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: no known allergies / adverse drug reactions attending: chief complaint: chest pain major surgical or invasive procedure: pericardiocentesis history of present illness: this is a 52 year old female with pmhx of hyperlipidemia who presents to the ccu tonight after her pcp sent her to emergency department for an enlarged heart on cxr. the patient's history begins about 5 weeks ago when she experienced left anterior chaest pain which woke her around 0500 that mornig. pain is worse with breathing and radiated into her left arm and left side of the neck. she went to (which records were obtained) and had an mi workup including 2 sets of negative cardiac enzymes, a negative stress test, and an unremarkable echo. she also with ct scan for r/o pe which found a 5 mm nodule in the rul but not other findings. patient was discharged from the hospital with no clear diagnosis. prior to onset of symptoms, she denied any recent local or foreign travel or cough/cold symptoms. patient continued to have chest pain over the next month. earlier this week she started having fevers, chills, and night sweats. temperature taken at home was max 100.8. she did experience some sob and nausea, but no vomiting. she presented to an osh where she refused labs as she had already undergone workup and was discharged with a zpack. she noted continued symptoms and decided to see her pcp today who ordered a cxr and saw cardiomegaly, pleural and pericardial effusion and sent her to the ed. in the ed, initial vitals were 18:04 8 99.2 106 116/72 20 97%. she was having pain worse while lying supine and relieved sitting upright. pt states pain in chest, neck, upper abdomen and upper back. pt with some sob with exersion. patient given toradol iv and zosyn, 1l ns, fentanyl. pulses done at bedside by cardiology fellow which revealed only 10 mmhg. bedside echo showed moderate to large pericardial effusion with right atrial diastolic collapse and impaired r ventricular filling upon inspiration. . on arrival to the ccu patient has an aching pain with family at the bedside. . review of systems on review of systems, s/he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. s/he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: past medical history: 1. cardiac risk factors: diabetes, dyslipidemia, hypertension 2. cardiac history: -cabg: -percutaneous coronary interventions: -pacing/icd: 3. other past medical history: -intimal thickening in r carotid artery hystectomy for fibroids hemorrhoids, recent negative colonoscopy 5 years ago mammogram one month prior- normal . medications: pravastatin 40mg daily docusate sodium 100 mg daily lactobacillus rhamnosus gg 1 capsule daily allergies: nkda social history: -tobacco history: none -etoh: occasional -illicit drugs: none -works for shoe store in inventory moving boxes family history: family history: family history of cad in grandparents at older age. breast cancer in grandmother and pancreatic cancer in another relative . physical exam: physical examination: vs: t=99.8 bp=113/70 hr=102 rr=25 o2 sat= 98% general: nad, appears somewhat tired heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 6 cm cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2, no pericardial rub heard lungs: no chest wall deformities, scoliosis or kyphosis. mild crackles auscultated bilaterally but l>r abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: on admission: cbc: 13.1/9.2/28.3/322 differential: 82%n, 13%l, 4%mono, 0.1%e, 0.2%b 139 100 14 105 agap=16 4.4 27 0.6 lactate: 1.6 lfts: alt ast ld(ldh) ck(cpk) alkphos amylase totbili dirbili 37 22 160 153* 0.4 lipase: 18 iron studies: caltibc ferritn trf 195* 418* 150* complement levels: c3: 124 c4: 28 hiv: negative tsh: 0.95 on discharge: wbc rbc hgb hct mcv mch mchc rdw plt ct 7.6 2.99* 8.2* 26.1* 87 27.6 31.6 12.3 459* glucose urean creat na k cl hco3 angap 87 9 0.4 143 4.0 106 29 12 ua: color yellow appear clear specgr 1.011 ph 6.0 urobil neg bili neg leuk neg bld tr nitr neg prot tr glu neg ket neg rbc 1 wbc 1 bact none yeast none epi <1 other urine counts casthy: 4 mucous: rare ekg: sinus tachy, rate 103, normal axis and intervals, no st changes, low voltage 2d-echocardiogram: overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the mitral valve appears structurally normal with trivial mitral regurgitation. there is a moderate to large sized pericardial effusion. there is brief right atrial diastolic collapse. there is significant, accentuated respiratory variation in mitral/tricuspid valve inflows, consistent with impaired ventricular filling. . tte overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there is a small pericardial effusion. the effusion is echo dense, consistent with blood, inflammation or other cellular elements. there are no echocardiographic signs of tamponade. compared with the prior study (images reviewed) of , the findings are similar. . cxr: impression: overall cardiac contour appears somewhat smaller than on previous study in this patient status post pericardiocentesis for a pericardial effusion. there continued to be layering bilateral effusions with associated bibasilar airspace opacities, which most likely represent partial lower lobe atelectasis, although pneumonia cannot be entirely excluded. there is cephalization of the pulmonary vasculature consistent with pulmonary venous hypertension but no overt pulmonary edema. no pneumothorax is seen, although the