pericardiocentesis. she had a follow-up echocardiogram on which again demonstrated a normal left ventricular ejection fraction with a reaccumulation of a moderate-sized pericardial effusion which appeared somewhat loculated. there was imaging consistent with impaired ventricular filling and elevated intrapericardial pressure and brief right atrial collapse. she then had one on which again showed the moderate-sized effusion, loculated. then she had one on , status post pericardial window, which demonstrated a trivial pericardial effusion, left pleural effusion, and large resolution of pericardial effusion. she had cytology sent on the pericardial fluid which showed numerous lymphocytes of various size, rare reactive mesothelial cells. the second sample showed reactive mesothelial cells and numerous neutrophils. hospital course by issue/system: 1. pericarditis: the patient had a pericarditis of unknown etiology and pericardial tamponade. she underwent pericardiocentesis in cardiac catheterization laboratory, followed by reaccumulation of the effusion, and then pericardial window by cardiothoracic surgery. she had one episode of hypotension and bradycardia in the coronary care unit for which she was treated with intravenous fluids, and atropine, and temporary pressors with subsequent restoration of her blood pressure and heart rate. following the pericardial window, until , the patient did well with stable blood pressures with systolic pressures between 90 and 110 and diastolic pressures in the 50s to 70s range, but she remained tachycardic with sinus tachycardia from 100 to 120. the patient was followed in consultation by the cardiology service. the etiology of the pericarditis and effusion was unknown as of . the patient was being seen by infectious disease to help sort out if this was a possible viral pericarditis. 2. pleural effusions: the patient had bilateral pleural effusions; presumably from the same inflammatory process causing the pericarditis. she had bilateral chest tubes placed during the pericardial window procedure. there was a hydropneumothorax formed on the left, simple pericardial effusion on the right. the right chest tube was taken out on , and the left chest tube remained in place as of . 3. thyroid nodule: the patient has a thyroid nodule in the left thyroid lobe. it is unclear if this is related to a pericarditis; although this seems unlikely. the patient needs a fine-needle aspiration of this nodule which is to be arranged in house. 4. anemia: the patient has iron deficiency anemia and was started on iron. she will need a colonoscopy as an outpatient. she was guaiac-negative in house. 5. sinus tachycardia: the patient has persistent sinus tachycardia even after pericardial window. the etiology of this was unclear. the patient did not appear hypovolemic. although she was anemic, she was not anemic to the degree that this should cause a sinus tachycardia to this degree. she was not hypoxemic, and not in pain, and her left ventricular ejection fraction was normal. this was puzzling, and the etiology was still not determined as of . 6. edema: after aggressive fluid resuscitation to maintain her blood pressure had significant lower extremity edema bilaterally. this was likely accentuated by her low albumin, and she was encouraged to take additional protein supplementation with meals. diuretics were avoided given the lability of her blood pressure. , m.d. procedure: pericardiocentesis pericardiotomy biopsy of pericardium right heart cardiac catheterization other operations on thorax diagnoses: unspecified pleural effusion unspecified disease of pericardium other specified cardiac dysrhythmias hypotension, unspecified iron deficiency anemia, unspecified cardiomegaly nontoxic uninodular goiter 

Answer: The patient is high likely exposed to