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: sulfonamides / erythromycin base / nsaids / lisinopril / lipitor attending: chief complaint: right flank pain major surgical or invasive procedure: none history of present illness: 45-year-old female with lupus nephritis s/p living related renal x-plant in who presented with right flank pain for the past 4 days. she has had rising creatinine over the last couple of months and had a biopsy in with evidence of chronic allograft nephropathy. she is currently undergoing another transplant evaluation from another brother as she is chronically rejecting. . on admission, the patient reported 3-4 days of right flank pain. she described the pain as a burning pain, without significant radiation, located over the flank and the back approximately at the level of the iliac crest. she denied any pain over her transplanted kidney. she had been tolerating pos without any n/v/d. she denied any trauma to the site prior to development of pain or musculoskeletal strain. she also denied any f/c/r, hematuria, dysuria, and urinary frequency. the patient also denied any sick contacts (although she works as a clinical lab technician drawing labs from patients in local med center), as well as any travel or exposure to new pets. of note, she did have an illness with diarrhea approximately one month ago, but recently she had been having one regular stool/day. in terms of medications, she has been compliant with her medications without any missed doses. she has been prescribed ultram for prn pain which she has been taking nightly for years. with the onset of pain, she has been taking 1-2 tabs q6 hours over the last 4 days. the only new medications are aranesp injections as well as iron tablets started 6 weeks ago for anemia. she was previously on lisinopril for several months which was stopped in due to angioedema. . in the ed, she was thought to have had some tenderness to palpation. a renal graft ultrasound was performed and demonstrated increasing size and edema of the kidney. the transplant service was called, but did not have any specific recommendations. the patient was given morphine 2mg x2, at which point she developed nausea and vomiting. she was subsequently given dilaudid 2mg x1, and anzemet 12.5mg x2. . at 4am her peripheral iv infiltrated. the iv nurse found her unresponsive, grey, clammy, and hypoxic (?) with an oxygen sat of 40%. she was hypotensive to 100/palp (nl sbp 180) and mildly tachycardic with a heart rate of 100. her fingerstick at that time was 200. she was placed on a nrb with an increase of her oxygen sats to 100% at which time she quickly regained consciousness. she was rapidly titrated down to 2l via nasal cannula with an o2 sat of 100%. her abg (?timing and ?fio2) was 7.3/65/70. . on review of systems here in the icu, she has not had any fevers, chills, sob, cp, weight loss, recent diarrhea, rashes, hematuria, or traumatic injuries. she does snore at night and likely has sleep apnea from what her husband has told her. on further reflection, she has felt much more tired recently and has been "sleepy." past medical history: 1. lupus diagnosed in . 2. lupus nephritis status post transplant; baseline creatinine rising over the last last 6mo. 3. gout. 4. childhood rheumatic fever. 5. hypertension. 6. cataracts. 7. s. pneumonia in her sputum in 02/. 8. cmv viremia in treated with ganciclovir. 9. squamous cell ca followed by derm. 10. chf- ef 35% social history: lab technician who lives with her husband and her two adopted children. tob: five-pack-year history of smoking but quit 10 years ago etoh: three glasses of ethanol per week. family history: mother: mi in her 60s. father: aaa rupture in 60s physical exam: initial vitals on admission: 98.3 162/104 16 93%3l icu vitals: t 100.1, hr 112, bp 153/105, rr 14, o2 sat 83-87% ra, 93-94% on 2l nc gen: overweight. nad. heent: eomi, anicteric, op clear, mmm. cv: regular tachycardia without m/r/g. difficult to assess jvd. chest: bibasilar crackles back: slight point tenderness to palpation over right superior iliac crest at its lateral margin. abd: soft, nt, nd, no tenderness to