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: s/p vfib arrest, for pacemaker placement major surgical or invasive procedure: defibrillator/pacemaker placement history of present illness: 65 yo f w/ h/o dilated, non-ischemic cardiomyopathy, transferred from s/p vf arrest thought aspiration in setting of an ef of 20-25% and mod-severe mr d placement. review of osh reveals pt was at ent office for management otitis externa, suffered witnessed arrest, cpr initiated with ems giving 3 shocks, epi, atropine, and lido gtt followed by amiodarone gtt. admitted to osh icu, intubated, treated for pulmonary edema and aspiration pna w/zosyn (course completed). echo showed ef 20%, no aicd. neurology was consulted for hypoxic brain injury and she required ng tube placement for feeds mental status but was able to tolerate honey thickend liquids/pureed diet at time of transfer. pt was transfered to for -v pacemaker/icd placement. . on admission to the cardiology floor, the patient was unable to recall the details of the events leading to her hospital course. she was continued on metoprolol, lasix 40mg p.o to prevent volume overload in setting of low ef and dilated cardiomyopathy. her outpatient cardiologist and pcp were to attempt to obtain her most recent catheterization records, but none were able to be located. she received a cardiac mr for scar, which showed effective lvef of 28%. echo showed lvef severely depressed (lvef= 25 %). . of note, she had been receiving oral ciprofloxacin for management of otitis externa, which were started prior to although exact date unclear. she was switched to topical cipro on admission to as was having continued drainage. there is some concern for qtc prolongation in the setting of prolonged use of ciprofloxacin. in order to determine whether patient suffered drug induced torsades de pointes which deteriorated into vf, she was transferred to the ccu for ciprofloxacin challenge. . the patient was given ciprofloxacin in the ccu with a prolongation of her qt but without reucrrence of vf. qt prolongation resolved by the following morning. she underwent electrical mapping in the ep lab on , where they were unable to induce vt, and was transferred back to the floor to await her icd placement on . . on arrival to the floor, the patient denied chest pain, shortness of breath, or any other complaints. . review of systems: the patient reports significant left ear and left facial pain for the last several days associated with drainage and worse with movement of the external ear. denies fevers/chills. pt also reports becoming "thinner" and losing weight in the past several months but cannot quantify the amount of weight loss. she 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. she denies recent fevers, chills or rigors. she 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: - s/u cardiac catheterization in - dilated, non-ischemic cardiomyopathy - per pt etiology unknown, ef 20% - dyslipidemia social history: -tobacco history: remote tobacco x6yrs, quit many years ago -etoh: occasional -illicit drugs: denies lives at home with her husband. as a certified nurse assistant. family history: mother with cardiomyopathy, ? mi, deceased but age not known. denies cardiac h/o in father. further details unknown. physical exam: admission vs: t= 98 bp=123/46 hr=88 rr=16 o2 sat= 98% on ra vs on transfer from ccu: t98.7 bp 126/60 p85 r18 po2 98%ra general: wdwn female in nad. alert, a&ox2. heent: right temple hematoma. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 5 cm. cardiac: pmi displaced inferiolaterally. rrr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ dp 2+ pt 2+ left: carotid 2+ dp 2+ pt 2+ on discharge: vs: 97.9/97.9, 101/50 (94-123/50-59), 59 (59-69), 100%ra general: wdwn female in nad. aaox3. heent: perrl, eomi, mmm, neck supple, jvp of ~5 cm. cardiac: pmi displaced inferiolaterally. rrr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ dp 2+ pt 2+ left: carotid 2+ dp 2+ pt 2+ pertinent results: at the osh labs on significant for: wbc 18.3 (down trending from 35.6 on ) hct 35.4 (stable) plts 369 ptt 45.5/inr 1.09/pt 13.5 144 103 41 ------------<149 3.4 31 0.8 ca 9.4 phos 3.4 tp 7.8 alb 3.2 tbili 0.3 ast 48 alt 109 ap 116 trop i 0.98 ck 1164 (peak on ) . admission labs: . 141 100 35 ------------ 99 3.8 33 0.7 . ck: 25 mb: notdone trop-t: <0.01 . ca: 9.8 mg: 2.5 p: 3.7 dig: 0.8 . ......11.6 14.7 ------ 578 ......34.4 . pt: 13.2 ptt: 40.8 inr: 1.1 . cxr (): negative for acute cardiopulmonary process . tte (): the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular ejection fraction is severely depressed (lvef= 25 %). the left ventricle appears to contract dyssynchronously. