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: patient recorded as having no known allergies to drugs attending: chief complaint: dyspnea major surgical or invasive procedure: none history of present illness: ms is a 60 year old female with a hx of dm2, htn, and cva who presents with dyspnea x 3 days. pt states that her symptoms began acutely on sunday evening when she was lying supine. she stated that she has previously never had similar symptoms. she states that her shortness of breath is worse at night when she lays down and is relieved with sitting up. this am, she was noted at her pcp's office to be in afib with rvr (140s) and also had twi in lateral leads that were new. . in the ed, vs were bp 108/72 hr 115 o2sat 95%ra. given her rvr, patient recieved iv dilt 10mg x 4 and dilt 30mg po. her hr decreased to the 110s and she remained hd stable during the entire episode. patient also had sob and chest pressure in the ed and responded to nitro. in addition, the patient received a dose of cipro for a positive ua, though she denies dysuria. she was also found to be in arf with a cr of 1.4 (b/l 0.8) and received 2l of ns. however, her bnp was later found to be significantly elevated to 7600. . pt was initially admitted to the floor. she was initially rate controlled with po metoprolol and iv lopressor with 1 dose of diltiazem. in addition a bedside echo done (given low voltage on ekg, ? muffled heart sounds and possible concern for pericardial ffusion)-->showed ef 15% that was new and no evidence of effusion. in addition, her bp remained low 70-80s and thus decision made to transfer to ccu for closer monitoring and inotropic support with dobutamine. . patient denies having any recent colds, but admits to allergies associated with rhinorrhea and watery eyes. . denies fever or chills. admits to nausea and vomiting. no diarrhea, constipation or abdominal pain. no melena or brbpr. past medical history: pmh: - type 2 diabetes - history of cerebrovascular accident - depression - remote history of necrotizing fasciitis social history: social hx: lives with nieces and nephew. non-, rare alcohol use. practicing catholic. family history: family hx: father died of mi at age 50. positive for lung and throat cancer in siblings who smoked. physical exam: vitals: t: 98.9, 113, 127/75, 85, 25, 97%ra general: alert and oriented x 3, nad heent: atnc, eomi, no aniscoria neck: supple, 12 cm jvd. no carotid bruits pulmonary: ctab, no wheezes or rhonchi. cardiac: irreg irreg, distant hs, no murmurs, rubs, or gallops. rv heave, laterally displaced pmi. abdomen: soft, nt, nd, normoactive bowel sounds, no masses or organomegaly extremities: 1+ le edema, 2+ pt/dp pulses b/l lymphatics: no cervical, supraclavicular, axillary or inguinal lymphadenopathy noted skin: no echymoses. extremities were cool on examination prior to transfer to ccu. neuro: cn grossly intact . pertinent results: 07:30pm ck(cpk)-60 07:30pm ck-mb-notdone ctropnt-0.03* 07:30pm hbsag-negative hbs ab-negative 07:30pm hcv ab-negative 12:30pm urine hours-random creat-350 sodium-33 12:30pm urine color-amber appear-hazy sp -1.029 12:30pm urine blood-mod nitrite-neg protein-30 glucose-tr ketone-tr bilirubin-sm urobilngn-4* ph-5.0 leuk-mod 12:30pm urine rbc-0-2 wbc-21-50* bacteria-few yeast-none epi- 12:30pm urine hyaline-0-2 12:00pm estgfr-using this 12:00pm alt(sgpt)-74* ast(sgot)-45* ck(cpk)-62 alk phos-132* tot bili-0.6 12:00pm ctropnt-0.02* 12:00pm ck-mb-notdone probnp-7612* 12:00pm albumin-4.0 calcium-8.8 phosphate-3.3 magnesium-1.5* iron-40 12:00pm caltibc-307 ferritin-270* trf-236 12:00pm tsh-1.2 12:00pm free t4-1.3 12:00pm wbc-10.7# rbc-3.68* hgb-11.5* hct-34.1* mcv-93 mch-31.2 mchc-33.7 rdw-14.4 12:00pm neuts-81.2* lymphs-14.4* monos-3.8 eos-0.3 basos-0.2 12:00pm plt count-240 12:00pm d-dimer-2381* 12:00pm ret aut-2.6 echo : the estimated right atrial pressure is 10-20mmhg. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. there is severe global left ventricular hypokinesis (lvef =15-20 %). transmitral doppler imaging is consistent with grade iii/iv (severe) lv diastolic dysfunction. the right ventricular cavity is markedly dilated with moderate global free wall hypokinesis. the aortic valve leaflets appear structurally normal with good leaflet excursion. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. the left ventricular inflow pattern suggests a restrictive filling abnormality, with elevated left atrial pressure. moderate tricuspid regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: severe global biventricular systolic dysfunction. elevated filling pressures. mild to moderate mitral regurgitation. moderate tricuspid regurgitation. brief hospital course: assessment: 60 year old female with a hx of dm2, htn, and cva who presents with dyspnea x3 days, afib, and new dilated cm with ef 15-20%. . # atrial fibrillation: patient presented in a. fib with rvr and was managed in the ed with iv and po diltiazem, though she required high doses of each. on the floor, she again became tachycardic with afib with rvr and was given iv and po lopressor. a bedside echo was performed for concern of pericaditis, as the patient had low voltage on her ekg and there was some concern that she may have had a pericardial effusion. the study revealed acute, decomponsated chf, with a dilated cardiomyopathy and an ef of 15%, compared to a baseline ef of 56% on . she also became hypotensive with sbps in the 80s and was transferred to the ccu. it was thought that she had received too much negatively inotropic medication. in the ccu, the patient was started on dobutamine gtt with goal sbp > 100. this was rapidly weaned. tee was done which did not reveal any or echo contrast. therefore, cardioversion was attempted. however, this failed. she was started on amio and lisinopril were started. dig was