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 / aspirin / colchicine attending: chief complaint: chest and back pain major surgical or invasive procedure: right heart catheterization history of present illness: ms. is a 64 year-old female with pmh of diabetes mellitus, hyperlipidemia, and hypothyroidism who is transferred from osh with acute onset of chest/back pain and concern for aortic dissection. patient was in her usual state of health until this morning at 2am, when she woke up with acute back - central, bilateral subscapular, and chest pain. the chest pain was b/l and pressure like in quality. it was exacerbated by movement and deep inspiration. she felt some sob, denied palpitations. has never had similar pain before. at the same time, she also had alternating chills/shakes with feeling extremely hot. pt was also having diarrhea until 7am. she went to osh in the early afternoon (see below for detail) at baseline, patient walks for 1 hr 3-4 times per week, independent in adls, some sob after walking up a flight of stairs but no chest pain. pt is up to date with malignancy screening: last mammogram 1 year ago was normal, last colonoscopy was in , had 1 polyp, was told to repeat in 5 years. has traveled to in . no sick contacts, no contact with small children. . patient initially presented to an osh where initial vitals were t 99 hr 120 bp 106/73 rr 24 o2 95 2l. pain was , relieved with morphine. labs relevant for wbc 10.2 hct 38.2 plt 237 na 136 k 4.2 cr 0.7 bun 14 cl 100 hco3 26 trop i neg. per wet read at osh, chest x-ray showed marked cardiomegaly and suggestion of mild infiltrate at l base. cta chest w/ contrast showed large pericardial effusion, no pe. there was some concern that patient had an aortic dissection causing blood to leak into the pericardium, and she was tranferred to for further evaluation. . in the ed, initial vitals were t 98.7 hr 114 bp 130/79 rr 23 o2 97 2l nc. cbc and chem7 were wnl. she underwent another cta to urgently evaluate for dissection given acute back pain and effusion. no dissection was seen per preliminary report, but a large, nonhemorrhagic pericardial effusion was noted. a bedside echo showed a large pericardial effusion, but no rv diastolic collapse or respiratory variation of flow across mitral or tricuspid valve. a pulsus was between 12 and 16. pericardiocentesis was deferred as pt had no signs of tamponade and she was admitted to the ccu for close monitoring. . on arrival to the floor, patient feels okay. states that her chest pain is now , worse with deep inspiration. no sob, no abd pain, no nausea, no palpitations. no joint pains, no rashes. . review of systems as above past medical history: dm ii hyperlipidemia hypothyroidism vocal cord ca with recurrence (details unclear) social history: from , french is primary language. lives in 2 family house on the , son lives upstairs -tobacco history: smoked for 22 years 2 packs per day, quit in -etoh: denies -illicit drugs: denies family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: admission physical exam: vs: t 100.5 bp 123/63 hr 117 rr 22 o2 sat 97 2l nc general: wdwn f in nad. oriented x3. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. mucous membranes slightly dry neck: supple with no jvd cardiac: rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4, no rub. pulsus 12. lungs: resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. extremities: no c/c/e. pulses: right: dp 2+ pt 2+ left: dp 2+ pt 2+ discharge physical exam: vs afebrile, bp 120-140s/70-90s, hr 94-120s, saturations 96% ra exam unchanged pulsus 8 for several days before discharge pertinent results: admission labs: 05:35pm blood wbc-10.5 rbc-4.18* hgb-12.4 hct-37.9 mcv-91 mch-29.7 mchc-32.7 rdw-13.6 plt ct-289 05:35pm blood neuts-73.7* lymphs-20.3 monos-5.4 eos-0.3 baso-0.3 04:03am blood wbc-9.5 rbc-3.87* hgb-11.6* hct-36.0 mcv-93 mch-29.9 mchc-32.1 rdw-13.6 plt ct-262 05:35pm blood pt-12.6* ptt-32.9 inr(pt)-1.2* 05:35pm blood glucose-114* urean-12 creat-0.6 na-137 k-3.9 cl-102 hco3-23 angap-16 04:03am blood glucose-98 urean-10 creat-0.6 na-140 k-3.6 cl-106 hco3-26 angap-12 05:35pm blood alt-14 ast-16 alkphos-74 totbili-0.7 05:35pm blood lipase-14 04:03am blood ctropnt-<0.01 05:35pm blood ctropnt-<0.01 05:35pm blood calcium-8.9 phos-3.6 mg-1.9 04:03am blood tsh-0.25* . urine: 07:30pm urine color-yellow appear-clear sp -1.050* 07:30pm urine blood-tr nitrite-neg protein-tr glucose-neg ketone-neg bilirub-neg urobiln-neg ph-7.0 leuks-neg 07:30pm urine rbc-2 wbc-1 bacteri-none yeast-none epi-<1 . micro: blood cultures (): ngtd urine culture (): ngtd . studies: ct torso (): 1. no evidence of aortic dissection or pulmonary embolism. 2. moderate-size complex pericardial effusion. 3. coronary artery calcifications, moderate in severity. 4. bilateral lower lobe atelectasis. . echo : due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). the aortic valve leaflets are mildly thickened (?#). the mitral valve leaflets are mildly thickened. there is a moderate to large-sized pericardial effusion, predominantly located anterior to the right ventricle. no right ventricular diastolic collapse is seen. ivc is of normal caliber with >50% collapse during inspiration. respiratory variation with mitral and tricuspid inflow varies less than 25%. impression: moderate-to-large pericardial effusion without echocardiographic signs of tamponade physiology. grossly preserved biventricular systolic function. . echo : regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). there is a moderate to large sized pericardial effusion. there is accentuated variation in mitral and tricuspid inflows, consistent with some degree ventricular interdependence. there are no other echocardiographic signs of tamponade. impression: moderate-to-large pericardial effusion. echocardiographic evidence of elevated intrapericardial pressure. . cxr : moderate enlargement of the cardiac silhouette, due to known pericardial effusion, with radiologic signs of tamponade. no evidence of pulmonary edema . right heart cath : assessment & recommendations 1. rechallenge with colchicine despite ear swelling yesterday. 