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: ampicillin / amoxicillin / heparin agents attending: chief complaint: scheduled admission for autologous stem cell transplant major surgical or invasive procedure: central line placement history of present illness: a 61-year-old woman with amyloidosis, being admitted for autologous stem cell transplant. the patient was in her usual state of health until , then she developed pneumonia. she responded to antibiotics with resolution of fever and cough that continued after that point to have progressive fatigue, weight loss, early satiety, and constipation. the patient as part of her workup underwent a 24-hour urinalysis, which showed elevated quantitative protein with the presence of bence that is representing a minority of the protein with a presence of albuminuria. she had a protein to creatinine ratio that was markedly elevated at 12.0. she underwent a bone marrow biopsy, which revealed 10-20% plasma cells with some areas of amyloid deposition. a skeletal survey showed no bony lesions. the patient underwent a renal biopsy, which confirmed the presence of amyloidosis. she did not need a primary criteria for diagnosis of multiple myeloma and was felt that this was a primary amyloidosis in the setting of an underlying plasma cell dyscrasia. she underwent an extensive pretransplant evaluation was seen by cardiology. her ejection fraction was intact. she has had some ventricular hypertrophy on echocardiogram. she underwent a mri, which did show some evidence of amyloidosis. she underwent a stress test, which showed good effort, no evidence of ischemic disease, and ultimately after extensive discussions with cardiology, it was felt that the patient did have increased risk of transplantation in the setting of amyloidosis, but that this risk was not prohibitive and the functional impairment of the heart was quite modest. the patient underwent stem cell mobilization with g-csf and collected 8 million cd34 cells per kilo with good viability and is now being admitted for autologous stem cell transplant. the patient's primary complaint is continued to be fatigue and some abdominal discomfort. she has had easy bruisability with a normal pt and ptt. she has had no evidence of congestive heart failure. has had some mild edema in her lower extremities. she has had no shortness of breath, cough, fevers, sweats, chills, or other localizing complaints. past medical history: past medical history: 1. amyloidosis: + urine and serum paraprotein with a modest increase in plasma cells in the bone marrow, suggesting that amyloidosis is associated with a plasma cell dyscrasia, does not meed criteria for multiple myeloma. being prepared for autotransplant; received gcsf treatment starting for stem cell collection. 2. normal ef, minimal diastolic dysfunction, normal stress test. 3. asthma 4. hypertension 5. hypothyroidism 6. s/p fall at age 21 with resultant le neuropathy 7. s/p tonsillectomy at age 21 social history: she works as a hairdresser. she smoked for 30 years, she stopped for approximately 9 years but then restarted 7 years ago. mother with history of colon cancer. family history: she has a sister with rheumatoid arthritis, mother with history of colon cancer. physical exam: vs:t 98.3, hr 93, bp 110/74, rr 20, o2 sat 97% ra general: nad, obese heent: perrla, mmm, no adenopathy, sclerae anicteric skin: multiple bruises, petechial rash throughout cv: rrr, s1s2 quiet, no murmurs, no rubs pulm: ctab, large dressing around upper thorax (for skin exfoliations) abd: obese, nd, nt, +bs ob/gyn: patient will be examined today by ob/gyn for vaginal bleeding extr: 3+ edemas bl neuro: aox3 pertinent results: 02:44pm pt-12.3 ptt-34.2 inr(pt)-1.1 02:44pm plt count-618*# 02:44pm neuts-57.6 lymphs-34.3 monos-5.1 eos-2.0 basos-1.0 02:44pm wbc-9.6 rbc-4.64 hgb-13.6 hct-39.4 mcv-85 mch-29.3 mchc-34.5 rdw-17.3* 02:44pm anisocyt-1+ microcyt-1+ 02:44pm alt(sgpt)-8 ast(sgot)-16 ld(ldh)-174 alk phos-83 tot bili-0.2 02:44pm albumin-2.1* calcium-9.0 phosphate-4.0 magnesium-1.7 uric acid-5.2 02:44pm glucose-116* urea n-13 creat-0.6 sodium-137 potassium-3.6 chloride-102 total co2-27 anion gap-12 . cxr : right effusion. in order to see any underlying lung disease on the right, a left decubitus rather than a right decubitus views would be necessary. . ct : large right-sided and smaller left-sided pleural effusions. moderate gallbladder distension without evidence of cholecystitis. apparent wall thickening of the descending colon is likely secondary to collapse, although an intrinsic process cannot be excluded on this examination. there is no pericolonic stranding. clinical correlation is advised. . chest ct : 1. 11 mm left apical spiculated mass with pathologic mediastinal adenopathy is concerning. a pet scan is recommended for further evaluation. 2. bilateral pleural effusions with associated atelectasis (right greater than left). . head ct : no intracranial hemorrhage. . echo : there is symmetric left ventricular hypertrophy. