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: doxycycline / lisinopril attending: chief complaint: unresponsiveness major surgical or invasive procedure: intubation history of present illness: ms. is a 78-year-old female with past medical history significant for hypertension,type 2 dm, distant breast cancer, ttp (lengthy hospitalization which required corticosteroids, plasmapheresis, and rituximab), relapsing polychondritis and anca positive pulmonary vasculitis. the patient was in her usual state of health this evening at 6:30 pm, speaking to her son on the phone. he said, to ems (from whom we got direct sign-out), that his mother sounded slightly tired, but this is her baseline and otherwise was normal. he then came to see her after running errands about 1 hr later and found her lying in emesis and stool. she was unreponsive and he could not wake her. ems called and found to develop a generalized tonic-clonic seizure. the seizure lasted about 3.5 mintues, then stopped spontaneously. she was then given ativan 2mg, then intubated with succinylcholine 100mg and etomidate 20mg, followed by versed 2.5 mg given concern about airway protection. she was then brought to . of note, son reports that this presentation is almost identical to her prior presentation last year, which required pheresis, and believes this was ttp. in the field ej and io access was obtained. she was in sinus rhythm, in the 80s, blood pressure was 200/80 mmhg, and breathing spotaneously (before intubation and medications). finger stick was 175. in the ed ct head/neck showed no acute intracranial hemorrhage. she does have subtle areas of hypodensities in left basal ganglia, pons, and midbrain maybe artifactual or represent ischemia. cta basilar artery appears patent. sedation was continued with propofol. ekg showed 1st degree avb. she was noted to be febrile to 102. cxr without pna. she was started on vanc/ctx/amp/acyclovir, but no lp was done due to low plt. ua showed no bacteria or leuks, but did have large blood, 300 glucose, 300 protein of note, pt noted to have trop of 1.03, with flat mb. cardiology was conuslted who felt no need for urgent cardiac intervention in setting of unchanged ekg. on transfer, vs were 106 146/80s, 99% on cmv fi02 100, peep 5, rr 16, tv 500. on arrival to the micu, vs were 100.1 109 106/63 100% on above vent settings past medical history: - diabetes, likely ii - hypertension, on several agents - breast cancer, s/p left mastectomy, 's - gerd (inference, on omeprazole), and peptic ulcer disease - gout - coronary artery disease - h/o shingles - carpal tunnel - anca positive pulmonary vasculitis - s/p appendectomy - s/p cholecystectomy - s/p tah-bso, mastectomy, - s/p bilateral carpal tunnel release - bone spurs social history: lives with her son. doesn't smoke or drink. family history: no early coronary artery disease. no other cancers physical exam: initial physical exam vitals: tmax: 37.8 ??????c (100.1 ??????f) tcurrent: 36.8 ??????c (98.2 ??????f) hr: 86 (80 - 110) bpm bp: 144/88(102) {103/60(71) - 144/88(102)} mmhg rr: 20 (17 - 20) insp/min spo2: 100% heart rhythm: 1st av (first degree av block) o2 delivery device: endotracheal tube ventilator mode: cmv/assist/autoflow vt (set): 450 (450 - 500) ml rr (set): 14 rr (spontaneous): 1 peep: 5 cmh2o fio2: 50% pip: 24 cmh2o plateau: 17 cmh2o spo2: 100% abg: 7.42/31/126/19/-2 ve: 9.8 l/min pao2 / fio2: 252 general: intubated, sedated, not waking up or following commands. withdraws to pain in all 4 extremeties heent: sclera anicteric, c-collar on cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation anteriorly abdomen: soft, non-tender, slightly distended, bowel sounds present, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema. no petichae pertinent results: initial laboratory data 09:46pm blood wbc-6.6 rbc-3.13* hgb-9.9* hct-30.7* mcv-98 mch-31.7 mchc-32.2 rdw-16.4* plt ct-33* 09:46pm blood neuts-80.9* lymphs-11.9* monos-6.2 eos-0.5 baso-0.6 09:46pm blood hypochr-2+ anisocy-2+ poiklo-1+ macrocy-1+ microcy-occasional polychr-occasional ovalocy-1+ target-1+ schisto-occasional tear dr 09:46pm blood pt-12.5 ptt-42.1* inr(pt)-1.2* 01:01am blood glucose-370* urean-42* creat-2.0* na-134 k-4.4 cl-100 hco3-19* angap-19 09:46pm blood alt-31 ast-97* ld(ldh)-2419* ck(cpk)-307* alkphos-85 totbili-3.1* dirbili-0.8* indbili-2.3 09:46pm blood ck-mb-10 mb indx-3.3 ctropnt-1.03* 09:46pm blood albumin-3.2* calcium-7.7* phos-3.4 mg-1.3* 09:46pm blood hapto-<5* 02:18pm blood vanco-22.5* 01:02am blood type-art rates-/16 tidal v-500 peep-5 fio2-50 po2-126* pco2-31* ph-7.42 caltco2-21 base xs--2 -assist/con intubat-intubated 09:54pm blood glucose-241* lactate-1.6 na-136 k-4.6 cl-103 calhco3-21 radiographic reports cta head indication: 77-year-old woman with altered mental status and seizures. comparison: none. technique: contiguous axial ct images through the head were obtained without contrast in the axial plane. after intravenous administration of contrast, mdct images of the head and neck were obtained in the arterial phase and axial plane. mips, volume-rendered images, and curved reformats were generated and reviewed. findings: ct head: there is no acute intracranial hemorrhage, vascular territorial infarction, edema, or mass effect seen. however, hypodense regions in left basal ganglia (2:14), pons (2:10) and midbrain maybe artifactual or represent edema, difficult to