sensitivity to detect pneumothorax is diminished given supine technique. overall mediastinal contours are stable. . pericardial fluid cytology: negative for malignant cells. . micro: urine culture (final ): no growth. pericarlial fluid. fluid culture in bottles (preliminary): no growth. pericarlial fluid. gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. this is a concentrated smear made by cytospin method, please refer to hematology for a quantitative white blood cell count.. fluid culture (final ): no growth anaerobic culture (preliminary): no growth. acid fast smear (final ): no acid fast bacilli seen on direct smear. acid fast culture (preliminary): fungal culture (preliminary): no fungus isolated. . blood culture: : ngtd brief hospital course: assessment and plan ms is a 52 y/o female with no significant past medical history who initially presented with constitutional symptoms for 1 week found to have pericardial effusion transferred to ccu for pericardial drainage. # pericardial effusion: ddx was infectious vs. neoplastic vs. autoimmune. symptoms likey represent viral pericarditis with effusion development however in the setting of systemic complaints a broad ddx was entertained. she underwent an uncomplicated pericardicentesis on with drain placed. 400 cc serosanginous fluid was initially drained; additional 200cc drained thereafter. once fluid slowed drain was pulled. fluid analysis: wbcs 275, 69% lymphs; cytology returned negative and cultures without growth. additional work-up notable for tsh: 0.95, : 1:40, complement levels wnl, cardiac enzymes negative x3. quantiferon gold (ordered on ) was pending at time of discharge. of note, patient reports cancer screening uptodate with nl mammography in and c-scope ~7years prior. due to concern for underlying pericarditis patient was started on ibuprofen and colchicine and patient symptomatically improved. discharged with plan to continue ibuprofen and colchicine for 2 weeks. patient instructed to take nsaids with food to avoid gastritis follow-up: obtain repeat tte in 1 week to ensure resolution of effusion follow-up quantiferon gold continue treatment of presumed pericarditis x2weeks. . # bilateral pleural effusions. on admission cxr with enlarged cardiac siluette and clear lung fields. on patient developed fever to 101 and cxr was obtained in broad fever work-up. imaging revealed interval development of small bilateral pleural effusions and mild interstitial markings. ddx: cardiac congestion/pulmonary edema vs serositis. repeat cxr confirmed findings of fluid overload. remainder of exam was without signs of heart failure (elevated jvp, le edema) or signs of reaccumulation of pericardial effusion leading to heart failure. patient was completely asymptomatic with o2 saturation wnl. at time of discharge patient was saturating >95%ra with respiratory rates . outpatient issues: repeat cxr in 1 week to assess effusions # hyperlipidemia: patient continued on pravastatin 40 mg daily # normocytic anemia: patient with baseline normocytic anemia. previous etiology thought to be fibroid uterus (she is now s/p hysterectomy) as well as potential gi bleed (c-scope ~7yrs ago without overt pathology per patient) on admission no signs of blood loss - denying melena, hematchezia, hematemesis. iron studies were suggestive of anemia of chronic disease. outpatient issues: trend hematocrit consider further gi work-up # hypoalbumenia. on admission albumin 2.9. inr on discharge 1.2. remaining lfts wnl. no preceding hx of liver disease; no stigmata of concern liver disease on exam outpatient issue: repeat albumin and lfts as outpatient medications on admission: preadmission medications listed are correct and complete. information was obtained from patient. 1. pravastatin 40 mg po daily 2. docusate sodium 100 mg po bid 3. lactobacillus acidoph & bulgar *nf* 1 million cell oral daily discharge medications: 1. colchicine 0.6 mg po bid rx *colcrys 0.6 mg one tablet(s) by mouth twice a day disp #*60 tablet refills:*1 2. ibuprofen 400 mg po bid please take with food to avoid gastritis 3. docusate sodium 100 mg po bid 4. pravastatin 40 mg po daily 5. lactobacillus acidoph & bulgar *nf* 1 million cell oral daily discharge disposition: home discharge diagnosis: pericardial effusion pleural effusions discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: it was a pleasure taking care of you at . you were found to have an effusion or collection of fluid in your lungs and surrounding your heart. we think this is because of a virus but we have sent tests to look for other causes. these test results will be communicated to you by dr. next monday. we drained the fluid around your heart it does not seem to have reaccumulated. you will need to have an echocardiogram and a chest xray done on friday. please take colchicine and ibuprofen twice daily for two weeks to decrease the pain and inflammation. followup instructions: name: , specialty: primary care when: monday at 11:30am address: ,ste 5a, , phone: . echocardiogram and chest xray . this will be done at . please call if you have not heard about this test in the next 1-2 days. procedure: pericardiocentesis right heart cardiac catheterization diagnoses: anemia, unspecified unspecified pleural effusion other and unspecified hyperlipidemia other specified cardiac dysrhythmias other disorders of plasma protein metabolism acute idiopathic pericarditis cardiac tamponade 

Answer: The patient is high likely exposed to