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: history of present illness: the patient is a 66-year-old female transferred from for question of lymphoma. the patient recently presented to the on , with a history of weakness, 50-pound weight loss over the past 3 months, and mouth sores. her mouth sores were not responding to topical nystatin or p.o. diflucan. at the , she was found to have an urinary tract infection, hyponatremia to 127, an elevated alkaline phosphatase of 238, leukocytosis with an overall lymphopenia (white blood cell count 13.7, with a differential of 75 polys, 15 bands, 3 lymphocytes). a cat scan of her thorax was performed at the outside hospital on , showing bilateral axillary nodes as well as mediastinal, hilar, and pretracheal nodes that were enlarged. she also had enlarged inguinal nodes that were biopsied and preliminary pathology reports showed distorted architecture with eosonophilic predominance. during that hospitalization at the , she also had a rash that was biopsied and that was consistent with a lichenoid keratosis or lichen planus. while at the , she received a course of antibiotics, including levofloxacin for uti and a course of augmentin for a question of pneumonia by ct. she also received a short taper of prednisone from to for the possibility of pemphigus as a cause of her oral lesions. she received a short course of acyclovir for a small lesion on her left lower eyelid, which was potentially herpetic. she had negative hiv test and negative at the outside hospital. she had intermittent fevers while an inpatient and continued to complain of mouth pain, chronically poor vision, and a generalized rash. she also complained of increasing diarrhea. past medical history: type 2 diabetes. hyperlipidemia. peptic ulcer disease/gastritis. macular degeneration. hypertension. siadh. past surgical history: status post cholecystectomy. status post appendectomy. status post total abdominal hysterectomy. allergies: nsaids. home medications: 1. lopressor. 2. hydrochlorothiazide. 3. cozaar. 4. neurontin. 5. ________. 6. calcium and vitamin d. 7. lescol. 8. insulin, dosage is not noted on the chart. social history: the patient has no history of tobacco use or ethanol ingestion. she has 3 children and a sister who lives in the area. physical examination: on initial presentation, the patient's vital signs were as follows; temperature of 98.6, blood pressure of 128/51, heart rate of 76, respiratory rate of 18, saturation of 94 on room air. she was a woman in her mid 60s in no apparent distress. she had bilateral surgical pupils that were equally reactive and had full extraocular motions. she had no cervical lymphadenopathy, but large nontender axillary nodes were noted on exam. she had a regular rate with normal s1 and s2. there were no murmurs, rubs, or gallops. she had bibasilar rales noted. her abdomen was nontender. there were two well-healed old surgical scars, one in the right upper quadrant from old a cholecystectomy and one below the umbilicus in the midline from her tah. she had no hepatosplenomegaly noted on exam. she had no extremity clubbing, cyanosis, or edema. her skin exam was notable for a diffuse macular rash on the legs and arms with signs of excoriation. she was alert and oriented times 3. cranial nerves were intact. she had a normal strength and 1 plus symmetric dtrs. laboratory data: her initial cbc showed a white count of 11.1, hematocrit of 32.6, platelet count of 375. her chemistry showed a sodium of 128, potassium of 5.1, chloride of 93, co2 of 26, bun of 13, creatinine of 0.7, and glucose of 225. her lfts were as follows; alt of 37, ast of 27, total bilirubin of 0.3, alkaline phosphatase of 199, ldh of 183, albumin of 2.2. hiv and tests were negative per the outside hospital. hospital course: this 66-year-old female with history of mouth ulcerations, diffuse skin rash, lymphadenopathy, diarrhea, lymphopenia, hyponatremia, and anemia, was transferred in from the for workup of symptoms of unclear etiology. multiple consult services were involved in order to determine the etiology of this lady's symptoms. dermatology was consulted on in order to investigate her rash and oral ulcerations. they noted a diffuse maculopapular rash with a wide differential noted on their note. they requested several additional labs including hcv antibodies and performed a dfa of one of the lesions from the inside of her mouth. they followed upon the biopsy results from the outside hospital of the rash, which was most consistent with lichen planus. they recommended aquaphor to her lips for symptomatic treatment. the gastrointestinal service was consulted on , due to her diarrhea and oral ulcerations. the gi service wound up performing both the colonoscopy as well as an egd on this patient. the colonoscopy was performed on tuesday, , for the history of diarrhea and weight loss. they found multiple non-bleeding aphthous ulcers ranging from 5 to 10 mm seen throughout the entire colon as well as terminal ileum. the differential at that time for the ulceration included crohn's disease as well as behcet disease or some form of vasculitis. biopsies were performed at multiple sites. the egd was also performed on . they found diffuse erythema and friability of the mucosa with no bleeding in the stomach, body, and antrum. findings were compatible with gastritis. biopsies were also performed here. the duodenum was noted to be normal. surgery was also consulted on to determine if there is a surgical cause for her symptom. they recommended adding some additional studies to follow up on the elevated alkaline phosphatase. optimizing nutrition, and offered to repeat open biopsy despite the fact that it has had been done previously at the outside hospital. she initially had been admitted to the bmt service because of the question of lymphoma, but was transferred over to the acove service on . the patient was started on tube feeds and was given tpn supplementation in order to optimize her nutritional status. the pulmonary service was consulted on , given the diffuse pulmonary infiltrates that were seen as well as the chest ct patchy infiltrates and lymphadenopathy, they recommended adding some additional rheumatological investigations such as panca, canca, sedimentation rate, and requested a high-resolution chest ct to better evaluate the lung changes. differential for her pulmonary complaints included eosinophilic pneumonitis versus some form of vasculitis. mrsa had been noted on the sputum , she was started on vancomycin. the ophthalmology service was consulted on because of her complaints of gradually decreasing vision bilaterally over the past month. she had a past eye history significant for