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic arch is mildly dilated. there are focal calcifications in the aortic arch. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. . cardiac mri (): 1. mildly increased left ventricular cavity size with abnormal left ventricular function. severe hypokinesis in the basal to mid interventricular septum with paradoxical motion and mild hypokinesis in the remaining lv segments. the lvef was moderately decreased at 32%. the effective forward lvef was severely decreased at 28%. resting myocardial perfusion images suggestive of delayed perfusion in the inferior and inferoseptal walls. there was a questionable focal area of hyper-enhancement in the basal lateral wall consistent with myocardial fibrosis. 2. normal right ventricular cavity size and systolic function. the rvef was normal at 59%. 3. moderate mitral regurgitation and moderate tricuspid regurgitation. 4. the indexed diameters of the ascending and descending thoracic aorta were normal. the main pulmonary artery diameter index was normal. 5. aortic atheroma. . cardiac catheterization (): comments: 1. coronary angiography in this left dominant system revealed no angiographically apparent flow limiting stenoses. the lmca, lad, lcx, and rca were patent. 2. no resting hemodynamics reported as case performed concurrently with electrophysiology study. . final diagnosis: 1. no angiographically apparent flow limiting cad. . . cxr (): icd in place. brief hospital course: 65 yo f w/ dilated cardiomyopathy, ef 20% s/p vfib arrest, pulmonary edema, aspiration pna, being transferred from osh for icd placement. . # coronaries: no known history of cad, no records of ett, cath, echo. cardiac mr did not show significant scar to account for patient's vf arrest. cardiac catheterization did not show any apparent flow limiting lesions. the patient was transferred on acs medications, but these were discontinued prior to discharge given there was no evidence of ischemia precipitating her vf arrest. she was continued on aspirin 81 mg daily for primary prevention. . # pump: pt with h/o non-ischemic cardiomyopathy, found to have ef 20% at osh, no clinical evidence of decompenstated heart failure. tte showed normal valvular function, ef 25%. the patient was started on lasix at the osh prior to transfer, presumaband was continued on a daily po dose of lasix during her hospital stay. she became hyponatremic, however, and the patient was encouraged to increase her po water intake. she had transient hyponatremia that resolved with normal po intake. she was discharged on toprol xl 100mg daily, aceinhibitor, digoxin, and lasix 40mg daily. . # rhythm: vfib arrest , unclear precipitant but possibly aspiration in the setting of dilated cardiomyopathy with low ef. cardiac mr showed no significant scar as cause of vf, and cardiac catheterization showed no flow limiting disease. there was also a question of whether ciprofloxacin had precipitated vt by prolonging the patient's qt interval. the patient was transferred to the ccu to receive a trial of ciprofloxacin and assess the effects on her qtc. the patient was given ciprofloxacin 500 mg po on . her qtc was 418 pre-cipro and 447 4-hours post-cipro. she was not given any additional doses of cipro (which she had taken for 24 hours prior to her event) and her qtc resolved the following morning. the patient was taken to the ep lab on , where she was not found to have any inducible vt. the decision was made to place an icd on . the patient underwent icd/pacemaker placement without complications and was discharged on toprol xl 100mg daily. . # left ear pain: patient was seeing ent on day of vf arrest for left ear pain since before . appears to be otitis externa, presented with antibiotic ear drops. patient with continued yellow drainage and worsening pain. ent was consulted and suspects otitis externa vs. otitis media with perforated tympanic membrane, and suggested increasing dose of cipro/dexamethasone ear drops and initiating po bactrim. patient's ear pain and drainage improved, she completed a seven day course of bactrim. pain was controlled with tylenol & tramadol prn. beta-2-transferrin was sent to r/o csf leak, though it was thought low likelihood and was still pending on discharge. patient will be discharged on ciprodex ear drops through and will follow up with ent as an outpatient. . # aspiration pna: patient was found to have aspiration pna at osh and completed a full course of zosyn on at osh. no evidence of active infection in-house following transfer given negative cxr, afebrile. speech and swallow was consulted and performed video swallow study, cleared the patient without caution to advance slowly. . # anoxic brain injury - evaluated by osh neurology, no notes in transfer paperwork. initially alert, oriented