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: pericardial effusion major surgical or invasive procedure: left side thoracentesis history of present illness: 59 yo m with cad was diagnosed with acute pericarditis on at an outside hospital. he presented with 'global' st elevations, pleuritic chest pain, esr 55, crp 155. tte at that time showed no effusion. he was discharged home on ibuprofen 800mg tid initially with good effect. he was also given abx for abnormalities on a chest cxr/ct, although he had no clinical signs of pna and radiology reports described the posterior left base opacity as likely atelectasis. two days after completing the 5 day course of ibuprofen 800mg tid which he was prescribed, he developed diffuse left sided chest pain different from his initial pleuritic pain (and not as intense). he recalls what his stable angina felt like 10 years ago prior to having stents placed in the proximal lad and mid rca; states this is different from his angina. repeat echo done at showed a moderate effusion (report not available) which had evolved within 5 days--reportedly not concerning for tamponade. no pulsus on exam with bp 95-105/50-60. pt was transferred to for further mgt. on arrival, neck veins wnl, bp at baseline, no pulsus, prelim echo without diastolic collapse of rv. of note, co-synotropin testing at showed that pt is adrenally insufficient s/p distant unilateral adrenalectomy after which he never followed up with an endocrinologist. on review of systems, 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. he denies recent chills or rigors, although felt briefly febrile on the night prior to admission. 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: 1. cardiac risk factors: -diabetes, +dyslipidemia, -hypertension 2. cardiac history: -cabg: none -percutaneous coronary interventions: : palmaz- sents to mid-rca and proximal lad for stable angina -pacing/icd: none 3. other past medical history: -dyslipidemia -unilateral adrenalectomy for syndrome; he was told that contralateral gland was hypoplastic, but her never followed with endocrine regarding this. labs at osh notable for inadequate co-synotropin stim. social history: -tobacco history: distant limited cigar smoking -etoh: no etoh abuse -illicit drugs: none family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; father and mother with cad in 60s-70s physical exam: general appearance: well nourished eyes / conjunctiva: perrl head, ears, nose, throat: normocephalic cardiovascular: (s1: normal), (s2: normal), no(t) rub peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: present), (left dp pulse: present) respiratory / chest: (expansion: symmetric), (breath sounds: crackles : left base) abdominal: soft, non-tender, bowel sounds present extremities: right lower extremity edema: absent, left lower extremity edema: absent skin: warm neurologic: attentive, responds to: not assessed, oriented (to): x3, movement: not assessed, tone: not assessed pertinent results: 07:10pm pt-15.2* ptt-34.0 inr(pt)-1.3* 07:10pm hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 07:10pm neuts-73* bands-0 lymphs-17* monos-10 eos-0 basos-0 atyps-0 metas-0 myelos-0 07:10pm wbc-10.4 rbc-4.03* hgb-12.3* hct-36.3* mcv-90 mch-30.5 mchc-33.8 rdw-12.8 07:10pm calcium-8.5 phosphate-3.4 magnesium-2.4 07:10pm ck-mb-notdone ctropnt-0.01 07:10pm alt(sgpt)-44* ast(sgot)-35 ld(ldh)-183 ck(cpk)-87 alk phos-76 tot bili-0.6 07:10pm glucose-104 urea n-16 creat-1.2 sodium-133 potassium-4.9 chloride-102 total co2-21* anion gap-15 microbiology: pleural fluid : this is a corrected report 12:50pm. 2+ (1-5 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen (smear remade). this is a concentrated smear made by cytospin method, please refer to hematology for a quantitative white blood cell count.. previously reported as . 3+ (5-10 per 1000x field): polymorphonuclear leukocytes. 2+ (1-5 per 1000x field): gram negative rod(s). reported by phone to 7:45pm. corrections reported by phone to dr. 12:50pm. fluid culture (preliminary): no growth. anaerobic culture (preliminary): no growth. urine cx: : negative blood cx: : no growth to date telemetry: no events . ett: reportedly negative within last few years . 2d-echocardiogram: the left atrium and right atrium are normal in cavity size. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (?#) appear structurally normal with good leaflet excursion. no aortic regurgitation is seen. the mitral valve leaflets are structurally normal. no mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is a moderate sized circumferential pericardial effusion without echocardiographic evidence of tamponade physiology. impression: moderate circumferential pericardial effusion without echocardiographic evidence of tamponade physiology. if clinically indicated, serial evaluation is suggested . 2d-echocardiogram: the left atrium and right atrium are normal in cavity size. