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: iodine; iodine containing / iodipamide meglumine attending: chief complaint: hypotension and hypoxia major surgical or invasive procedure: central line placement and removal on history of present illness: 71 f with htn, dyslipidemia, recent pacer placement for sinus arrest complicated by recurrent hemorrhagic pericardial effusions, admitted to for episode of hypoxia in the setting of worsened chest pain and doe; on she is transferred to the icu for hypotension, new o2 requirement and confusion. . she was reportedly doing well at rehab s/p hemorrhagic pericardial effusion after ppm placement, until the day prior to presentation, when she developed worsening chest pain and sob. she reported that the pain felt like it was "going around her heart", was sharp, worse with deep inspiration, and radiated to the left jaw. she also had sob, with worsening doe while walking at rehab. she otherwise denied n/v, diaphoresis. no lower extremity pain or swelling. she was found to have an o2 sat of 69% on ra. she was placed on a nrb with improvement in o2 sat to 89%. sent to ed for evaluation. . ed course: o2 sats >97% on 3l by nc, and sbp remained > 100. she had a bedside focused echo which showed a "small effusion and no wall motion abnormalities." pulsus measurements in the ed remained < 10 mm hg. a subsequent formal tte showed a small to moderate circumferential pericardial effusion that was echo dense, consistent with "blood, inflammation or other cellular elements", without echocardiographic signs of tamponade. overall ef 70%. she also received a v/q scan for an elevated d-dimer (h/o contrast allergy) which showed multiple large and small matched defects through out all lobes of the lungs, consistent with copd. it also showed an unmatched defect (greater on perfusion) in the posterior left lower lobe, thought related to shifting effusion upon position change from ventilation to perfusion. the study was read as intermediate probability. . hospital course: patient was admitted to medical service. today () patient had trigger episode with hypotension responsive to ivf (75/48), new o2 requirement (96% on 2l), mental status changes - found to be cool and diaphoretic; this prompted her transfer to the icu team. abg at the time was 7.33/43/145. . recent course: initially presented to with syncope and found to have sinus pause with junctional escape of 35. she received ppm on @ . on (2 days after discharge for pacer implantation) came back to with chest pain and palpitations and was found to be in atrial fibrillation with a rapid ventricular response of 190. she was electrically cardioverted, but remained hypotensive. she was found to have a pericardial effusion with tamponade. a pericardiocentesis drained 200 cc of hemorrhagic fluid. however, she had recurrent effusion later that same day, and ultimately underwent mediastinotomy, where she was found to have a small bleeding vessel "at the site of her prior pericardiocentesis." her atrial lead could also be seen in the atrium, though it was noted not to be protruding through, and was oversewn. also of note, she was evaluated here for siadh - found to have normal urine osm (656) and low serum osm (278), urine na of 81; this resolved spontanteously. she was discharged to at on . past medical history: hypertension hyperlipidemia parkinson's seizure disorder s/p ppm placement for sinus arrest with syncope ( ) c/b hemorrhagic effusion and tamponade physiology from "leaking vessel" cerebellar anerysm s/p coiling blind in left eye aneurysm social history: lives with daughter's family. current tobacco, ~1ppd x 50yr. no etoh or illicits. family history: nc physical exam: vitals - t 96.4, bp 107/67, hr 91, rr 18, o2 sat 97% 2l nc, wt 56.1 kg, pulsus 10 mm hg general - elderly female, nad heent - l eye medially deviated. r eye eomi. op clr, mm dry, no jvd cv - rrr, no rubs chest - decr bs at l base abdomen - soft back - non-tender extremities - no edema . pertinent results: vq scan: interpretation: ventilation images obtained with tc-m aerosol in 6 views demonstrate multiplelarge and small defects through out all lobes of the lungs, consistent with copd. perfusion images in the same 6 views show matched defects with the ventilation scan with a somewhat greater sized perfusion defect seen in the posterior leftlower lobe, likely related to shifting effusion upon position change fromventilation to perfusion. chest x-ray shows a small left pleural effusion. the above findings are consistent with an indeterminant probability scan. impression: indeterminant probability scan. severe