x 1.5. however, mental status improved during the hospitalization and pt is now a&ox3 with impaired memory and recall. . # elevated lfts - this was thought most likely shocked liver in the setting of vf arrest. they steadily trended down and resolved during hospital stay. . . code: full communication: daughter, (cell) medications on admission: (pt reports she has not been compliant with medications) at home: simvastatin 20mg po daily carvedilol 12.5mg digoxin 0.25mg daily enalapril 10mg po bid motrin 800mg tid prempro 0.625-2.5mg po daily x90 days tramadol 50mg po tid prn pain . on transfer from osh: acetaminophen 650 mg po/ng q6h:prn aspirin 325 mg po/ng daily ciprodex *nf* 0.3-0.1 % as 5x day otitis externa digoxin 0.25 mg po/ng daily docusate sodium (liquid) 100 mg po/ng daily enalapril maleate 10 mg po/ng furosemide 40 mg iv bid heparin iv per weight-based dosing metoprolol tartrate 5 mg iv q4h milk of magnesia 30 ml po/ng q6h:prn ondansetron 4 mg iv q8h:prn nausea oxazepam 10 mg po hs:prn insomnia pantoprazole 40 mg iv q12h amiodarone prn lorazepam 1-2mg prn agitation mg//simthicone q4h prn morphine 2mg iv prn chest pain nitro prn chest pain discharge medications: 1. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 2. digoxin 250 mcg tablet sig: one (1) tablet po daily (daily). 3. enalapril maleate 10 mg tablet sig: one (1) tablet po bid (2 times a day). 4. prempro 0.625-2.5 mg tablet sig: one (1) tablet po once a day for 90 days: as directed for 90 days total. 5. tramadol 50 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for pain. 6. ciprofloxacin 0.3 % drops sig: five (5) drop ophthalmic tid (3 times a day) as needed for otitis externa : continue until and appointment with ent. disp:*qs small bottle* refills:*0* 7. dexamethasone 0.1 % drops, suspension sig: five (5) drop ophthalmic tid (3 times a day) as needed for otitis externa : continue until and appointment with ent. disp:*qs small bottle* refills:*0* 8. furosemide 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 9. aspirin 81 mg tablet sig: one (1) tablet po once a day. 10. metoprolol succinate 100 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). discharge disposition: extended care facility: rehab hospital discharge diagnosis: ventricular tachycardia, ventricular fibrillation dilated cardiomyopathy (non-ischemic) discharge condition: mental status: clear and coherent level of consciousness: alert and interactive activity status: ambulatory - requires assistance or aid (walker or cane) discharge instructions: you presented to an outside hospital after having an arrhythmia and cardiac arrest. you were successfully recussitated with cpr and shocks to your heart. it is believed that the ciprofloxacin you took may have caused you to enter into an irregular heart rhythm, precipitating this event. while at the other hospital, you were also treated for pneumonia with antibiotics. you were transferred to for placement of a defibrillator/pacemaker to prevent your heart from entering into an irregular rhythm in the future. you tolerated this procedure well without complications. while in the hospital, an ear, nose, and throat specialist saw you for your ear pain and yellow drainage. your ear drop dose was changed, and you were started on an oral antibiotic with improvement of your pain and drainage. your medications have change, please make note of the changes as listed below: - new medication: ciprofloxacin 0.3 % drops, 5 drops to your ear three times a day - new medication: dexamethasone 0.1 % drops, 5 drops to your ear three times a day - new medication: aspirin 81 mg tablet, 1 tablet daily - new medication: furosemide 40 mg, 1 tablet daily - stop taking carvedilol - start taking toprol xl 100mg daily weigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: you have the following appointments scheduled: primary care physician . 11:15am dr. (ear, nose, throat) at 8:15am , , ( provider: (st-4) gi rooms date/time: 12:30 provider: , md phone: date/time: 12:30 procedure: coronary arteriography using two catheters left heart cardiac catheterization injection or infusion of thrombolytic agent catheter based invasive electrophysiologic testing implantation of cardiac resynchronization defibrillator, total system [crt-d] diagnoses: other primary cardiomyopathies mitral valve disorders congestive heart failure, unspecified acute and subacute necrosis of liver hyposmolality and/or hyponatremia other and unspecified alcohol dependence, in remission anoxic brain damage ventricular fibrillation other specified antibiotics causing adverse effects in therapeutic use nonspecific abnormal electrocardiogram [ecg] [ekg] unspecified suppurative otitis media 

Answer: The patient is high likely exposed to