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). there is a small circumferential pericardial effusion (0.5cm around the apex, <0.5cm inferolateral to the left ventricle and anterior to the right ventricle. there are no echocardiographic signs of tamponade. . cxr: pa, lateral: there is evidence of substantial effusion posteriorly on the lateral view. to evaluate the amount of free pleural fluid, a lateral decubitus view would be recommended. brief hospital course: 59 yo m w/ cad developed pericarditis one week ago, then developed moderate sized effusion w/o tamponade over the course of one week. 1. pericardial effusion/pericarditis: the patient had a rapid accumulation of moderate sized effusion over the span of one week. etiology unknown, negative evaluation most consistent with viral infection. preliminary echo without tamponade physiology. pulsus remained . he remained hemodynamically stable during this admission. a repeat echocardiogram 2 days later showed decrease in size of the pericardial effusion. he was treated empirically with standing nsaids, once his renal function had improved. at time of discharge, patient had no further recurrence of chest discomfort, dyspnea, lightheadedness or other symptoms consistent with pericarditis/ pericardial effusion. patient will follow up with outpatient cardiologist in 3 weeks for repeat echo. 2. pleural effusion: although the pericardial effusion improved, the patient was noted to have a significant left sided pleural effusion. he underwent thoracentesis on , with fluid studies revealing an exudative effusion. the gram stain was initially reported as having 2+ gnrs and 3+ pmns. the patient's ceftriaxone was restarted after having been temporarily discontinued. several hours later, though, the microbiology lab reported an error in their reporting, stating that nothing had grown on culture and that there were actually no micro-organisms seen. ceftriaxone was discontinued, as the patient was afebrile at this time, with no localizing signs of infection. of note, his breathing felt significantly easier after the thoracentesis. 3. fevers: the patient had fevers to 101.6 during this hospitalization. he did not have an elevated white blood cell count. fevers were most likely secondary to inflammation from the pericarditis. the patient was initially treated empirically with vancomycin and ceftriaxone to cover a purulent pericarditis, which was later changed to ceftriaxone for the erroneously-reported positive gram stain on the pleural fluid (see above). patient discharge without requirement for further antibiotic use. 4. possible adrenal insufficiency: the patient was started on replacement doses of hydrocortisone given his history of adrenalectomy and -stimulation test at the osh. endocrine recommended that the patient take hydrocortisone 20mg qam and 10mg qpm, and follow up in the endocrine clinic. 5. subclinical hypothyroidism: in addition, his tsh was elevated at 10, but his free t4 was normal. he will need thyroid function tests rechecked in weeks. code status: the patient was confirmed full code for the duration of the hospitalization medications on admission: simvastatin 10' niacin (unsure about dose) 500'? asa 81' fish oil folic acid vitamins discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. hydrocortisone 10 mg tablet sig: two (2) tablet po once a day: take in the morning. disp:*120 tablet(s)* refills:*2* 4. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever/pain. 5. hydrocortisone 10 mg tablet sig: one (1) tablet po take between 4pm and 5pm at night. 6. folic acid 1 mg tablet sig: one (1) tablet po once a day. 7. fish oil 1,000 mg capsule sig: one (1) capsule po twice a day. 8. niacin 500 mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: acute pericarditis pericardial effusion pleural effusion anemia adrenal insufficiency discharge condition: mental status:clear and coherent level of consciousness:alert and interactive activity status:ambulatory - independent discharge instructions: you had pericarditis and a fluid collection around your heart. this improved without needing to be drained. you also had some fluid collections in your lungs that was tapped and cultured. initially it seemed the fluid was infected and you were on antibiotics. eventually the fluid was found not to be infected and the antibiotics were discontinued. your fluid collection around your heart is improving. you will need another echocardiogram by dr. when you see him in . . medication changes: 1. start hydrocortisone 10 mg tablets: take two in the morning and one at night to treat your adrenal insufficiency 2. stop taking ibuprofen followup instructions: primary care: , a. phone: date/time: wed at 11:00 am. . cardiology: , md phone: date/time: friday at 11:00am. . endocrine: shun how phone: date/time: procedure: thoracentesis diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery unspecified acquired hypothyroidism percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia glucocorticoid deficiency acute idiopathic pericarditis 

Answer: The patient is high likely exposed to