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: levaquin / quinolones attending: chief complaint: hypotension, pulmonary emboli major surgical or invasive procedure: none history of present illness: ms. is a 63 year old female with past medical history significant for lung cancer with brain metastasis, htn, hyperlipidemia, and history of pes on home coumadin which was recently stopped for surgery and re-started 2 days ago who presents now to ed as transfer from her outpatient brain xrt appointment after notable hypotension today to 70s systolic range with mild dizziness and new complaints of shortness of breath and feeling "winded". she explains having fairly acute onset of her dyspnea while lying in bed at rest last night and shortness of breath has been constant over the past 24 hours. . patient had been holding her home coumadin since recent neurosurgery last month (~) and only restarted her coumadin without bridging 2 days ago. of note, ms. was diagnosed with brain mets in after presenting with unsteady balance, nausea and emesis. she is s/p open brain resection on with drain-placement and later csf diversion procedure with placement of a vp shunt on . . in the ed, initial vital signs were: t97.4f, systolic 70/palp, hr 120, rr 23 and o2 sat 89% ra. she complained of shortness of breath but denied any dizziness, chest pains, headaches, nausea or emesis. stated she did have some nausea earlier in morning at her brain xrt appointment. in ed, she was initially given iv order for iv vanco/zosyn which was soon stopped after cta confirmed large saddle emboli as cause for her hypotension. she was fluid responsive and bps came up to 109-130s/50-80s range after 2l ivfs. o2 sats were improved to 97-100% on 3-5l nc. ct head showed no intraparenchymal hemorrhages and revealed stable post-operative changes in posterior fossa. . neurosurgery was consulted regarding her ability to safely start heparin gtt given her metastatic brain lesions and felt it was safe to start with plan for no bolus dose, ptt goal 40-60 and repeat head ct once she was in this ptt range. in ed, bedside tte done and showed no overt effusions, no rv strain or collapse. ekg showed rate 118, sinus, twis in v1-v2 with deep t-waves and rv strain. . on arrival to the , initial vital signs were: afebrile, hr 117, bp 130/95, rr 21, 98% on 3l nc. she was fully alert and oriented and denied any pain. complained of feeling occasionally winded even with nasal cannula in place. appeared to be in no acute distress. denies dizziness. past medical history: parkinsons disease -stage iiia (t1n2mo) right-sided lung ca s/p chemoradiation (ct-guided biopsy at hospital revealed adenocarcinoma. flexible bronchoscopy and lymph node sampling here on showing metastatic carcinoma. now s/p neoadjuvant cisplatin and etoposide, followed by chest irradiation. mediastinoscopy on showed residual carcinoma. now undergoing brain xrt for recent discovered brain mets to cerebellum. -resection, craniotomy & placement of a vp shunt -pe on lovenox/coumadin -hyperlipidemia -htn social history: lives in with her husband. retired manager from insurance business. smoked 1ppw cigarettes x 22 years and quit in . no etoh, no illicit drugs. has 4 children. walks with a walker at baseline now family history: mother died at age 85 from chf. sister is 53 years of age and she has breast cancer. she has 3 daughters and a son, and they are all healthy physical exam: vitals: afebrile, hr 117, bp 130/95, rr 21, 98% on 3l nc. general: fully alert and oriented x 3, no acute distress, scalp with large healed scar and head half shaved. heent: perrl, eomi. sclera anicteric, mmm, oropharynx clear neck: supple, jvp 9cm-10cm, no lad lungs: slight bibasilar crackles, no wheezes, rhonchi cv: rapid rate but regular. s1 + loud s2 appreciated , no clear murmurs but limited due to rapid rate. no rubs. abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: slightly cool, 2+ pulses, no clubbing, cyanosis or edema neuro: cns grossly in tact. sensation to light touch in tact. toes downgoing bilaterally. upper extremity strength 