2. repeat echocardiogram in 1 week. 3. call out to floor today. . echo : overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there is a moderate to large sized pericardial effusion. presence or absence of tamponade physiology was not evaluated on this study. compared with the prior study (images reviewed) of , the anatomic findings are similar. brief hospital course: brief clinical summary: ms. is a 64 year-old female with pmh of diabetes mellitus, hyperlipidemia, and hypothyroidism who is transferred from osh with acute onset of chest/back pain found to have a large pericardial effusion. active issues: # pericardial effusion/chest pain: patient p/w chest pain pleuritic in nature as well as back pain of acute onset. this was also in the setting of sudden onset chills alternating with sweats and diarrhea. cta chest showed moderate pericardial effusion but no dissection. etiology was thought to be viral given concurrent chills and diarrhea. a rapid respiratory viral screen was attempted but the specimen was inadequate. tuberculosis was considered unlikely because her ct was normal and she lacked other symptoms. no other sx of rheumatic disease so this was also thought to be unlikely. tsh was checked and was slightly low. malignancy workup was up to date as an outpatient per the patient. tte on admission showed moderate pericardial effusion with no signs of tamponade despite a pulsus of 14 on admission. her chest pain improved with tylenol but was recurrent, so she was started on colchicine for pericarditis given her allergy to asa. pt developed ear swelling following colchicine which was relieved with benadryl. repeat tte and cxr showed some concern for increased pericardial pressure and patient was taken to right heart cath. right heart catheterization was not indicative of tamponade physiology, and effusion was deemed too small for effective pericardiocentesis. it was decided to treat patient as stable viral pericarditis and rechallenge with colchicine following benadryl pretreatment. she was tolerating this regimen at the time of discharge and her pulsus had decreased to 8 for several days before discharge. # sinus tachycardia: hr was in 110s on admission. this was thought most likely due pain, dehydration, and concurrent viral infection. she was given several liters of fluid and her hr improved although she still became tachycardic with exercise. she did not have tamponade physiology on right heart catheterization. # allergic reaction: patient has an extensive allergy history to nsaids. she developed ear swelling and redness following colchicine administraton which she reported was similar to penicillin and aspirin allergies. there was no throat swelling, sob, or change in her voice. she responded to 50mg iv bendadryl. it was decided to continue treatment with colchicine following benadryl premedication. # hypothyroidism: initially continued home levothyroxine 175mcg po qd. tsh slightly low (0.25), so decreased to 150 mcg daily. will need outpatient follow up. chronic problems # hyperlipidemia: continued crestor 10mg qday # diabetes mellitus: patient to resume her home regimen at the time of discharge. transitional issues: - repeat tsh as outpatient in about 6 weeks - will need repeat echo in 1 week (ordered in omr) and then outpatient cardiology follow-up the following day. her colchicine should be tapered per her outpatient cardiologist based upon symptoms and evidence of effusion resolution on echo medications on admission: ketoconazole shampoo metformin 500mg po bid levothyroxine 175mcg po qd zyrtec 10mg qd crestor 10mg discharge medications: 1. ketoconazole topical 2. metformin 500 mg tablet sig: one (1) tablet po twice a day. 3. crestor 10 mg tablet sig: one (1) tablet po once a day. 4. zyrtec 10 mg tablet sig: one (1) tablet po once a day as needed for allergy symptoms. 5. synthroid 150 mcg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*1* 6. benadryl 25 mg capsule sig: one (1) capsule po twice a day as needed for allergy symptoms: if needed for allergy symptoms related to colchicine. disp:*60 capsule(s)* refills:*1* 7. colchicine 0.6 mg tablet sig: one (1) tablet po every twelve (12) hours. disp:*60 tablet(s)* refills:*2* discharge disposition: home with service facility: multicultural vna discharge diagnosis: primary diagnosis: viral pericarditis complicated by pericardial effusion discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mrs. , it was a pleasure taking care of you. you were admitted to the for a pericardial effusion, which is fluid around your heart. you were observed closely and we performed diagnostic tests to further characterize the fluid (ct scan, echocardiogram, and right heart catheterization). we think the fluid and pain is caused by a viral infection and we started medication to help relieve your symptoms. you should continue taking all of your medications, except for the following changes: medications started: 1. colchicine 0.6mg twice daily 2. benadryl 50mg twice daily, take 30 minutes before colchicine if needed if you develop an allergic reaction medications stopped/changed: decrease levothyroxine to 150mcg daily follow-up needed for: 1. evaluate the progress of your symptoms 2. recheck your thyroid levels in 6 weeks followup instructions: name: -,maysabel location: healthcare group address: , , , phone: appointment: thursday 10:30am *your primary care provider is leaving on for a 2 week vacation. it is very important you follow up before she leaves. department: echo lab when: thursday at 10:00 am with: echocardiogram building: gz building (felbeerg/ complex) campus: east best parking: main garage department: cardiac services when: thursday at 12:20 pm with: , md building: sc clinical ctr campus: east best parking: garage name: , location: cardiology address: , ste#404, , phone: appointment: monday 3:30pm md, procedure: coronary arteriography using a single catheter right heart cardiac catheterization diagnoses: diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism other and unspecified hyperlipidemia other specified cardiac dysrhythmias dehydration acute idiopathic pericarditis personal history of malignant neoplasm of larynx uric acid metabolism drugs causing adverse effects in therapeutic use other disorders of ear 

Answer: The patient is high likely exposed to