bilateral cataract surgeries as well as panretinal photocoagulation for diabetic retinopathy done by dr. . she also has a history of iritis of unclear etiology in the past. the ophthalmology service recommended intensive course of topical lubrication as well as erythromycin ointment. they also recommended that they continue the travatan drops that she has been receiving while in the hospital. thus it was obvious from the above dictation, multiple services were involved with this patient in order to determine the cause of her diffuse multisystem disease. the overall clinical picture was puzzling. the small bowel-follow-through initially requested by gi had been performed which showed a stricture in the terminal ileum that the radiologist felt could be consistent with crohn 's disease. however, the biopsies done from the diffuse colonic ulcerations were not consistent with crohn's. the cutaneous biopsies were also not consistent with crohn's disease. vasculitis was still in everyone's differential, but there was no firm diagnosis at this time. rheumatology was consulted on the in order to see if an unifying diagnosis could be discovered for her symptoms. the initial impression of the rheumatologist was that the most likely diagnosis at this point was crohn's disease covering oral ulceration, chronic ulceration, ileal stricture, diarrhea, and weight loss, with possible associated complication of the sclerosing cholangitis leading to the biliary ductal dilatation and elevation of alkaline phosphatase and gtt. however, this could not explain the wide spread lymphadenopathy that has been noted. the thoracic service was consulted on to investigate the possibility of lung biopsy to further characterize her infiltrates and lymphadenopathy. on the patient had right upper lobe biopsies via vats. she tolerated the procedure well. in the pacu, however, they were unable to wean the neo-synephrine drip for pressure. she also had a perioperative decreased urinary output under 10 cc an hour that was not responsive to multiple fluid boluses. she had an arterial line that was placed in the or for monitoring of her blood pressure. she also had increasing hypoxia over her baseline 4 l requirement. the gas taken around that time was 7.31, 50, 90 on a 70 percent facemask and then 7.39, 46, 178, on a 100 percent nonrebreather. status post vats she had a chest tube kept to suction followed by ct surgery. the issue of whether or not to institute steroids was a longstanding conversation between the multiple services following this patient. she was on ocular steroids per ophthalmology and topical steroids for her rash, but systemic steroids were initially withheld secondary to concern for systemic infection. the patient had periodic fevers as well as the history of mrsa-positive sputum which was previously mentioned. there was also a question of whether or not she had pneumonia that was being treated. the ultimate perspective was that if there was no source of infection found following the vats procedure that they would likely start systemic steroids. on at 2350 hours, the code was called stat for respiratory arrest possibly secondary to a postictal period. the patient was obtunded. she was intubated with etomidate and succinylcholine and 7-0 ett tube was easily passed. per notes from the overnight attending, the patient prior to that intubation was found semiconscious with her eyes rolled back, thrashing her arms, and unresponsive. at that time her vitals were 89/60 for blood pressure and heart rate of 130. an egd was repeated on wednesday secondary to an episode of hematemesis. they found grade 4 esophagitis with spontaneous bleeding seen in the middle third of the esophagus and lower third as well. the entire gastric mucosa was noted to be oozing, friable, and edematous. there was no discrete site of bleeding. the findings were consistent with a severe hemorrhagic gastritis. the duodenal mucosa was normal in that study. the recommendations of upper gi service were to continue the pantoprazole that she had been on and to begin carafate slurry q.i.d. and follow her hematocrit. she was extubated on , but had to be re-intubated several hours later for respiratory distress. this was done by anesthesia using the etomidate and succinylcholine with a 7.5 ett tube. there were no complications from the reintubation. additional complications aroused during her micu stay including mrsa positive blood cultures. the patient was put on linezolid therapy. she was also found to be hep positive, therefore all heparin products were stopped. there was a consideration of argatroban to be started, however, the patient's hematocrit was stable; even still they were concerned about the history of severe gastritis and gi bleeding that occurred several days prior. the patient was started on solu-medrol for question of ibd. she was seen by dr. who saw the patient and was not convinced that crohn's was the ultimate diagnosis to unite her symptoms. the patient continued to do poorly on the . a repeat head ct was done to look for evidence of cns pathology which found new small infarcts including wedge shaped low attenuation sections in the right occipitoparietal junction and left anterior frontal area. a right basal ganglia lacunar infarct was also seen. these mini-strokes were possibly embolic and mri was considered, but held pending a family meeting to discuss wishes regarding how aggressive they wanted to be in her treatment in the phase of this information. a family meeting was held later that day including the daughter. this patient was initially full code, but later that day was changed to cmo. the patient was put on the morphine drip and was pronounced dead later that evening. disposition: the patient deceased. dr., 12-981 procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances other endoscopy of small intestine diagnostic ultrasound of heart interruption of the vena cava biopsy of bone marrow closed [endoscopic] biopsy of bronchus esophagogastroduodenoscopy [egd] with closed biopsy closed [endoscopic] biopsy of large intestine transfusion of packed cells other local excision or destruction of lesion or tissue of lung closed biopsy of skin and subcutaneous tissue transfusion of other serum injection or infusion of oxazolidinone class of antibiotics diagnoses: congestive heart failure, unspecified unspecified protein-calorie malnutrition hyposmolality and/or hyponatremia methicillin susceptible staphylococcus aureus septicemia methicillin susceptible pneumonia due to staphylococcus aureus cerebral artery occlusion, unspecified with cerebral infarction adult failure to thrive acute gastritis, with hemorrhage 

Answer: The patient is high likely exposed to