copd. cxr:comparison is made with prior study performed a day earlier. there has been progressive interval increase in small-to-moderate right pleural effusion, moderate left pleural effusion is unchanged as is left lower lobe retrocardiac atelectasis. left transvenous pacemaker leads terminate in the standard position in the right atrium and right ventricle. right subclavian catheter tip remains in the proximal right atrium. the aorta is elongated. cardiac size is top normal. there is engorgement of the pulmonary vasculature with no overt chf. patient is post median sternotomy. ekg: sinus rhythm. t wave inversion in leads vi-v2 and t wave flattening in leads avl and v3 which is non-specific. ischemia should be considered. clinical correlation is suggested. no previous tracing available for comparison. echo: the left ventricular cavity is small. left ventricular systolic function is hyperdynamic (ef>75%). right ventricular chamber size and free wall motion are normal. the aortic valve is not well seen. there is a moderate sized pericardial effusion subtending the apex, right ventricular free wall, and lateral wall. the effusion is echo dense, consistent with blood, inflammation or other cellular elements. there are no echocardiographic signs of tamponade. no right atrial or right ventricular diastolic collapse is seen. compared with the findings of the prior study (images reviewed) of , the findings are similar. 05:15pm blood wbc-12.3* rbc-4.87 hgb-14.1 hct-42.8 mcv-88 mch-29.0 mchc-33.0 rdw-14.6 plt ct-176 02:01am blood wbc-8.6 rbc-3.58* hgb-10.4* hct-31.5* mcv-88 mch-29.0 mchc-33.0 rdw-14.9 plt ct-157 05:15pm blood neuts-82.1* lymphs-13.5* monos-4.0 eos-0.3 baso-0.1 08:57pm blood neuts-92.4* lymphs-4.2* monos-3.3 eos-0.2 baso-0 02:01am blood pt-13.0 ptt-34.8 inr(pt)-1.1 05:15pm blood d-dimer-* 02:01am blood glucose-81 urean-17 creat-0.5 na-134 k-4.0 cl-104 hco3-25 angap-9 12:45pm blood alt-8 ast-46* ld(ldh)-202 ck(cpk)-8* alkphos-173* totbili-0.4 05:15pm blood ctropnt-<0.01 04:00am blood ctropnt-<0.01 11:05am blood ctropnt-<0.01 05:05pm blood ctropnt-<0.01 06:10am blood ck-mb-2 ctropnt-<0.01 12:45pm blood ck-mb-notdone ctropnt-<0.01 12:45pm blood albumin-2.4* calcium-7.6* phos-2.7 mg-1.6 02:01am blood calcium-8.2* phos-2.5* mg-1.5* 11:05am blood osmolal-272* 06:10am blood tsh-3.9 06:10am blood free t4-1.3 11:00pm blood cortsol-37.3* 10:41am blood lactate-1.6 10:41am blood type-art po2-145* pco2-43 ph-7.33* caltco2-24 base xs--3 brief hospital course: a/p: 71 f with htn, dyslipidemia, recent pacer placement for sinus arrest complicated by recurrent hemorrhagic pericardial effusions, admitted to for episode of hypoxia in the setting of worsened chest pain and transferred to the icu for hypotension (75/48), new o2 requirement (96% on 2l) and mental status changes. was found to have klebsiella uti, was started on broad spectrum abx and then tailored to cipro. clinically improved, vitals stable >24hrs. pt transferred back to medicine floor on , where she remained until day of discharge. . #) klebsiella uti/septicemia -- pt presented with a high white cell count and hypotension. she was started on broad spectrum antibiotics. the urine culture grew klebsiella, and with subsequent sensitivities was changed to oral course of ciprofloxacin. the wbc count improved and the hypotnesion resolved on antibiotics. end date for ciprofloxacine is for 14 day course. . #) atrial fibrillation- atrial fibrillation with rvr in the setting of sepsis. she was hemodynamically stable without signs of tamponade (pulses paradoxes <10). she initially required 15 iv metoprolol and 10 mg iv dilt to control her rate, and was placed on dilt gtt temporarily for rate control. she continued on her previous dose of amiodarone. she was not anticoagulated given her recent history of hemorrhagic effusion. she converted to sinus rhythm (sr) on dilt gtt and remained in sr for the remainder of her hospitalization. she was transitioned to po diltiazem 30mg qid and dilt gtt was weaned. following conversion to sinus rhythms, the pt remained asymptomatic throughout the remainder of her admission. we discharged the pt on po diltiazem and her outpt dose of amiodarone. . #) anemia, acute blood loss: in the setting of volume repletion for hypotension/sepsis, and right subclavian line placement. guaiac has been negative. at rehab, the pt should have repeat hct drawn for the next 2 days to ensure that hct does not continue to decrease. at discharge, iron studies and vitamin b12/folate were pending. please call for results. . #) hypoxia - initially pt required 2-3l supplemental o2 by nasal cannula to maintain o2 