palpation over the transplanted kidney, no rebound or guarding. +bs. ext: warm. trace bilateral le edema. no pain with rotation or flexion/extension of the right hip. skin: no rashes. pertinent results: 07:00pm urine color-straw appear-clear sp -1.012 07:00pm urine blood-sm nitrite-neg protein-500 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.0 leuk-neg 07:00pm urine rbc-0-2 wbc-0-2 bacteria-rare yeast-none epi-0 04:10pm glucose-95 urea n-57* creat-3.0* sodium-141 potassium-3.2* chloride-98 total co2-32 anion gap-14 04:10pm calcium-8.6 phosphate-3.2 magnesium-2.0 04:10pm wbc-8.2 rbc-4.15* hgb-11.9* hct-34.7* mcv-84 mch-28.8 mchc-34.4 rdw-15.9* 04:10pm neuts-57.4 lymphs-34.5 monos-5.6 eos-1.4 basos-1.1 04:10pm microcyt-1+ 04:10pm plt count-172 04:10pm pt-11.0 ptt-19.9* inr(pt)-0.9 . ct without contrast - 1. comment on pe cannot be made without iv contrast. 2. peribronchial cuffing and interstitial edema with bilateral basilar pleural effusions and consolidation. 3. atrophy of both native kidneys. . renal transplant ultrasound : transplanted right kidney now measures 12.3 cm in length, and previously measured 9.7 cm. there is a heterogeneous and edematous appearance of the transplanted kidney. there are no peritransplant fluid collections. there is no hydronephrosis or stone. the arterial and venous flow is patent and normal. the ris range from 0.58-0.67. impression: compared to the prior examination, the transplanted kidney has increased in size and has an edematous appearance. there is normal flow demonstrated with ris within normal limits. there is no peritransplant fluid collection. . cxr: subtle opacity in the right lower lobe concerning for early pneumonia or aspiration. mild cardiomegaly. pulmonary arterial hypertension. . v/q scan : perfusion images in 8 views show slightly heterogeneous perfusion without definite focal perfusion defect. ventilation images obtained with tc-m aerosol in the same 8 views demonstrate some central deposition of tracer consistent with airway disease. there are no mismatched defects. chest x-ray shows right lower lobe pneuomonia. impression: low likehood ratio for recent pulmonary embolism. . chest ct: impression: 1. comment on pe cannot be made without iv contrast. 2. peribronchial cuffing and interstitial edema with bilateral basilar pleural effusions and consolidation. 3. atrophy of both native kidneys . echo : ef 35%, dilated, mild symm lvh, moderate global lv hk, 1+ ar, 2+ mr brief hospital course: # hypoxia/hypercarbia - the patient was ruled out for pe with a v/q scan that was low-prob. cxr was consistent with pneumonia and the pt was started on levofloxacin. her o2 sats improved gradually as did her cough and on day of discharge her ambulatory sats were 94% on ra. she was discharged to complete a 10 day course of levofloxacin. . # flank pain: given the increase in size as well as the edematous appearance of the x-planted kidney with associated sx of pain and nausea, there was a possibility of acute on chronic rejection of the x-planted kidney. however she had no pain/tenderness over her transplanted kidney and she has a creatinine of 3 which was lower than it has been since . ultrasound of the transplanted kidney showed that it had increased in size and had an edematous appearance. however, normal flow was demonstrated with ris within normal limits. on the 3rd day of admission the pt developed a vesicular rash on the skin in her flank area consistent with herpes zoster. she was started on valacyclovir and neurontin. this was felt to be the likely culprit of her pain. she continued to have pain and was d/c'd on oxycontin with oxycodone for breakthrough pain related to the zoster. the rash did remain within one dermatome and did not cross the midline. . # h/o kidney transplant: pt was continued on prednisone 5mg and rapamune alternating 2mg and 1mg doses. rapamune levels were therapeutic. . # htn: the pt had elevated bp in ed of max sbp 200. it was felt that pain may have been contributing, but even when her pain appeared to be controlled she still was hypertensive. she was continued on diltiazem 240 mg daily and imdur 30mg po daily