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: no known allergies / adverse drug reactions attending: chief complaint: advanced ovarian cancer icu admission #1: hypotension, intubation, require intense monitoring immediately post-operation. icu readmission #2: desaturation secondary to flash pulmonary edema. major surgical or invasive procedure: -exploratory laparotomy, radical resection of tumor, infragastric omentectomy, left hemicolectomy, end colostomy, bso for advanced ovarian cancer -intubation history of present illness: ms is a 67 year old with a history of er/pr positive breast cancer who presented with a recent ct scan revealing a large right adnexal mass, ascites as well as peritoneal irregularities suggestive of metastatic disease. this scan was obtained after a fall caused significant low back and abdominal pain. she also notes having had abdominal distention, lack of appetite, fatigue and diarrhea. she denies nausea, vomiting, and vaginal bleeding. ct scan at an osh revealed a 9.4 x 7.1 x 12.0 cm right adnexal mass, cystic with areas of nodularity. there was abdominal ascites noted. there were several areas of nodularity within the omentum, measuring up to 6.0x3.0 cm, as well as small bilateral pleural effusions. ca-125 was elevated at 989. past medical history: pmh: asthma, htn, depression, panic attacks, er/pr positive dcis of the right breast. denies h/o dm, thromboembolic disorder. psh: vaginal hysterectomy secondary to prolapse , left breast biopsy , right breast biopsy , right breast lumpectomy . ob: g1p1, nvd x1 gyn: menarche age 12, regular. lmp s/p vag hyst. denies h/o fibroids, ovarian cysts, sti/pid, and abnormal pap smear. social history: never smoker, denies etoh, denies illicit drugs family history: mother had breast cancer in her 70s. mgf had dmii. pgf had htn and cad. physical exam: admission exam to the icu after the surgery: general: intubated, sedated, no acute distress heent: sclera anicteric, oropharynx clear, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-distended, bowel sounds hypoactive, no tenderness to palpation, no rebound or guarding, jp drain in place, ostomy in periumbilical region gu: foley catheter in place ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema, left arm cooler than right, but intact pulses neuro: withdraws to pain pertinent results: admission labs: 03:23pm blood wbc-3.3*# rbc-4.46 hgb-12.8 hct-37.7 mcv-84 mch-28.6 mchc-33.9 rdw-15.3 plt ct-437 03:23pm blood neuts-79* bands-1 lymphs-14* monos-5 eos-0 baso-0 atyps-0 metas-0 myelos-1* 03:23pm blood pt-15.0* ptt-27.5 inr(pt)-1.4* 03:23pm blood fibrino-158* 09:00pm blood ret aut-1.6 03:23pm blood glucose-217* urean-12 creat-0.6 na-141 k-3.8 cl-111* hco3-22 angap-12 11:06pm blood ck(cpk)-236* 11:06pm blood ck-mb-2 ctropnt-<0.01 03:23pm blood calcium-7.7* phos-4.4 mg-1.3* 12:40pm blood type-art temp-36.4 po2-234* pco2-41 ph-7.33* caltco2-23 base xs--4 11:02am blood glucose-162* lactate-2.4* na-133 k-3.9 cl-108 calhco3-22 12:40pm blood freeca-1.02* discharge labs: 06:15am blood wbc-15.8* rbc-4.85 hgb-13.2 hct-41.4 mcv-86 mch-27.3 mchc-32.0 rdw-15.5 plt ct-615* 06:20am blood glucose-124* urean-14 creat-0.7 na-139 k-4.1 cl-101 hco3-26 angap-16 06:20am blood ldlmeas-87 06:20am blood tsh-4.3* 06:20am blood hiv ab-pnd urine culture: pseudomonas aeruginosa. 10,000-100,000 organisms/ml.gram negative rod(s). ~1000/ml. sensitivites: cefepime-------------- 2 s ceftazidime----------- 4 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s meropenem-------------<=0.25 s piperacillin---------- s tobramycin------------ <=1 s cxr: ng tube tip has been inserted and its tip is in the stomach. et tube tip is 4.5 cm above the carina. mediastinal drain is in place. heart size is top normal. the assessment of the mediastinum demonstrates bulging of the aortopulmonic window that might be due to pericardial effusion or hematoma, attention to this area is recommended. patient has mild pulmonary edema. left retrocardiac opacity is new and might reflect atelectasis, although aspiration cannot be excluded. cxr: as compared to the prior study, there is interval improvement of the mediastinal appearance, most likely consistent with resolution of atelectasis. bilateral pleural effusions have slightly increased as well as bibasal atelectasis. no pneumothorax is present. cta: no evidence of pulmonary embolus. bilateral pleural effusions, increased in size since , with overlying atelectasis; however, infectious process cannot be excluded, particularly in the right lower lobe. mild pulmonary edema. slightly enlarged mediastinal lymph nodes since . calcified thyroid nodule in the right lobe. cxr: heart size and mediastinal contours remain within normal limits