5/5. slight tremor with upper ext. pertinent results: 08:15pm hct-31.2* 08:15pm pt-14.8* ptt-91.8* inr(pt)-1.3* 05:30pm urine hours-random 05:30pm urine gr hold-hold 05:30pm urine color-straw appear-clear sp -1.035 05:30pm urine blood-tr nitrite-neg protein-25 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 05:30pm urine rbc-0-2 wbc-0-2 bacteria-few yeast-none epi- 02:29pm comments-green top 02:29pm glucose-124* lactate-2.5* na+-146 k+-4.0 cl--110 tco2-23 02:20pm glucose-133* urea n-31* creat-0.9 sodium-144 potassium-4.0 chloride-109* total co2-23 anion gap-16 02:20pm wbc-7.0 rbc-3.43* hgb-11.1* hct-33.8* mcv-99* mch-32.4* mchc-32.8 rdw-16.0* 02:20pm neuts-86.7* lymphs-9.0* monos-3.1 eos-0.7 basos-0.5 02:20pm plt count-126* 02:20pm pt-13.8* ptt-22.9 inr(pt)-1.2* 01:45pm glucose-138* urea n-32* creat-0.9 sodium-142 potassium-3.8 chloride-110* total co2-22 anion gap-14 01:45pm estgfr-using this 01:45pm ck-mb-4 ctropnt-0.04* 01:45pm wbc-6.9 rbc-3.54* hgb-11.6*# hct-35.2*# mcv-99* mch-32.7* mchc-32.9 rdw-16.6* 01:45pm neuts-85.7* lymphs-8.8* monos-4.2 eos-0.6 basos-0.7 01:45pm plt count-114* . imaging: cxr impression: 1. no acute cardiopulmonary process. 2. unchanged right hilar mass and small right pleural effusion. . cta chest: large saddle emoblism with bilateral segmental and subsegmental emboli and right heart strain. . cta neck and head: no dissection, aneurysm, or focal stenosis. no intraparenchymal hemorrhage. post op changes in posterior fossa. . ekg: rate 118, sinus, twis in v1-v2 with deep t-waves and rv strain. . brief hospital course: assessment and plan: in summary, ms. is a 63yo female with history of parkinson's disease, metastatic lung cancer (undergoing brain xrt), and h/o pulmonary embolisms who presents now with hypotension, and new saddle pe in setting of being off of her usual coumadin for several weeks. she was transferred to the floor on and then transferred back to the on for acute hypotension, found to have gnr bactermia secondary to uti; then tx back to floor and did well. . #hypotension / saddle pulmonary embolism: patient has history of pulmonary emboli that dates back to . she had been on home coumadin which was discontinued mid- for neurosurgery and never restarted until she began her home coumadin dosing 2 days prior to admission with no bridging. inr on admission was 1.2 range and cta confirms large saddle embolus. ekg with right heart strain. after 2l ivfs , bp improved to low 100-120s systolic range. o2 saturations maintained at >95% now on 3l nasal cannula; she was eventually weaned to 1l. management options for any thrombolysis contraindicated as patient with intracranial brain metastasis. the patient was put on a heparin drip, day 3 on with a goal ptt of 50-70. an ivc filter was also placed. she was subsequently transitioned to lovenox for discharge. #sepsis due to e coli bacteremia: she was re-admitted to the icu on for hypotension and was placed on pressor support and empiric antibiotics. on , her blood grew gram(-)rods. she was already on appropriate coverage for this infection with vancomycin and cefepime. on , the patient's urine grew pan-sensitive e. coli. her antibiotics were tailored to ceftriaxone. her pressure support was removed in the afternoon on and she remained normotensive. she received stress dose steroids for 1 day and was then transitioned back to her normal home regimen of dexamethasone. she will complete a course of iv ceftriaxone (preferred over po cefpodoxime given fluoroquinolone allergy) which should continue through . . #lung cancer / brain metastasis : diagnosed with stage iiia (t1n2mo) right-sided nsclc in winter with metastatic spread. she is now s/p neoadjuvant cisplatin/etoposide and s/p chest xrt. undergoing brain xrt for brain mets to cerebellum which was discovered in after she p/w headaches, nausea. she underwent brain resection, craniotomy & placement of a vp shunt 6/. the patient was continued on daily 2mg po dexamethasone therapy. she received brain radiation treatment while in the hospital and will continue as an outpatient. . # pt had some