was added and her bp came down to the 140's/70's. the renal transplant team recommended decreasing her lasix from 80 mg to 40mg daily since her cr had risen slightly over the admission. she was continued on aspirin 325 mg daily for primary cad ppx. . # anemia: the pt has had chronic stable anemia with hct in the 30s since . of '. hct was relatively stable and she did not require any transfusions. she was continued on fe. aranesp was held while in house. . # fen: she was continued on nutritional supplementation with calcium carbonate 500mg , multivitamins and fish oil 1g . . # ppx: heparin sc, ppi . # code status = full code medications on admission: 1. prednisone 5mg once daily 2. rapamune 2mg alternating with 1mg once daily 3. lasix 80 mg daily 4. diltiazem 240 mg daily. 5. allopurinol 200 mg daily. 6. aspirin 325 mg daily 7. aranesp once weekly 8. ultram p.r.n. -> which she has been taking 1-2 tabs q4-6hours over the last couple of days 9. potassium chloride 20 meq daily 10. fe 11. calcium carbonate 600mg . 12. multivitamins. 13. fish oil 1g . discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 3. sirolimus 1 mg tablet sig: two (2) tablet po mwf (monday-wednesday-friday). 4. sirolimus 1 mg tablet sig: one (1) tablet po qtu, thurs, sa, sun (). 5. diltiazem hcl 240 mg capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). 6. allopurinol 100 mg tablet sig: one (1) tablet po every other day (every other day). 7. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). 8. multivitamin capsule sig: one (1) cap po daily (daily). 9. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 10. omega-3 fatty acids 550 mg capsule sig: two (2) capsule po bid (2 times a day). 11. levofloxacin 250 mg tablet sig: one (1) tablet po q48h (every 48 hours) for 5 days: last day . disp:*3 tablet(s)* refills:*0* 12. isosorbide mononitrate 30 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). disp:*30 tablet sustained release 24hr(s)* refills:*2* 13. valacyclovir 500 mg tablet sig: two (2) tablet po qd () for 10 days. disp:*20 tablet(s)* refills:*0* 14. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 15. gabapentin 300 mg capsule sig: one (1) capsule po bid (2 times a day) for 10 days: may refill if pain continues after 10 days. . disp:*20 capsule(s)* refills:*1* 16. oxycodone 5 mg tablet sig: 1-3 tablets po q4h (every 4 hours) as needed for 10 days: may cause sedation. do not drive or operate machinery while taking this med. . disp:*30 tablet(s)* refills:*0* 17. senna 8.6 mg tablet sig: two (2) tablet po bid (2 times a day). 18. docusate sodium 100 mg capsule sig: two (2) capsule po bid (2 times a day). 19. promethazine 12.5 mg suppository sig: one (1) suppository rectal every 4-6 hours as needed for nausea. disp:*10 suppositories* refills:*1* 20. oxycontin 10 mg tablet sustained release 12hr sig: tablet sustained release 12hrs po every twelve (12) hours as needed for pain for 10 days: may cause sedation. do not drive or operate heavy machinery. . disp:*20 tablet sustained release 12hr(s)* refills:*0* discharge disposition: home discharge diagnosis: shingles pneumonia hypertension discharge condition: stable discharge instructions: if you develop fevers, chills, irretractable nausea, vomiting, chest pain, or shortness of breath, please call your pcp or return to the ed. changes to medications: allopurinol - please only take 100mg every other day. lasix - please only take 40mg daily. followup instructions: please follow up with dr. in the next 1-2 weeks. provider: / md phone: date/time: 10:30 provider: , md phone: date/time: 11:20 provider: , transplant social work date/time: 2:00 procedure: venous catheterization, not elsewhere classified diagnoses: pneumonia, organism unspecified chronic glomerulonephritis in diseases classified elsewhere systemic lupus erythematosus anemia in chronic kidney disease congestive heart failure, unspecified unspecified essential hypertension gout, unspecified surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation complications of transplanted kidney herpes zoster without mention of complication 

Answer: The patient is high likely exposed to