characterize further. smaller hypodensities are seen in bilateral periventricular white matter concerning for small vessel ischemic disease. there is no hydrocephalus or midline shift. dense atherosclerotic calcifications are seen in bilateral intracranial vertebral arteries and cavernous carotid arteries. no fracture is seen. cta head: bilateral intracranial internal carotid arteries, vertebral artery, small basilar artery and their major branches are patent with no evidence of stenosis, occlusion, dissection, or aneurysm formation. right vertebral artery is dominant. cta neck: there is a bovine arch configuration with a common origin of the innominate and left common carotid artery from the aortic arch. bilateral common carotid arteries, internal carotid artery and vertebral arteries in the neck appear patent with no evidence of stenosis, occlusion, dissection or pseudoaneurysm formation. the right vertebral artery is dominant. the left vertebral artery appears congenitally hypoplastic. both vertebral artery origins are patent. visualized soft tissue structures in the neck appear unremarkable. impression: 1. while there is no evidence of hemorrhage or acute vascular territorial infarction, there is subtle hypoattenuation in the basal ganglia, thalami, pons and midbrain, suspicious for edema. 2. evidence of small vessel ischemic disease. 3. unremarkable cta of the head and neck, with no evidence of steno-occlusive disease. 4. no finding to suggest cerebral venous thrombosis. ct c-spine findings: there is no evidence of acute fracture or malalignment. multilevel degenerative joint changes are most pronounced at c6-c7 with intervertebral disc space narrowing, subchondral sclerosis and disc osteophyte complex formations. evaluation of prevertebral soft tissue is limited due to et tube placement. no critical central canal stenosis is noted. calcifications of the ligamentum flavum are incidentally noted. nonunion of the c1 posterior arch is present. the esophagus appears patulous with moderate amount of secretions, which may predispose the patient to aspiration. imaged lung apices are clear. impression: 1. no evidence of acute fracture or malalignment. degenerative changes are most pronounced at c6-c7 level. 2. dilated and patulous esophagus with moderate amount of secretions, may predispose patient to aspiration. the study and the report were reviewed by the staff radiologist. brief hospital course: 78 yof admitted to micu for unresponsiveness, concern for ttp. initially presented with thrombocytopenia, renal failure, seizures, fevers, and hemolytic anemia consistent with ttp. intubated due to hypercarbic respiratory distress/ failure to maintain air way. plasmapharesis was initiated without much improvement in clinical presentation. head imaging revealed multiple cerebral and brainstem infarcts in context of ttp. patient also sufferred a stemi. course was complicated by line infections and ventilator associated pneumonia. family meeting was held which discussed poor prognosis and poor recovery given multiple organ distress and cerebral pathology. patient was made dnr. on hd 13, sufferred a bradyarrhythmia, went into pea arrest, and passed away. autopsy was declined by hcp. medications on admission: allopurinol - 100 mg tablet - 2 tablet(s) by mouth daily - no substitution amlodipine - 10 mg tablet - 1 tablet(s) by mouth daily (daily) glipizide - 2.5 mg tablet extended rel 24 hr - 1 tablet(s) by mouth daily hydralazine - 50 mg tablet - 1 tablet(s) by mouth every eight (8) hours isosorbide dinitrate - 20 mg tablet - 1 tablet(s) by mouth three times a day metoprolol succinate - 200 mg tablet extended release 24 hr - 1 tablet(s) by mouth once a day metoprolol succinate - 50 mg tablet extended release 24 hr - 1 tablet(s) by mouth daily take with 200mg tablets omeprazole - 20 mg capsule, delayed release(e.c.) - 1 capsule(s) by mouth twice a day sitagliptin - 100 mg tablet - 1 tablet(s) by mouth daily cholecalciferol (vitamin d3) - 1,000 unit tablet, chewable - 1 tablet(s) by mouth daily omega-3 fatty acids-vitamin e - 1,000 mg capsule - 1 capsule(s) by mouth daily discharge medications: patient deceased discharge disposition: expired discharge diagnosis: patient deceased discharge condition: patient deceased discharge instructions: patient deceased followup instructions: patient deceased procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances therapeutic plasmapheresis central venous catheter placement with guidance diagnoses: esophageal reflux unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified gout, unspecified personal history of malignant neoplasm of breast other convulsions other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure cardiac arrest bacteremia other encephalopathy acquired hemolytic anemia, unspecified do not resuscitate status acute myocardial infarction of unspecified site, initial episode of care hyperosmolality and/or hypernatremia ventilator associated pneumonia cerebral artery occlusion, unspecified with cerebral infarction coma other specified diseases of pulmonary circulation other specified bacterial infections in conditions classified elsewhere and of unspecified site, other gram-negative organisms jaundice, unspecified, not of newborn bloodstream infection due to central venous catheter primary thrombocytopenia,unspecified 

Answer: The patient is high likely exposed to