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: morphine / iodine; iodine containing attending: chief complaint: fevers major surgical or invasive procedure: none history of present illness: 47yo f with metastatic breast cancer with bone and liver mets s/p recent 2nd dose of gemzar() and xrt presents with c/o fever to 102 at home x 2d. +malaise, f/c, l ear "pulsating", n/v 3d ago and x 1 tonight. no cp, sob, cough, sore throat, congestion, rhinorrhea, postnasal gtt, dysuria, diarrhea, abd pain, rash. reports 3 kids had uri sxs last week, though she did not. here in ed t 101, borderline hypotensive with sbp in 80s, low wbc without neutropenia, hct 23 and guiaic positive brown stool. blood cultures x 2 were sent from the portacath and peripherally. u/a which was neg and ucx were sent. she received cefepime 2g x 1, anzemet, oxycontin 80 mg, and 2l ns. gi c/s requested for heme + stool and anemia, but rec cont. ivf and prbc resuscitation, no role for scoping. given the borderline bp, she was admitted to o/n for observation. . past medical history: onc hx: primary onc: dr. metastatic breast ca- in past, undewent chemo w/ adriamycin/cytoxan, then taxol. then, she received 5fu/leukovorin and zometa. her course has been complicated by compression fractures in t1-t6 and t9. she underwent radiation treatment for t1 and developed more pain and t6 then was found to have a compression fracture with cord compression. she was hospitalized while she started radiation treatment. the decision had initially been made to continue her chemotherapy through her radiation treatment as a radiation sensitizer; however, the patient had episodes of severe nausea and vomiting and diarrhea resulting in additional hospitalizations. she is finishing off her radiation treatments with the omission of 5-fu leucovorin. she was restarted weekly taxol on until . pt was switched to gemzar since due to apparent progression of disease. ct on showed progression in size of liver mets and development of new right sided pulmonary nodules. pet showed widespread metastatic bone lesions which were stable in intensity and number. . past medical hx: s/p ccy ovarian clot- requiring coumadin hypertrigylceridemia pancreatitis social history: married with 3 children. denies any t/a/d family history: aunt with breast cancer on father's side. mother with bladder cancer. uncle with unknown type of cancer. physical exam: pe: vs t 100.6, bp 101/51 (90s/50s), hr 87, r 16, o2 96% ra gen: pleasant pale f in nad heent: short hair, perrla though 2 mm pupils, no photophobia, dry mm neck: no lad or masses. no nuchal rigidity. chest wall portacath c/d/i, no erythema/ttp cv: rrr nl s1, s2 no m/r/g pulm: cta bilat abd: soft nabs, nd/nt extr: no c/c/e neuro: aao x 3, neg kernig/brudzinski's signs, nl strength throughout in all extremities, nl sensation to light touch, nl gait pertinent results: 01:55pm wbc-4.5# rbc-2.77* hgb-8.6* hct-23.8* mcv-86 mch-30.9 mchc-36.0* rdw-15.4 01:55pm neuts-89.2* lymphs-9.6* monos-0.4* eos-0.7 basos-0.1 01:55pm poikilocy-1+ 01:55pm plt count-137* 01:55pm pt-13.6* ptt-23.9 inr(pt)-1.2 01:43pm glucose-103 lactate-1.4 na+-138 k+-3.2* cl--111 tco2-21 01:55pm lipase-12 01:55pm glucose-103 urea n-10 creat-0.6 sodium-137 potassium-3.3 chloride-106 total co2-21* anion gap-13 01:55pm alt(sgpt)-108* ast(sgot)-125* alk phos-48 tot bili-1.4 05:30pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.0 leuk-neg 05:30pm urine color-straw appear-clear sp -1.007 . data: cxr: the heart is of normal size. the mediastinal and hilar contours are within normal limits. the pulmonary vasculature is normal without evidence of chf. there is a right chest wall port-a-cath with the tip in the cavoatrial junction. there are again noted surgical clips overlying the left breast. there is a patchy opacity in the right perihilar region and infrahilar region with nodular densities, which is likely due to post- radiation changes. no definite evidence of pneumonia is seen. there is a stable compression fracture of t6 and t9 vertebral bodies. there are surgical clips in the gallbladder fossa and subcutaneous tissues in the left abdomen. the patient is status post tram flap. the patient is status post left mastectomy. impression: 1. post-radiation changes. no evidence of pneumonia. 2. stable compression fractures of t6 and t9 vertebral bodies. . ultrasound of abdomen : findings: gallbladder is not seen as patient is status post cholecystectomy. common duct is not dilated. the liver appears echogenic consistent with fatty liver. multiple rounded hypoechoic lesions are seen within the liver, the largest measuring 2.5 cm in largest dimension. the right kidney measures 11.2 cm. the left kidney measures 11.6 cm. there is no hydronephrosis or stones. the pancreas and spleen appear unremarkable. the aorta is of normal caliber throughout. impression: 1. multiple hypoechoic lesions seen within the liver corresponding to findings on ct performed . these findings are suggestive of liver metastases. 2. the liver is echogenic consistent with fatty liver. however, other forms of liver disease and more advanced liver disease, including significant hepatic fibrosis/cirrhosis, cannot be excluded on the study. 