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: bilateral saddle pulmonary emboli major surgical or invasive procedure: percutaneous thrombectomy x2 history of present illness: 44 yo f with no previous medical history who is transferred from an osh for bilateral saddle pulmonary emboli who is now s/p percutaneous thrombectomy. she presented to hospital this am complaining of anxiety with hyperventiliation as well as mid back pain with leaning forward. the pt was noted to be anxious on exam and breathing in a paper bag and was given 1 mg iv ativan. an ekg was significant for sinus tachycardia with a s1q3t3 and rv strain. an abg was 7.12/25/120/8/97.8 on a nrb and the pt was intubated. this was then followed by hr 32 and the pt was given atropine with improvement in hr to the 50s. a stat chest cta was significant for bilateral saddle pulmonary emboli with thrombus also seen in the more distal branches of the bilateral pulmonary arteries. shortly thereafter, the pt was started on levophed at 4 mcg/kg/hr which was titrated up to 20 mcg/kg/hr and vasopressin 0.04 units/hr for sbps in the 40s. a hco3 gtt was also started at 200 cc/hr for severe respiratory acidosis on a rpt abg. she was given 10 units retaplase iv x 1 prior to being transferred to . . on arrival, labs were significant for hct 34.2 and abg 7.03/69/90/20 with lactate of 6.3. the pt was sent immediately to the or for percutaneous tpa and thrombectomy. in the or, a tee was significant for massive clot burden in the main pa, r pa, and l pa with some flow distally. a percutaneous thrombectomy was performed of the main pa and right pa with residual clot but flow visualized in the right pa. levophed and vasopressin were shut off and she was started on neo at 2 mcg/kg/min and epi gtt at 0.04. she was also given 100 meq hco3 and was then transferred to the ccu for further management. . ros unable to be performed as pt sedated and intubated. per her family, the pt has not had any recent travel and has not complained recently of shortness of breath, chest pain, or leg swelling/pain. of note, the family reports that she is a heavy smoker and is on ocps. past medical history: anxiety s/p ccy social history: no alcohol or illicits. 1 ppd x 20 yrs. family history: no family history of blood clots. physical exam: (on admission) vs: t 93.5 oral, bp 125/94, hr 114, rr 24, o2 100% on ac fio2 100%, peep 10, tv 600, rr set at 24 gen: obese female, sedated and intubated. hugger in place. heent: pupils dilated and fixed, ngt in l nare, sanguinous fluid draining from r nare, ett tube in place neck: rij present with area of diffuse ecchymoses and 3x4 palpable hematoma. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no s4, no s3. no murmurs appreciated chest: no chest wall deformities, scoliosis or kyphosis. no crackles, wheeze, rhonchi. abd: obese, soft, ntnd, no hsm or tenderness. ext: no c/c/e. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp left: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp foley draining grossly bloody urine neurologic: sedated, pupils dilated and fixed bilaterally, does not withdraw to pain, does not move extremities spontaneously, slightly decreased motor tone b/l, unable to perform motor strength or sensation testing, +1 dtrs b/l, babinski equivocal b/l, twitch test performed by neurology resident at bedside negative. pertinent results: port cxr - underinflation with elevation of r diaphragm and bibasilar atelectasis. cardiomediastinal silhouette and pulmonary vascularity are grossly unremarkable. ett present in the trachea above the carina. . chest cta - large central saddle pulmonary embolism present with thrombus seen beyond this central saddle embolus in the central and more distal branches of both pulmonary arteries. scatterred areas of ground glass opacification in both lungs with some pleural thickening on the right. 3 cm long stenotic semenet of hte r common iliac artery on the order of 70% with less than 50% segmental stenosis of the l common iliac artery. . tee - pre-pulmonary angiography: 1. the left atrium is normal in size. 2. overall left ventricular systolic function is normal (lvef>55%). 3. the right ventricular cavity is moderately dilated. there is moderate global right ventricular free wall hypokinesis. 4. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. 5. the mitral valve appears structurally normal with trivial mitral regurgitation. 6. moderate tricuspid regurgitation is seen. 7. significant pulmonic regurgitation is seen. the main pulmonary artery is dilated. there is an area of echogenicity in the right pulmonary artery consistent of pulmonary embolism. there is limited flow across this area. an area of echogenicity in the main pulmonary artery cannot be excluded. unable to visualize the left pulmonary artery. 