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: this is a 61-year-old russian woman with hypertension, hypercholesterolemia, hyperthyroid, elevated lfts, gastritis, anemia, who had three prior admissions for shortness of breath and chest pain. most recently ruled out for an mi three weeks ago with a previous admit of for left sided pleural effusion and shortness of breath. effusion was tapped and was found to be transudative in nature with mild elevations in her pulmonary arterial pressures and question right heart failure at that time. she was discharged on lasix but was not taking any currently on . she presents again with shortness of breath. the week prior to this admission the patient noticed increasing dyspnea on exertion and increasing lower extremity edema with transient chest pain plus minus pleuritic in nature. she went to her pcp's office and had an echocardiogram there which showed increased pulmonary arterial pressures to 79, 3+ tr and normal left ventricular function with a sinus bradycardia at 52. she was sent to the emergency room for concern of pe. she had an oxygen saturation of 100% on room air in the emergency room. ct angio was negative for pe. chest x-ray and ct showed a right base patchy infiltrate and effusion with interval increase in size in her bulky mediastinal and hilar lymphadenopathy on the ct scan. review of systems: revealed a baseline weight of 120 lbs, had a recent weight loss with lasix treatment, no nausea, vomiting or diarrhea, no melena, no weakness, no dizziness and positive complaints of chest pain when her blood pressure is high, relieved with sublingual nitro. past medical history: notable for hypertension, hypercholesterolemia. the patient had previously been on lipitor but this was stopped secondary to increased lfts, hyperthyroidism. the patient was diagnosed in with hyperthyroidism with an undetectable tsh and high t4. the patient had been started on tapazole but this was also discontinued three weeks ago because of increased lfts. history of chronic anxiety and depression, gastritis, anemia. the patient is seeing dr. as an outpatient. history of a transudative pleural effusion in , rule out mi on , increased lfts and increased pulmonary arterial pressures and question right heart failure. medications: patient was on compazine prn, sublingual nitro, prilosec 20 mg q d, lithium 250 mg q d, trazodone 50 mg q d, restoril 30 mg q d, calcium supplements, vitamin d. social history: the patient is a retired pharmacist. she is married and lives with her husband. she is originally from . she is a 20 pack year tobacco history, quit in . she moved from 8 years ago. family history: positive for coronary artery disease. her brothers both had mis at the age of 40 and no history of dvt. physical examination: she had vitals, temperature 96.2, heart rate 47, blood pressure 140/45, respiratory rate 16, o2 100% on room air. in general she is alert and pleasant, spoke in full sentences, in no acute distress. heent: revealed anicteric sclera, oropharynx was clear without ulcers or lesions, positive gingival bleeding. neck, positive jvd to the jaw at a 45 degree angle, positive hepatojugular reflux. chest, decreased breath sounds and positive dullness to percussion at the right base. heart, bradycardic, regular s1 and s2, murmur at the right and left lower sternal borders, no right ventricular heave. abdomen soft, nontender, non distended, liver edge at one inch past the costal margin, no splenomegaly. extremities, no clubbing, 2+ pitting edema to mid shins, no calf tenderness, positive spider angiomas over ankles bilaterally. neuro exam, alert and oriented times three, grossly non focal, positive tremulousness. laboratory data: admission labs include a white count of 7.3, hematocrit 31.5, platelet count 245,000, inr 1.2, ptt 27, calcium 9.7, sodium 139, potassium 5.1, hemolyzed, chloride 107, co2 17, bun 29, creatinine 0.9, glucose 93, ck 44, troponin less than 0.3, lithium less than 0.2. pertinent recent exam, on the patient had an esr of 46, negative . on alt 53, ast 39, alkaline phosphatase 408, br 0.4, tsh less than 0.05, hep b surface antigen negative, hep b surface antibody negative, hep a antibody positive, hep c antibody negative, hep c pcr negative. anca negative. spep negative. iron 24, tibc 264, ferritin 203, b12 540, folate 13.7. chest x-ray showed cardiomegaly with mild chf, small bilateral pleural effusions, right greater than left, patchy opacity at the right base, no pneumothorax. ct angio was negative for pe, showed positive bulky lymphadenopathy and a right lung opacity. echo report from dr. office earlier that day, pulmonary arterial pressure 79, 3+ tr, normal left ventricular function. echocardiogram from showed a pulmonary arterial pressure of 36, mild mr and normal left ventricular function. ekg showed sinus bradycardia at 47 beats per minute, normal access, normal intervals, positive t wave inversions in v2 and v3 that were new. hospital course: 1. pulmonary hypertension. the patient had a repeat echocardiogram on that showed the left atrium mildly dilated, right atrium mildly dilated, positive pfo, left ventricular function normal, right ventricle mildly dilated, rvss slightly depressed, pulmonary arterial pressure 45-58 mmhg and 2+ tr. the second echocardiogram was done after the patient was diuresed with iv lasix and was given nitro paste due to the four previous echos which all showed normal left ventricular function. the diagnosis was leaning towards primary pulmonary hypertension and the patient was scheduled to have a bronchoscopy with short acting vasodilator trials, however, after the patient's cardiac catheterization where wedge pressure was found to be 24, differential was changed to include left heart failure, elevated left sided pressure, as contributing to the elevated pulmonary arterial pressures. definitive diagnosis of pulmonary hypertension remains unresolved. 