3. status post cholecystectomy. . cxr : history of metastatic breast cancer with fever. right subclavian cv line is in distal svc. no pneumothorax. right para mediastinal post-radiation changes as previously demonstrated. no new pulmonary consolidation or pleural effusions. impression: no evidence for pneumonia or other change since prior film of . . labs at discharge: 04:43am blood wbc-3.6* rbc-3.84* hgb-11.2* hct-30.7* mcv-80* mch-29.2 mchc-36.5* rdw-16.3* plt ct-73* 04:43am blood neuts-44* bands-7* lymphs-25 monos-10 eos-1 baso-0 atyps-4* metas-9* myelos-0 nrbc-1* 04:43am blood gran ct-2140* 04:43am blood glucose-96 urean-11 creat-0.7 na-139 k-4.2 cl-103 hco3-21* angap-19 04:43am blood alt-102* ast-88* ld(ldh)-365* alkphos-62 totbili-1.2 04:43am blood albumin-4.0 calcium-10.0 phos-4.1 mg-2.0 05:11am blood triglyc-578* . ucx : no growth (final) bcx : no growth (final) bcx : no growth (final) brief hospital course: a/p: 47 yo f w/metastatic breast ca s/p multiple regimens of chemo and xrt, most recently gemzar , p/w fever to 102 and mild hypotension. . 1. fever of unclear etiology/hypotension: in the , the patient was empirically covered with cefepime, vancomycin, and azithromycin. her hypotension responded to ivf and 2 units of prbcs. pt was transferred to the floor on in a stable condition. the patient did not require any ivf and maintained her sbp in the 90s with good po intake. the vancomycin and cefepime were subsequently discontinued as the patient remained afebrile, not neutropenic, and cultures remained negative, and switched to levaquin. the source of fever remains unclear as final urine and blood cultures are negative and repeat x-ray showed no pneumonia(port-a-cath was a concern although the site looked clean, but the patient remained afebrile off of vancomycin). . 2. anemia/guiaic + stool: pt's hct was 23.8 (baseline 30) and stool was heme + in the ed. in the ed hct over several hours stayed stable. new anemia was felt likely due to chemotherapy as other cell lines also decreased. the patient received 2 units of prbc in the , resulting in appropriate rise in hct to 32.2. her hct remained stable on the floor. for gi consulted in ed and no acute recs for colonoscopy/ imaging. of note, the patient has chronic + heme since xeloda induced colitis. . 3. elevated lfts- was felt to be secondary to liver mets and/or gemzar. pt did not have any abdominal complaints. u/s of abdomen showed echogenic liver with multiple hypoechoic lesions consistent with corresponding to findings on ct performed . . 4. metastatic breast ca- s/p gemzar . the patient was continued on neurontin and oxycontin for peripheral neuropathy. . 5. hypertriglyceridemia: continued tricor. since the patient has a h/o pancreatitis with elevated tg, triglyceride was rechecked and was improved to 578 ( 1397) the patient had normal amylase and lipase during this hospitalization. . 6. h/o r ovarian v clot: continue coumadin (unclear effect as inr 1.2) 7. depression/anxiety: continued wellbutrin and lexapro. ativan for sleep prn. . 8. fen: received ivf for hydration and regular diet . 9. proph: ppi, pneumoboots; on coumadin. medications on admission: wellbutrin 150 , lexapro 10 qd, oxycontin 80 , protonix, tricor 145 mg qd, coumadin 1 mg a day, neurontin 300 mg qd, ativan as needed, vicodin, zometa. discharge medications: 1. bupropion 75 mg tablet sig: two (2) tablet po bid (2 times a day). 2. escitalopram 10 mg tablet sig: one (1) tablet po daily (daily). 3. fenofibrate micronized 145 mg tablet sig: one (1) tablet po qd (). 4. warfarin 1 mg tablet sig: one (1) tablet po daily (daily). 5. gabapentin 300 mg capsule sig: one (1) capsule po daily (daily). 6. oxycodone 20 mg tablet sustained release 12hr sig: four (4) tablet sustained release 12hr po q12h (every 12 hours). 7. hydrocodone-acetaminophen 5-500 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. lorazepam 1 mg tablet sig: one (1) tablet po hs (at bedtime) as needed. 10. levaquin 500 mg tablet sig: one (1) tablet po once a day for 5 days. disp:*5 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: metastatic breast cancer fevers discharge condition: afebrile, stable to go home. discharge instructions: return to the emergency department or call your primary care physician if you develop fever, chills, intractable nausea/vomiting, dizziness, bright red blood per rectum, shortness of breath, chest pain, or any other worrisome symptoms. . take your antibiotics as prescribed. . have your hematocrit checked at your oncology appointment. . please, call radiology and schedule an appointment to get a ct of abdomen and follow up with dr. with the result. followup instructions: provider: , md date/time: 9:00 provider: , /oncology-cc9 phone: date/time: 9:00 provider: , rn phone: date/time: 9:30 procedure: transfusion of packed cells diagnoses: anemia, unspecified malignant neoplasm of liver, secondary personal history of malignant neoplasm of breast antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use long-term (current) use of anticoagulants secondary malignant neoplasm of lung unspecified hereditary and idiopathic peripheral neuropathy secondary malignant neoplasm of bone and bone marrow 

Answer: The patient is high likely exposed to