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. left ventricular systolic function is hyperdynamic (ef>75%). right ventricular chamber size and free wall motion are normal. trivial mitral regurgitation is seen. ventricular cavity sizes appear small suggestive of hypovolemia. . cxr : moderate right and small left pleural effusion have progressively enlarged since . mild pulmonary edema and mediastinal venous engorgement indicate biventricular cardiac decompensation, although heart is not particularly enlarged. severe right lower lobe atelectasis is partially obscured by pleural effusion. . lue u/s: limited study, no subclavian, axillary, or internal jugular thrombus. . cxr: almost complete resolution of pulmonary edema. bilateral pleural effusions improved. . irregular antibodies: this patient has a newly acquired anti-jka (kidd) antibody. kidd antibodies are igg antibodies that fix complement. they have the potential to cause delayed hemolytic transfusion reactions that are intravascular and severe. the possiblility of delayed hemolytic transfusion reaction as well as the fact that the coombs test was negative was discussed with the clinical team. these reactions typically occur from 7-10 days post sensitization but may occur later. as a result, the patient must receive blood products lacking the jka antigen should future need for transfusion arise. . lung scan : this is a limited examination. perfusion abnormalities are consistent with the patient's known right sided pleural effusion. there are no other segmental or subsegmental perfusion defects. . echo : the left atrium is normal in size. there is symmetric left ventricular hypertrophy. the left ventricular cavity is unusually small. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. left ventricular systolic function is hyperdynamic (ef>75%). the right ventricular cavity is small. right ventricular systolic function is normal. the aortic valve is not well seen. there is no valvular aortic stenosis. the increased transaortic gradient is likely related to high cardiac output. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is a very small pericardial effusion. there are no echocardiographic signs of tamponade. compared with the prior study (images reviewed) of , findings are similar although views are technically suboptimal for comparison. a very small pericardial effusion is now detected. . cxr : 1) new small left pleural effusion with underlying collapse and/or consolidation. right effusion and underlying collapse and/or consolidation unchanged. mild chf. 2) a spiculated left apical mass seen on the ct scan is not appreciated radiographically. at the time of that ct scan, a pet scan was recommended for further evaluation. clinical correlation is requested. . cytology, sputum : negative for malignant cells. . cxr : stable appearance to the bilateral pleural effusions. brief hospital course: the patient is a woman with what appears to be primary amyloidosis as such we are going forward with autologous transplant. we have carefully reviewed potential risks and benefits of autologous transplant and explained that in phase ii data. this has been associated with improvement or stabilization of symptoms in patients with amyloidosis and disease free for progression free survival of approximately 4 to 6 years. there has been no randomized phase iii studies comparing this directly to standard chemotherapy, but in case control, this does appear to be advantageous risks of autologous transplant and include complications from infection, bleeding, need for transfusion, risk of end organ damage including hepatic, renal, pulmonary, and cardiac toxicity, potential risk for poor engraftment, myelodysplasia, acute leukemia, and appears transplant mortality of % that transplant related morbidity and mortality is increased in the setting of cardiac amyloid and as a result the patient underwent an extensive evaluation by cardiology and was felt that her degree of involvement is quite modest and that based on the patient's overall symptoms that will be reasonable to look forward. this was carefully discussed with the patient who would like to look forward as indicated. she went through the eligibility assessment process and met eligibility criteria as per the treatment plan for autologous stem cell transplantation and is to be admitted for this purpose. ______________________ ms. is a 61yo f w/ amyloidosis. she was admitted on and underwent conditioning w/ melphalan. she had a relatively unremarkable pre-transplant course. she was having postmenopausal bleeding on admission, for which she was evaluated by gyn, with the question of ? vaginal amyloid. has also had some mild hematuria, emesis x1 w/ blood (not frank hematemesis) and issues with fluid management, requiring almost daily lasix doses to keep i/o even (is now up 30# from baseline weight). after her stem cell infusion, had significant n/v and was given ativan and compazine but dropped her bp and required fluid boluses to bring bp back up (on ). allopurinol was added on for elevated ldh and uric acid (for ? tumor lysis syndrome, with good results). cardiology was consulted on for volume overload and possible diastolic dysfunction, but recommended diuresis which has been difficult given her hypotension. she has started to develop mild mucositis and decreased appetite, requiring tpn to keep her nutritional status up. per bmt team, pt was doing well yesterday, afebrile, and without any complaints. . at 4am vs check, patient