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: patient is a 69-year-old female with diabetes diet controlled, atrial fibrillation on coumadin with unknown cad presents to after one week of progressive dyspnea on exertion. per patient's symptoms started approximately two months ago with progressive shortness of breath and inability to exercise as she previously tolerated. of note, the patient recently had ddd pacemaker placed on for sick sinus syndrome and a-v block. at , the patient was found to be hypotensive, anemic with a hematocrit of 24, and in acute renal failure with a creatinine of 4.1, coagulopathic, inr 4.5. patient treated with subq vitamin k 2.5 mg, 3 units of ffp, transfused 2 units of packed red blood cells. course was complicated by hypotension with systolic blood pressure in the 70s, given 200 cc/hour iv fluids, and dobutamine 2 mg/kg/minute. no tachycardia, adequately paced. echocardiogram obtained showed a 1-3 cm circumferential pericardial effusion with early tamponade, question for left atrial collapse, no pulsus paradoxus noted. patient was transferred to for further management. patient is hypotensive on admission. systolic blood pressure in the 70s with lightheadedness, neck and jaw pain. dobutamine stopped and bolused 500 cc of normal saline x2. refractory hypertension, peripheral dopamine started at 5 and increased to 8 mcg. bedside echocardiogram demonstrated diastolic rv collapse with inr of 4.7, 4 units of ffp infused, as well as 5 mg of iv vitamin k. an atrial line was placed which demonstrated inspiratory variation. patient on call to the catheter laboratory for assessment for presumed cardiac tamponade. past medical history: 1. diabetes adult onset. 2. atrial fibrillation on coumadin. 3. pacemaker placed on . 4. complete heart block with sick sinus syndrome. 5. hypercholesterolemia. 6. renal insufficiency, baseline creatinine of 1.5-2. allergies: erythromycin. social history: negative tobacco, iv drug use, alcohol. the patient lives alone. has a daughter and son, who are involved. vital signs on admission: afebrile, 97.6, blood pressure 82/60, dopamine 5 mcg, rate 63, ventricular paced, respirations 18, and 93% on 4 liters nasal cannula. physical examination: general: mild respiratory distress, unable to speak in full sentences. heent: perrla. eomi. oropharynx clear, nonicteric. elevated jugular venous pressure to tmj, no thyromegaly. cardiovascular: distant heart sounds, murmurs, rubs, or gallops not appreciated. pulmonary: anterolateral clear to auscultation with decreased breath sounds at left base. abdomen is mildly distended, obese nontender, no hepatosplenomegaly, no pulsatile liver. extremities: 2+ bilateral pitting edema to mid calf, +2 femoral pulses, no bruits. dopplerable dp and pt pulses. neurologic is alert and oriented times three. strength 5/5 throughout. laboratories on admission: white count 9.2, hematocrit 30.7 status post 2 units of packed red blood cells. sodium 124, potassium 5.7, chloride 93, bicarb 18, bun 84, creatinine 4.0, glucose 132, inr of 4.5. ekg: atrial fibrillation, paced, no ischemic st changes. hospital course: patient on coumadin for atrial fibrillation recently placed pacemaker, subacute pericardial effusion of unclear etiology likely hemorrhagic, workup viral, malignant physiology. patient is taken to catheterization laboratory for therapeutic diagnostic drainage. pericardial centesis performed removal of 1,050 cc of hemorrhagic pericardial fluid. echocardiogram showed minimal residual fluid. filling pressures remained elevated with wide respiratory variation with ra pressure 35, pa 60/30, and pcw 35. improvement in cardiac output and resolution of paradoxical pulse. dobutamine originally 8 mcg/kg was discontinued. runs of vt with good blood pressure noted during procedure possibly related to catheterization manipulation. patient is currently chest pain free and sent back to ccu for recovery. fluid sent for cytology and other studies. patient's pericardial drain remained in place, on hospital day one drained 300 cc of bright red blood. on hospital day two, 215 cc of bright red blood. repeat echocardiogram showed minimal change and small amount of pericardial effusion, no tamponade physiology. the patient continued to be chest pain free. inr was reversed successfully to 1.8 on hospital day one. patient remained normotensive off pressors and began diuresing. elevated pa diastolic pressures of 22 post procedure suggest volume overload in the setting of aggressive fluid resuscitation during periods of hypertension. patient was given 20 mg of iv lasix q.d. plus 1.5 liter output. initial cytology negative. viral cultures pending. gram stain negative. cbc consistent with hemorrhagic fluid. ep evaluation was obtained to assess proper lead placement suspicious for lv lead position on chest x-ray. under fluoroscopy, pacer lead was withdrawn and replaced likely perforating into pericardial sac. interrogation read no abnormal impedance. appropriate sensation of pacing. patient remained off aspirin and anticoagulation in the setting of hemorrhagic pericardial effusion. drain was discontinued on hospital day #3. patient continued to be chest pain free. was transferred to the floor, where she underwent physical therapy with continual shortness of breath. 2. renal function: on arrival, patient likely prerenal secondary to poor cardiac output due to tamponade physiology. autodiuresis post procedure significantly improved creatinine. at time of discharge, patient had baseline creatinine of 1.2. 3. id: viral bacterial serologies were sent for pericardial analysis. gram negative cultures negative at time of dictation. 4. pulmonary: stable pcwp 30 at time of catheterization, likely volume overload in the setting of aggressive fluid rehydration. continue with diuresis of lasix 20 iv q.d. chest x-ray negative for pneumothorax post procedure. continued to be sating 98% on 2 liters nasal cannula, 95% on room air at time of discharge. 5. fen and gi: hyponatremia: patient likely sodium wasting secondary to from atn from hypotensive episode. at time of discharge, sodium normalized to 136. potassium repleted. magnesium repleted and appropriate throughout. 6. heme: coagulation reversed in setting of hemorrhagic pericardial effusion with 4 units of ffp, 5 mg iv of vitamin k. hold on anticoagulation for at least one month. no aspirin for at least one month. patient is discharged to followup with cardiology device clinic in one week. will need to followup with cardiologist, dr. within two weeks. patient desires continual care at . patient given number for dr. for possible future followup. medications on discharge: to be addended at a later date. , m.d. dictated by: medquist36 procedure: pericardiocentesis right heart cardiac catheterization replacement of transvenous atrial and/or ventricular lead(s) [electrode] replacement of transvenous atrial and/or ventricular lead(s) [electrode] diagnoses: urinary tract infection, site not specified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia atrial fibrillation hypotension, unspecified primary pulmonary hypertension mechanical complication due to cardiac pacemaker (electrode) acute pericarditis, unspecified 

Answer: The patient is high likely exposed to