allowing for technique. there is marked interval improvement in bilateral upper zone pulmonary vascular re-distribution and patchy consolidation consistent with improvement in pulmonary edema. bilateral infrahilar and bibasilar opacities persist. probable small left pleural effusion. no evidence of pneumothorax. echo: very poor image quality. overall left ventricular systolic function is probably moderately depressed (lvef= 30-35 %). no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. with normal free wall contractility. there is no pericardial effusion. compared to the prior study dated , no clear change (lvef was probably overestimated on prior). brief hospital course: 67 yo female with history of er/pr positive breast dcis s/p ex lap, resection of tumor, infragastric omentectomy, left hemicolectomy, end colostomy, bso for advanced ovarian cancer, who was admitted to the icu for post-procedure extubation and hypotension and another icu admission for flash pulmonary edema. #icu admission #1 for hypotension, intubation, require intense monitoring immediately post-operation: 2 liters of ascitic fluid was drained upon opening of her abdomen, estimated blood loss for the surgery was 1 liter. during the surgery, patient transiently dropped her blood pressure during the procedure to 50s/30s, she was initiated on phenylephrine gtt through peripheral iv. she received 10 liters ns ivf during her procedure, ~2 liters ns while in pacu, 2 units prbcs, 2 units ffp. serial labs were obtained for monitoring. pt was gradually weaned off the phenylephrine gtt. hct were monitored and there was a slow decrease in her hct but no evidence of active bleeding, she was given 2 additional units of prbc. once pt's condition improved, she was extubated and transferred out of the icu. # icu admission #2/desaturation secondary to flash pulmonary edema: she had respiratory distress after cta of the chest was performed for tachypnea and persistent tachycardia in the 100's. cta was negative for pulmonary embolism but showed worsening bilateral pleural effusion with pulmonary edema. she did not improve with non-rebreather mask and was transferred to the icu for the 2nd time during her hospital stay. her lung exam was significant for extensive inspiratory crackles, cxr consistent with worsening pulmonary edema. ekg showed left bundle branch block that is unchanged compared to ekg on . she was placed on bipap. nebulizers were given with minimal improvement. iv lasix was administered with good urine output during her 2nd icu stay. a small troponin leak was noted during her 2nd admission to the icu. echo was of suboptimal image quality and showed ? ef of 45%. she was placed on iv nitro drip for a period of time for sbp in the 150-160's. cardiology team was consulted and following along. nitro drip was weaned off and carvedilol 6.25 mg twice daily was initiated. cardiology recommended aspirin of 81 mg daily, lasix 20 mg daily, continue with home medication lisinopril 40 mg daily and simvastatin. bipap was gradually weaned off and pt was transferred out of icu with saturation in her 90's on nc of 2-3l. repeat echo on confirmed prior echo and showed moderately depressed lvef at 30-35%. pt will follow up as outpatient with dr. (cardiologist) for medication adjustment and possible outpatient perfusion imaging versus catheterization. # hypotension: she had large volume fluid shifts during surgery and hypovolemia due to blood loss. there was low suspicion for sepsis or cardiogenic causes. she received 12 liters ivf resuscitation, and was placed transiently on phenylephrine gtt for pressure support and on propofol for sedation. her sedation and vasopressors were weaned without any difficulty, and her blood pressure remained normal at the time of transfer out of the icu and continue to be stable prior to discharge to rehab. # hematocrit: patient's hematocrit dropped from 39.9 on admission to 30.0 post-surgery. she received aggressive fluid resuscitation due to hypotension (see above) and some component of her hct drop is likely dilutional. she was transfused with 4 units blood cells and 2 units of ffp throughout her hospital stay, and her hct was stable at 41 at the time of transfer to rehab. # s/p intubation: patient was intubated for surgical procedure and was admitted to the icu sedated with propofol. this was slowly weaned and she was extubated without complication. # advanced ovarian carcinoma: s/p ex lap with resection of tumor, infragastric omentectomy, left hemicolectomy, end colostomy, bso, and optimally debulked. she will continue treatment as outpatient with dr. . #ostomy care: s/p consult and teaching from ostomy nurses. #incisional cellulitis/wound care: small 1.5 cm incisional