8. ivc is dilated. post-pulmonary angiography: 1. the area of echogenicity in the right pulmonary artery has decreased and there is an improvement of flow along the right pulmonary artery. there is flow along the main pulmonary artery. the left pulmonary artery remains difficult to visualize. . bilateral lower extremity ultrasound (): thrombus is identified within the right popliteal vein extending proximally. however, the superficial femoral vein on the right appears patent with normal compressibility, waveforms, and augmentation. partially occlusive thrombus is identified within the right common femoral vein. on the left, partially occlusive thrombus identified within the left popliteal vein. otherwise, the left superficial femoral and common femoral veins appear patent with normal compressibility, waveforms, and augmentation. impression: thrombus identified within the right popliteal vein with non- occlusive thrombus within the right common femoral vein. likely thrombus identified within the left popliteal vein. . cta : bilateral pulmonary embolism as described above. multifocal opacities/nodular opacities/ and consolidation in the lungs. notably, the area of consolidation in the right lower lobe appears to have components of ischemia/infarction; less likely would be a component of pneumonia. recommend follow up after clinical treatment to demonstrate resolution of these findings. soft tissue stranding in the anterior superior chest, surrounding the trachea in the superior mediastinum, and supraclavicular regions. . echo : lv unusually small. rv markedly dilated. severe global rv free wall hypokinesis. abnormal diastolic septal motion/position consistent with rv volume overload. no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. impression: suboptimal images due to patient being intubated. the right ventricle appears markedly dilated and moderately to severely hypokinetic. pressure overload of the right ventricle. lv cavity appears small, probably due to compressive effect of the large rv. lv function appears normal/hyperdynamic. brief hospital course: as mentioned above, on arrival to bimdc labs were significant for hct 34.2 and abg 7.03/69/90/20 with lactate of 6.3. the pt was sent immediately to the or for percutaneous tpa and thrombectomy. in the or, a tee was significant for massive clot burden in the main pa, r pa, and l pa with some flow distally. a percutaneous thrombectomy was performed of the main pa and right pa with residual clot but flow visualized in the right pa. pt was brought up to the ccu where she was very tenuous with hypotension requiring quadruple pressors, and multisystem organ failure including renal, liver, gi tract, endocrine, neurological systems the bilateral saddle pulmonary embolism and subsequent hypotension (and possibly to to embolisms to other organs other than lung). pt had a lactate at 11.1 that evantually peaked at 17 requiring nuumerous amps of bicarb. she received blood transfusions for oozing from several sites and for coffee ground, bloody drainage from upper gi tract throught the ngt. a stat ct scan of the head was negative for intracranial bleed on admission. pt had no risk factors for pe other than being on ocps and smoker. with signs of rv strain and dilatation on initial ekg and echos. once ptt was at goal, the heparin was restarted and continued. lenis were positive for bilteral dvts that were compressible suggesting fresh clots. pt was seen by neuro who thought but had little brain and brain stem fn but given young, there was still a small hope she would recover some function if surviving the first 24 hrs. pt managed to make it through the first night and then when weaned off sedation there was a question from neuro about weather she had recovery of her function to some extent; therefore she was taken back to have another percutaneous thrombectomy and placement of an ivc filter. despite this pt continued to require 4 pressors with worsening multisystem organ failure. her neuro exam was relevant for absent gag reflex, corneal reflex, with sluggish pupillary response and only response to pain was decortication. the prognosis was thought to be exceedingly poor at this time since it had been >72 hrs since first presenting at the osh. after discussion with the family including the hcp on , the decision was made to make the pt cmo. pt expired soon thereafter and was pronounced at 17:12 on . medications on admission: aspirin 162 mg po daily cilostazol 100 mg metoprolol tartrate 75 mg pantoprazole 40 mg daily warfarin 1 mg daily nitroglycerin 0.4 mg sl prn discharge medications: n/a discharge disposition: expired discharge diagnosis: saddle embolus/pulmonary embolism multisystem organ failure cardiopulmonary arrest discharge condition: expired discharge instructions: n/a followup instructions: n/a procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours coronary arteriography using a single catheter interruption of the vena cava injection or infusion of thrombolytic agent right heart cardiac catheterization incision of vessel, other thoracic vessels incision of vessel, other thoracic vessels diagnoses: acidosis tobacco use disorder acute kidney failure, unspecified cardiogenic shock acute venous embolism and thrombosis of deep vessels of proximal lower extremity other pulmonary embolism and infarction 

Answer: The patient is high likely exposed to