subsequently added for further rate control. carvedilol was up titrated and she was started on coumadin for anticoagulation. #chf, systolic, new diagnosis: stable. patient's bps when she reached the ccu was 60-80s systolic. on exam, patient's lungs were ctab, 12 cm jvd, cool extremities, c/w cardiogenic shock. patient's bps have been low, likely compounded with afib with rvr. the pt briefly required pressors, but was off dobutamine by the morning following admission. pt was started on a lasix drip and diuresed well and was transitioned to stable lasix dose. sx of hf and pressor requirement resolved completely. . # dilated cardiomyopathy: though the etiology of the patient's dilated cmp cannot be determined definitively, her toxicology screen was found to be positive for cocaine and she endorses etoh use. of note, the patient's echo did not show evidence of amyloid and her iron studies and tsh were all normal, with the exception of an elevated ferritin. viral studies have been negative: hiv, cmv, ebv (igm neg). . # arf: patient was found to be in arf with a cr that peaked at 2.0 compared to a b/l of 0.8. pt was thought to be prerenal from poor systolic function and cr decreased to 1.4 by the time of discharge. . # uti: positive ua. started on cipro in ed for ?uti, asymptomatic. urine sample contaminated with epithelial cells. repeat ua was negative and cipro was stopped. . # transaminitis: pt had elevated lfts on admission with alt and ast that peaked at 1100 and 1900. lft's trended down as pressures and forward flow improved. . # dm2: hba1c <6% on recent evaluation. patient was managed with an iss and oral hypoglycemics were held. given new diagnosis of heart failure pt was swiched to glyburide 5mg po bid (actos, metformin were dc'd given chf). medications on admission: clopidogrel 75 mg daily fluoxetine - 20 mg capsule - 1 capsule(s) by mouth m,w,f. 2 on t,t,s,s for depression metformin - 1000mg pioglitazone - 45 mg tablet - tablet(s)(s) by mouth once a day for sugar pravastatin - 20 mg tablet - 1 tablet(s) by mouth once a day for cholesterol triamcinolone acetonide - 0.1 % ointment - apply twice a day as needed for rash asa 81 discharge medications: 1. outpatient lab work please check inr on thursday and call results to dr. at 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. fluoxetine 20 mg capsule sig: one (1) capsule po qmwf (). 4. fluoxetine 20 mg capsule sig: two (2) capsule po qttss (). 5. pravastatin 20 mg tablet sig: one (1) tablet po daily (daily). 6. triamcinolone acetonide 0.1 % ointment sig: one (1) appl topical tid (3 times a day) as needed for rash. 7. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily): start . disp:*30 tablet(s)* refills:*2* 8. furosemide 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. carvedilol 6.25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 10. warfarin 2 mg tablet sig: one (1) tablet po once daily at 4 pm. disp:*60 tablet(s)* refills:*2* 11. glyburide 5 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 12. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: primary: atrial fibrillation acute dilated cardiomyopathy acute congestive systolic heart failure . secondary: type 2 diabetes cerebrovascular accident depression history of necrotizing fasciitis discharge condition: good discharge instructions: you were admitted because of shortness of breath. we diagnosed you with a heart arrhythmia called atrial fibrillation. we also determined that you had heart failure, as your heart was dilated. you had congestive heart failure which means that your heart is weak. to treat you for these conditions, we gave you medications to slow your heart rate down and improve its pump function. you will need to start warfarin (coumadin) to prevent blood clots and strokes. both the atrial fibrillation and weak heart function put you more at risk for a stroke or clot. . please take all of your medications as prescribed. please keep all of your follow-up appointments. . new medicines: 1. warfarin: to prevent blood clots and strokes. the goal blood level of warfarin is . you will need to have your blood drawn frequently until we have you on the right dose of warfarin. please see the sheet given to you about taking and monitoring warfarin. do not take warfarin tonight, resume taking 2mg tomorrow . 2. furosemide: a diuretic to prevent fluid accumulation 3. lisinopril: to help you heart beat stronger and lower blood pressure 4. carvedilol: to lower your heart rate and help your heart beat stronger 5. amiodarone: to keep your heart rate low 6. glyburide: to replace actos and metformin for your diabetes. please call your doctor or return to the hospital if you experience fevers, chills, sweats, chest pain, shortness of breath or anything else of concern. . weigh yourself every morning, md if weight > 3 lbs in 1 day or 6 pounds in 3 days. adhere to 2 gm sodium diet: information was given to you. fluid restriction: 1.5l or about 7 cups per day. . you will need your liver function and thyroid function rechecked in about 1 month. followup instructions: scheduled appointments : primary care: provider: , md phone: date/time: 8:30(group diabetes visit) provider: , md phone: date/time: 9:30 (personal visit with doctor) cardiology: provider: , md phone: tuesday at 1:00pm. procedure: diagnostic ultrasound of heart other electric countershock of heart diagnoses: other primary cardiomyopathies congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute and subacute necrosis of liver acute kidney failure, unspecified atrial fibrillation depressive disorder, not elsewhere classified cocaine abuse, unspecified cardiogenic shock long-term (current) use of anticoagulants personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits acute systolic heart failure 

Answer: The patient is high likely exposed to