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: weakness, shoulder/neck pain major surgical or invasive procedure: : right heart cath, pericardial tap, arterial puncture history of present illness: 80 yo m with htn, who presents with weakness and shoulder/neck pain. of note, he was recently observed in the ed on with similar complaints and had a mibi that showed no reversible defect. he reports 4 weeks of gradually worsening weakness, waxing and , without any sensory neurologic symptoms. on the day prior to presentation, he felt that he was unable to move at all prompting him to come to ed. he does also report neck/throat tightness with radiation to the shoulders for the last 5 days. it waxes and wanes, lasting 30-60 minutes, it's pleuritic without an exertional component. patient does report sob, palpitations, a "trembling chest", and five days' of a dry cough. . in ed: patient received asa 325 on , lasix 20 mg iv and 1 x slntg. ekg nsr @ 87, nl axis, ivcd, twi in iii, avf; q in iii - old; no new st changes, no new q waves. ce's flat x 2. a v/q scan was low likelihood for pulmonary embolism. . on the floor, he developed progressively worsening dyspnea and hypoxia. he was noted to have a pulsus of 22 and a bedside echo showed rv collapse; he was taken urgently for pericardial drainage with removal of 400cc of serosanguinous fluid and drain placement. . ros: no dysuria/hematuria, no abdominal pain, no back pain, no n/v/d, no diaphoresis. does report transient lightheadedness this am, with a headache that resolved. patient denies any urinary retention or fecal incontence. he does report hematochezia x1 approx 2 wks ago after straining for a hard bm; denies known hx of hemorrhoids. past medical history: ?previous silent mi incomplete lbbb neuropathy with footdrop hypertension diverticulosis esophageal ring gout social history: no smoking, occasional alcohol, no drug use. family history: non-contributory physical exam: t 100.4 bp 161/60 hr 83 rr 24 sat 98% on nrbm gen: pleasant, comfortable, nad heent: perrl, eomi, anicteric, mmm, op without lesions neck: no supraclavicular or cervical lymphadenopathy, no carotid bruits, jvp approx 10cm resp: cta b/l; no w/r/r cv: rr, s1 and s2 wnl, no m/r/g abd: nd, +b/s, soft, nt, no masses or hepatosplenomegaly ext: trace pt/dp pulses b/l; no c/c/e skin: no rashes/no jaundice neuro: aaox3. cn ii-xii intact. rectal: guaiac negative in ed pertinent results: v/q scan (): low likelihood ratio for recent pulmonary embolism. . mra chest (): no evidence of aortic dissection. questionable area of wall thickening in the ascending aorta at the level of the main pulmonary artery. although the finding is potentially artifactual, further assessment with a dedicated non-contrast chest ct is recommended to exclude an intramural hematoma. no evidence of aneurysm. moderate pericardial effusion. small bilateral pleural effusions with associated bilateral lower lobe atelectasis. . ecg (): ecg: nsr @ 87, nl axis, ivcd, twi in iii, avf; q in iii - old; no new st changes, no new q waves . bedside tte (): there is a moderate sized pericardial effusion. there is right ventricular diastolic collapse, consistent with impaired fillling/tamponade physiology. left ventricular systolic function is grossly preserved. . cardiac cath (): resting hemodynamics were performed. the femoral arterial pressures had a pulsus of 41mmhg at the beginning of the procedure. the right sided filling pressures were significantly elevated (mean ra pressures were 25mmhg). the pcwp pressures were elevated at 25-30mmhg. the pericardial pressures were elevated at 20mm hg. successful pericardiocentesis was performed with appx 300cc of serosanguinous fluid removed. drain left in place. post pericardiocentesis, there was resolution of respiratory variation of the femoral arterial tracing. the right sided filling pressures were mildly elevated (mean ra pressures was 12mmhg). the left sided filling pressures have improved (mean pcw pressures were 21mmhg). the cardiac index improved to 3.2 l/min/m2. the pericardial pressures were appx 0mmhg. . pericardial fluid cytology (): negative for malignant cells . ct chest (): tracheomalacia with narrowing of the main stem bronchi. pericardial effusion. bilateral pleural effusions. increased pulmonary parenchymal density most likely representing mild edema. compressive atelectasis. hepatic cyst. . tte (): the estimated right atrial pressure is 5-10 mmhg. there is symmetric left ventricular hypertrophy. the left ventricular cavity is small. left ventricular systolic function is hyperdynamic (ef>75%). the right ventricular cavity is dilated. right ventricular systolic function appears depressed. there is a small pericardial effusion subtending the lateral wall of the left ventricle. there are no echocardiographic signs of tamponade. . 