2. mediastinal and hilar lymphadenopathy. there has been an interval increase in size of the lymphadenopathy from her scans in to the scan on . the patient is planning on having an outpatient bronchoscopy and needle biopsy with dr. . 3. right sided pleural effusion. this effusion resolved after several days of lasix. 4. coronary artery disease. the patient had an episode of chest pain on after ambulating from the bathroom. she had 10/10 chest pain, positive nausea, positive diaphoresis. ekg showed st depression in v4 through v6 that was new. blood pressures were in the 180's at the time and pain was relieved by three sublingual nitroglycerin. with the resolution of pain, her ekg changes normalized. the patient ruled out by serial ck's. the patient was taken to cardiac catheterization on . exam was notable for 75% stenosis in the d1. the lesion was crossed with a bmw wire. after crossing the lesion the patient experienced an episode of vf with loss of consciousness. she was treated with 360 joules and iv atropine with the recovery of consciousness. after ptca times one, there was a residual stenosis of 20%. mean ra pressure was 13 mmhg, mean pcwp 24 mmhg with prominent v waves at 46 mmhg and lvedp was 25 mmhg. cardiac index was preserved at 2.8 liters per minute per meter sq. saturation revealed a 10% oxygen saturation step-up from 62 to 72% at the level of the mid right atrium consistent with a left to right shunt. calculated fraction was 1.13. left ventriculography revealed anterolateral wall hypokinesis, calculated lvef was 41%. impression: moderate systolic ventricular dysfunction and one vessel coronary artery disease. the patient was started on univasc 15 mg , lasix 20 mg q d and 325 mg of aspirin, lopressor was not added to her regimen secondary to asymptomatic bradycardia in the 40's to 50's. after catheterization the patient was admitted to the ccu where she stayed for three days. ccu course was uncomplicated. the patient desired a new cardiologist and has been set-up to have an appointment with dr. on . 6. id. the patient developed a left hand cellulitis at her iv site and 4/4 bottles positive for mrsa bacteremia. the patient was started on vanco and is currently on day #10. she defervesced quickly and surveillance cultures times three have been negative. there are no signs or symptoms of endocarditis or osteomyelitis. the patient was on 1 gm q 12 hours. 24 hour trough levels showed vancomycin levels of 24 and patient's dosing was changed to 1 gm q 36 hours. she will go home with a picc line to finish up her vancomycin 14 day course. 7. endocrine. the patient was followed by the endocrine consult service for her hyperthyroidism. the patient was started on ptu and is currently on a dose of 100 mg q a.m. and q p.m. and 50 mg q noon. t3 has normalized to 79, free t4 to 1.7, total t4 to 11.4. dr. will be following as an outpatient for her grave's disease. increase in lft's. patient's alkaline phosphatase is still elevated but has been trending down from 423 on to currently 286. ggt was also elevated at a level of 99. the patient has had two negative abdominal ct scans and a negative abdominal ultrasound on previous admissions. 8. anemia. tibc is decreased at 225, mcv 86, iron is low normal at 35, ferritin 135 normal. anemia likely of mixed etiology. anemia of chronic disease and iron deficiency. the patient is being followed by dr. and is to continue her vitamin c and iron supplementation. the patient was discharged in a stable condition to home with a visiting nurse her last dose of vancomycin. discharge diagnosis: 1. pulmonary hypertension. 2. coronary artery disease, status post ptca. 3. left hand cellulitis. 4. mrsa bacteremia. 5. hilar and mediastinal lymphadenopathy. 6. hypertension. 7. grave's disease. 8. anemia. 9. increased lft's. 10. congestive heart failure. discharge medications: vancomycin 1 gm iv q 36 hours, univasc 15 mg po bid, aspirin 325 mg po q d, propylthiouracil 100 mg po q a.m. q p.m., 50 mg q noon, lasix 20 mg po q d, prilosec 20 mg po q d, lithium 250 mg q d, trazodone 50 mg q d, restoril 30 mg q d, sublingual nitroglycerin prn. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures injection or infusion of platelet inhibitor other electric countershock of heart insertion of temporary transvenous pacemaker system diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified cardiac complications, not elsewhere classified infection with microorganisms resistant to penicillins other chronic pulmonary heart diseases other specified cardiac dysrhythmias cardiac arrest ostium secundum type atrial septal defect infection and inflammatory reaction due to other vascular device, implant, and graft 

Answer: The patient is high likely exposed to