was noted to be febrile. shortly thereafter the moonlighter was called for hypotension and came to evaluate the patient. the pt told the moonlighter that she felt "awful", like she was "going to die", worse than she's felt through the entire transplant. denied cp or sob. she was given 250cc ns bolus for sbp in the 80s, with minimal improvement (sbp to 90s). moonlighter did not feel comfortable giving more ivf given her h/o volume overload and instead began to administer pressors through her iv. she was originally going to receive neo given her tachycardia (hr was in 130s), but given her cad, her pressor was changed to levophed. her tpn was stopped so as to free up another port for access. abg was attempted x4 with no success. ekg was obtained and showed st elevations in v1-v2, somewhat more pronounced than in the past. cxr was performed and did not show frank pulmonary edema, but did show a new rll infiltrate vs. effusion. once the levophed was able to be started, the patient was stable for transfer and was brought to the for further management. in the , no source of sepsis was found. she was started on steroids for presumed adrenal insufficiency. her blood pressure resolved. after transfer back to the floor, on , she remained stable. she experienced several episodes of shortness of breath, but v/q scan, echocardiogram, chest x-ray showed no source of dyspnea. her oxygen saturations remained above 88% on room air, and she was given oxygen via nasal cannula for comfort. . she developed acute thrombocytopenia, which was attributable to a positive anti-platelet antibody. her platelets had resolved to ~70k at the time of discharge. . throughout her hospital stay, she was followed by the psychiatry consult service for anxiety and depression. at the time of discharge, she was stable on doses of ativan (tid), mirtazapine 15mg daily, and ritalin 15mg . she was discharged with bactrim for prophylaxis. medications on admission: lisinopril 10 mg po daily albuterol 0.083% neb soln 1 neb ih q6h:prn oxycodone (immediate release) 5 mg po q4-6h:prn levothyroxine sodium 125 mcg po daily lorazepam 0.5 mg po once mr1 hydrochlorothiazide 25 mg po daily salmeterol xinafoate diskus (50 mcg) 1 inh ih q12h discharge medications: 1. levothyroxine 125 mcg tablet sig: one (1) tablet po daily (daily). 2. salmeterol 50 mcg/dose disk with device sig: disk with devices inhalation q12h (every 12 hours). disk with device(s) 3. ipratropium bromide 17 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 4. oxycodone 5 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 5. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 6. fludrocortisone 0.1 mg tablet sig: one (1) tablet po daily (daily). 7. prednisone 2.5 mg tablet sig: one (1) tablet po qpm (once a day (in the evening)). 8. prednisone 5 mg tablet sig: one (1) tablet po qam (once a day (in the morning)). 9. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 10. methylphenidate 5 mg tablet sig: three (3) tablet po bid (2 times a day). 11. lorazepam 0.5 mg tablet sig: one (1) tablet po tid (3 times a day). 12. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 13. lactulose 10 g/15 ml syrup sig: thirty (30) ml po tid (3 times a day). 14. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 15. bactrim ds 160-800 mg tablet sig: one (1) tablet po bid mwf: please take twice a day on monday, wednesday, and friday. discharge disposition: extended care facility: & rehab center - discharge diagnosis: primary amyloidosis s/p autologous stem cell transplant discharge condition: stable, good oxygen saturation on room air. discharge instructions: you were admitted for autologous stem cell transplant. you are being discharged to a rehabilitation facility. please take all of your medications as prescribed. if you experience any shortness of breath, fevers, chest pain, or other concerning symptoms, please seek medical attention immediately. followup instructions: follow up appointment with dr. : please follow-up with dr. on at 2:30 pm. it will be important for youto tell rehab to arrange transportation for you to attend this appointment. dentist: nopsaran chaimattayompol, dds. private practice number: . three more follow up appointments for denture fitting. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances thoracentesis transfusion of packed cells injection or infusion of cancer chemotherapeutic substance transfusion of platelets infusion of vasopressor agent autologous hematopoietic stem cell transplant without purging diagnoses: hyperpotassemia nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere coronary atherosclerosis of native coronary artery unspecified pleural effusion unspecified essential hypertension unspecified septicemia severe sepsis unspecified acquired hypothyroidism asthma, unspecified type, unspecified chronic kidney disease, unspecified hypotension, unspecified cellulitis and abscess of upper arm and forearm unspecified hereditary and idiopathic peripheral neuropathy herpes simplex without mention of complication chronic diastolic heart failure inflammatory disease of breast chronic ulcer of other specified sites nutritional and metabolic cardiomyopathy postmenopausal bleeding 

Answer: The patient is high likely exposed to