opening, continue with twice daily wet to dry wound packing; mild erythema around the incision and wound opening, pt was started on a 10 day course of keflex. # uti: urine culture was positive for pseudomonas aeruginosa and it was pan-sensitive. she was started on a 10 day course of cipro. # post-op de-conditioning: pt was evaluated by the inpatient physical therapists and they recommended rehab care. once pt was medically stable, she was transferred to rehab for physical therapy. chronic issues: # hypertension: continued home med lisinopril, additional anti-htn meds were added due to the heart failure ( lasix 20 mg daily, carvedilol 6.25 mg twice daily) # asthma: continued home meds fluticasone and nebs prn # depression/anxiety: continued home meds bupropion and sertraline # hypercholesterolemia: continued home meds simvastatin medications on admission: preadmission medications listed are correct and complete. information was obtained from patient. 1. azelastine *nf* 0.15 % (205.5 mcg) nu 4 sprays 2. bupropion 150 mg po daily 3. fenofibrate *nf* 145 mg oral daily 4. fluticasone propionate 110mcg 4 puff ih 5. lisinopril 40 mg po daily 6. sertraline 100 mg po daily 7. simvastatin 10 mg po daily 8. xopenex neb *nf* 0.63 mg/3 ml inhalation prn sob discharge medications: 1. bupropion 150 mg po daily 2. fluticasone propionate 110mcg 4 puff ih 3. lisinopril 40 mg po daily 4. sertraline 100 mg po daily 5. xopenex neb *nf* 0.63 mg/3 ml inhalation prn sob 6. aspirin 81 mg po daily 7. carvedilol 6.25 mg po bid hold for sbp < 100, hr < 60 8. ciprofloxacin hcl 500 mg po q12h duration: 10 days 9. famotidine 20 mg po q12h 10. furosemide 20 mg po daily please hold for sbp < 100 11. ibuprofen 600 mg po q8h:prn pain 12. simvastatin 10 mg po daily 13. fenofibrate *nf* 145 mg oral daily 14. azelastine *nf* 0.15 % (205.5 mcg) nu 4 sprays 15. oxycodone-acetaminophen (5mg-325mg) tab po q4-6prn pain rx *oxycodone-acetaminophen 5 mg-325 mg tablet(s) by mouth every 4-6 hours disp #*50 tablet refills:*0 16. cephalexin 500 mg po q6h duration: 10 days discharge disposition: extended care facility: nursing and rehab center discharge diagnosis: ovarian cancer discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair, and some ambulation with assistance and walker. discharge instructions: dear ms you were admitted to the gynecologic oncology service after undergoing the procedures listed below. you have recovered well after your operation, and the team feels that you are safe to be discharged home. please follow these instructions: general instructions: * take your medications as prescribed. * do not drive while taking narcotics. * do not combine narcotic and sedative medications or alcohol * do not take more than 4000mg acetaminophen (apap) in 24 hrs * no strenuous activity until your post-op appointment * nothing in the vagina (no tampons, no douching, no sex), no heavy lifting of objects greater than 10lbs for 6 weeks. * you may eat a regular diet incision care: * you may shower and allow soapy water to run over incision; no scrubbing of incision. no bath tubs for 6 weeks. * your staples will be removed at your follow-up visit. to reach medical records to get the records from this hospitalization sent to your doctor at home, call . followup instructions: -provider: , md phone: ( (office), ( (fax); address: , , date/time: 10:00. -please call to schedule a follow-up appointment with dr. in the clinic in 2 weeks -provider: , md phone: date/time: 2:15 -provider: , md phone: date/time: 2:15 md procedure: open and other left hemicolectomy non-invasive mechanical ventilation other removal of both ovaries and tubes at same operative episode excision or destruction of peritoneal tissue permanent colostomy insertion of catheter into spinal canal for infusion of therapeutic or palliative substances systemic to pulmonary artery shunt diagnoses: other iatrogenic hypotension obstructive sleep apnea (adult)(pediatric) other postoperative infection cellulitis and abscess of trunk unspecified pleural effusion urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia asthma, unspecified type, unspecified personal history of malignant neoplasm of breast depressive disorder, not elsewhere classified other left bundle branch block other ascites acute systolic heart failure hypovolemia removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation tachycardia, unspecified pseudomonas infection in conditions classified elsewhere and of unspecified site acquired absence of both cervix and uterus acute edema of lung, unspecified secondary malignant neoplasm of retroperitoneum and peritoneum malignant neoplasm of ovary panic disorder without agoraphobia 

Answer: The patient is high likely exposed to