09:15pm wbc-10.3 rbc-2.88* hgb-9.5* hct-27.3* mcv-95 mch-32.9* mchc-34.7 rdw-14.7 09:15pm glucose-172* urea n-65* creat-3.1*# sodium-136 potassium-5.2* chloride-103 total co2-18* anion gap-20 09:15pm ck-mb-notdone probnp-778 09:15pm ctropnt-0.04* brief hospital course: shortly after admission to the floor for hypoxia, mr. mri from the ed was noted to show a moderate-sized pericardial effusion. although his ecg did not show electrical alternans or low voltages, a pulsus was checked and found to be elevated at 22 mm hg. an urgent cardiology consultation was obtained and a bedside tte showed rv collapse and tamponade physiology. he was taken directly to cardiac catheterization where 400cc of serosanguinous fluid was removed and a pericardial drain was placed; he was sent to the ccu for further care. all studies (including gram stain, culture, and cytology) returned as negative. he experienced relief of his dyspnea with the removal of this fluid but remained hypoxemic requiring 100% nrb facemask. . on hospital day 2, his percardial drain showed no fluid output and a followup tte showed no evidence of reaccumulation so his drain was pulled. a chest ct showed no evidence of malignancy or any other pathology that could potentially explain his tamponade. . due to a fever spike and concern for an infiltrate on his cxr, he was started on a 7-day course of empiric levofloxacin and metronidazole for suspected pneumonia. he was aggressively diuresed with a gradual decrease in his oxygen requirements over the course of his hospital stay. a v/q scan in the ed was low probability for pe and lenis were negative for dvt. a pulmonary consultation was obtained and agreed that his pneumonia and fluid overload were the most likely cause of his hypoxemia. by discharge, he was saturating 92-94% on room air. . of note, on admission, he was found to be in acute-on-chronic renal failure, though to be secondary to renal hypoperfusion from his tamponade. his meds were renally-dosed, his was held, and his creatinine gradually improved with diuresis and improvement of his cardiac functioning. . he was also noted to have an acute-on-chronic anemia, though no source of acute bleeding could be identified. iron studies were consistent with an anemia of chronic inflammation, although his very low serum iron also suggested some component of iron deficiency. he was started on iron repletion and further causes of anemia should be worked up as an outpatient. medications on admission: omeprazole 20mg proscar 5mg daily felodipine 10mg daily allopurinol 300mg daily folic acid 1mg daily gabapentin 1200mg qhs at 7pm; 400mg prn for restless legs mirapex 2.25mg qhs at 7pm gemfibrozil 600mg twice daily losartan 25mg daily terazosin 10mg daily asa 325mg daily vit c 1000mg mvi discharge medications: 1. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 2. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 3. felodipine 5 mg tablet sustained release 24hr sig: two (2) tablet sustained release 24hr po daily (daily). 4. allopurinol 300 mg tablet sig: one (1) tablet po once a day. 5. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 6. gabapentin 300 mg capsule sig: two (2) capsule po hs (at bedtime) as needed for leg/foot pain. 7. pramipexole 1 mg tablet sig: one (1) tablet po hs (). 8. gemfibrozil 600 mg tablet sig: one (1) tablet po daily (daily). 9. terazosin 5 mg capsule sig: two (2) capsule po hs (at bedtime). 10. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 11. hexavitamin tablet sig: one (1) cap po daily (daily). 12. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 3 days. disp:*3 tablet(s)* refills:*0* 13. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 3 days. disp:*9 tablet(s)* refills:*0* 14. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 15. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily) for 1 months. disp:*30 tablet(s)* refills:*0* 16. ipratropium bromide 0.02 % solution sig: one (1) inhalation q8h (every 8 hours) as needed for sob/wheezing. disp:*1 inhaler* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis: pericardial effusion with tamponade . secondary diagnosis: hypoxia acute on chronic renal failure hypertension coronary artery disease neuropathy gout discharge condition: good, ambulatory, respiratory status stable off oxygen discharge instructions: please take all medications as directed. you will be taking two antibiotics (levofloxacin and flagyl to complete a 7 day course). your gabapentin dose has been decreased to 600mg by mouth at night. you should not take losartan due to your kidney function until your primary doctor or cardiologist tell you to restart it. . if you develop shortness of breath, chest pain, dizziness, fever, or any other symptom that concerns you, call your doctor or go to the emergency room. . go to all of your follow up appointments. followup instructions: you have the following follow up appointments: provider: , m.d. phone: date/time: 11:40 call dr. to make an appointment for . phone:(. tell the office that dr. said it was okay to double book. you will also need to call to make an appointment for an echocardiogram prior to your visit with dr. . the phone number is (. you will need a follow up chest ct in 2 months to evaluate lung parenchyma. cat scan phone: date/time: 10:00. this is located in . do not eat or drink for 3 hours prior to this exam. you will need to have your doctor follow up on your cytology and pericardial cultures. procedure: coronary arteriography using a single catheter pericardiocentesis right heart cardiac catheterization diagnoses: pneumonia, organism unspecified congestive heart failure, unspecified acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified chronic kidney disease, unspecified mononeuritis of lower limb, unspecified other left bundle branch block iron deficiency anemia, unspecified hypoxemia other acquired deformities of ankle and foot restless legs syndrome (rls) acute pericarditis, unspecified 

Answer: The patient is high likely exposed to