sob; presumable secondary to saddle pe, also with wheezing felt to be likely underlying copd given tobacco history. she was treated with nebulizers and advair with improvement which were continued on discharge. . # pt was noted to have elevated calcium- she was given a dose of pamidronate and the ca resolved. the calcium should be followed up as on outpatient by her oncologist. . #parkinson's disease: the patient's home medications of sinemet and mirapex were continued. . #gerd: the patient was continued on her home medication famotidine. . #nausea: since diagnosis of her brain mets in she has been experiencing ongoing nausea, emesis and gait disturbances. the patient received prn zofran. . medications on admission: medications - prescription carbidopa-levodopa - 25-100 mg tablet - 1 tablet(s) by mouth three times a day dexamethasone - (prescribed by other provider) - 2 mg tablet - 1 tablet(s) by mouth once a day famotidine - (prescribed by other provider) - 20 mg tablet - 1 tablet(s) by mouth twice a day metoprolol succinate - (prescribed by other provider) - 25 mg tablet sustained release 24 hr - 1 tablet(s) by mouth twice a day pramipexole - (dose adjustment - no new rx) - 0.50 mg tablet - 1 tablet(s) by mouth three times daily simvastatin - (prescribed by other provider) - 20 mg tablet - 1 tablet(s) by mouth daily medications - otc acetaminophen - (prescribed by other provider) - 325 mg tablet - 2 tablet(s) by mouth every four (4) hours as needed docusate sodium - (prescribed by other provider) - 100 mg capsule - 1 capsule(s) by mouth twice a day multivitamin-min-calcium-fa - (prescribed by other provider; otc) - dosage uncertain sodium chloride - (prescribed by other provider) - 1 gram tablet - 2 tablet(s) by mouth three times a day discharge disposition: home with service facility: vna of discharge diagnosis: saddle pulmonary embolus gram negative bactermia urinary tract infection hypercalcemia 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: you were admitted to the hospital with low blood pressure. you were discovered to have a clot in your lungs that was causing this low blood pressure you were started on blood thinning medications. you also had a procedure to place a device that would help prevent further clots, called an ivc filter. . your hospital course was complicated by an additional icu stay where you were found to have an infection in your urine that spread to your blood. you are being treated with iv antibiotics for this infection. . in addition, your calcium was noted to be high and you were given a dose of medicine called pamidronate to help bring this level down. . you will be going to rehab in order to gain your strength and continue the medications you were receiving in the hospital. . the following changes were made to your medications: started: lovenox sc ceftriaxone to be completed on albuterol inhaler as needed to help with breathing advair inhaler- to help with breathing stopped: coumadin (instead of coumadin you will be on the blood thinning medication lovenox) metoprolol you should follow up with your pcp and oncology as documented below. followup instructions: name: , m. location: healthcare - address: , , phone: appointment: wednesday 11:00am department: hematology/oncology when: thursday at 3:30 pm with: , md building: sc clinical ctr campus: east best parking: garage procedure: venous catheterization, not elsewhere classified interruption of the vena cava other radiotherapeutic procedure angiocardiography of venae cavae diagnoses: acidosis unspecified pleural effusion urinary tract infection, site not specified unspecified essential hypertension unspecified septicemia severe sepsis obstructive chronic bronchitis with (acute) exacerbation personal history of tobacco use other and unspecified hyperlipidemia paralysis agitans secondary malignant neoplasm of brain and spinal cord malignant neoplasm of bronchus and lung, unspecified blood in stool septic shock primary hypercoagulable state other pulmonary embolism and infarction hypercalcemia 

Answer: The patient is high likely exposed to