sats. given her long tobacco history, and cxr findings, she likely has copd and may now be at baseline. pt initially reported some symptoms of pleuritic cp, thus raising the question of pe --> vq scan was performed and demonstrated multiple matched defects, cw copd but intermediate probability for pe. however, lenis were negative. anticoagulation was not considered given recent h/o hemorrhagic pericardial effusion. cxr did demonstrate , pt was started on incentive spirometry. her hypoxia significantly improved throughout her hospitalization, and she no longer had an o2 requirement by day of discharge. . #) pericardial effusion - no evidence of tamponade physiology on exam: pulsus wnl, hemodynamically stable. tte was performed on 2 occasions during this hospitalization, both with no echocardiographic signs of tamponade. she did not demonstrate any symptoms or signs of tamponade during her admission. . #) hyponatremia - siadh. admitted with na of 129 but clinically dehydrated, and with bu:cr > 20. pt was administered ns to alleviate hypotension. serum na improved to 130-134, with no clinical signs of dehydration. stim test and tsh were normal. pt did not demonstrate any sx/signs of hyponatremia this hospitalization. at rehab, her siadh can likely be managed with free h2o restriction initially 2l and then less if needed and close monitoring. . #) htn - pt was hypotensive at admission, most likely due to urosepsis/sir. thus, hypertension meds were held this admission. diltiazem was initiated for atrial fibrillation and worked well for her hypotension throughout the remainder of her stay. lisinopril can be reinitiated at the discretion of her rehab physcian. . #) parkinsons: we continued outpt regimen of sinemet. pt remained stable this admission. . #) seizure disorder: we continued outpt regimen of depakote; pt remained stable. . #) code status: was changed to full this admission (pt changed from dnr/i to full code after discussions with family). medications on admission: combivent amiodarone 200 qd lipitor 20 qd sinemet 25/100 2 tabs tid depakote 250 tid folate 1 qd lisinopril 10 qd senna discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 2. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 10 days. disp:*20 tablet(s)* refills:*0* 3. carbidopa-levodopa 25-100 mg tablet sig: two (2) tablet po three times a day. 4. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 5. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 6. divalproex 250 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po tid (3 times a day). 7. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 8. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: two (2) puff inhalation q6h (every 6 hours) as needed. 9. diltiazem hcl 30 mg tablet sig: one (1) tablet po qid (4 times a day). disp:*120 tablet(s)* refills:*2* 10. colace 100 mg capsule sig: one (1) capsule po twice a day. 11. dulcolax 10 mg suppository sig: one (1) rectal once a day as needed for constipation. discharge disposition: extended care facility: ctr. discharge diagnosis: primary: 1) urosepsis 2) hypoxia due to atelectasis- resolved 3) pericardial effusion- hemorrhagic- stable 4) atrial fibrillation . secondary: htn hyperlipidemia parkinson's seizure disorder discharge condition: stable, improving. discharge instructions: please return to the emergency room or call your rehab doctor if you develop dizziness, heart racing, fevers, chills, confusion, abdominal pain, nausea, vomiting, or any other worrisome symptoms. . the following changes were made to your medications: added: 1) ciprofloxacin- for treatment of your urinary tract infection 2) diltiazem- for treatment of your atrial fibrillation. 3) ipratropium-albuterol inhaler- prescribed to improve your breathing/oxygenation we stopped your lisinopril as we added diltiazem which is also a blood pressure pill. followup instructions: follow up with your primary care physician weeks. procedure: venous catheterization, not elsewhere classified diagnostic ultrasound of heart removal of other device from thorax diagnoses: pure hypercholesterolemia unspecified pleural effusion urinary tract infection, site not specified unspecified essential hypertension acute posthemorrhagic anemia severe sepsis chronic airway obstruction, not elsewhere classified atrial fibrillation pulmonary collapse constipation, unspecified paralysis agitans unspecified disease of pericardium septic shock cardiac pacemaker in situ other septicemia due to gram-negative organisms hypoxemia other disorders of neurohypophysis legal blindness, as defined in u.s.a. 

Answer: The patient is high likely exposed to