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: penicillins / xeloda attending: chief complaint: dyspnea major surgical or invasive procedure: left sided pleurex catheter placement with ip history of present illness: history of present illness: mrs. is an 81f with hx of metastatic breast cancer and recurrent left malignant hydrothorax who presents with increasing dyspnea over a week. the pt states that she has had progressive dyspnea for the past week, walking around the house has become more difficult, and it has become even worse over the last 2 days prior to admission to the point that she is now dyspneic with speaking. per her daughter, she came to visit this morning and was concerned about her sob. she endorses minimal coughing, not productive of sputum. she denies chest pain, pressure, fever or chills. she denies lightheadedness, dizziness, throat swelling, pleuritic cp, new medications. she denies orthopnea but does use 2 pillows with sleep. of note, the pt was diagnosed with malignant l pleural effusion in . she's had three thoracenteses (, , ). prior to these procedures she states she has felt similarly dyspneic. . on the floor, the pt was 96.6 126/67 81 rr33 100%2l. she continued to endorse dyspnea but denies any pain. because of her tachypnea, she was transferred to the icu where she underwent pleurex drain placement. the procedure was only complicated by mild hypotension with sbp 70s which improved to 130s with less than 1 liter of ivf, then she was hypertensive to 170s. on transfer to the floor, she felt her breathing was stable and very well. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: -metastatic breast cancer: first breast cancer at the age of 57 in ; that was an er positive breast cancer treated with lumpectomy and radiation at -kettering cancer center. she only took tamoxifen for two years. then in , she developed a left breast cancer, which was a triple negative breast cancer, 1.1 cm in size, grade 3 with six positive lymph nodes. she was treated with lumpectomy and radiation, but refused chemotherapy. . -l sided malignant pleural effusion: s/ x3. tapped and found to have malignant cells that were er negative, adenocarcinoma consistent with her breast cancer. . -hypothyroidism -hyperlipidemia - -depression per daughter - -clavicle fxr - -thoracic aneurysm (approx 5 cm) - -hypertension - -seasonal allergies - childhood -melanoma on face: removed, never recurred - . psh -r breast lumpectomy and node dissection - -l breast lumpectomy and node dissection - -thoracentesis - , , social history: lives alone, widowed. originally from poland. emigrated to in and lived there until 7 years ago when she moved to to be closer to her 2 daughters who are very active in her care. has 4 grandchildren. occupation: retired bookkeeper smoking history: never alcohol: never family history: breast cancer physical exam: admission exam: . physical exam: t 97.1 bp 120/80 hr 78 rr 22 sao2 992l general: alert, oriented, nad heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: decreased breath sounds in lower left lung, normal effort, no wheezes chest : l pleurex in place with dressings c/d/i, non-tender cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley skin: diffuse erythematous rash lesions, no excoriations ext: no edema neuro: no focal deficits psych: pleasant, cooperative . discharge exam: . physical exam: 97.6, 106/56, 68, 20, 98% 2l nc general: alert, oriented, nad heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: increased effort. sound clear bilaterally. sob with speaking chest : l pleurex in place with dressings c/d/i, non-tender cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley skin: diffuse erythematous rash lesions, no excoriations ext: no edema neuro: no focal deficits psych: pleasant, cooperative pertinent results: admission labs: 10:30pm type-art po2-99 pco2-41 ph-7.42 total co2-28 base xs-1 10:30pm lactate-2.3* na+-125* k+-3.7 10:30pm freeca-1.14 06:45pm urine hours-random urea n-240 creat-37 sodium-37 potassium-9 chloride-33 total co2-less than 06:45pm urine hours-random 06:45pm urine osmolal-201 06:45pm urine gr hold-hold 06:45pm pt-11.7 ptt-21.7* inr(pt)-1.0 06:45pm urine color-straw appear-clear sp -1.004 06:45pm urine blood-tr nitrite-pos protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.0 leuk-lg 06:45pm urine rbc-1 wbc-11* bacteria-few yeast-none epi-1 trans epi-<1 06:45pm urine ca oxal-rare 05:13pm k+-4.3 05:05pm glucose-116* urea n-13 creat-0.8 sodium-124* potassium-6.1* chloride-90* total co2-22 anion gap-18 05:05pm estgfr-using this 05:05pm ctropnt-<0.01 05:05pm calcium-9.0 phosphate-3.8 magnesium-1.9 05:05pm osmolal-260* 05:05pm tsh-8.2* 05:05pm free t4-1.3 05:05pm wbc-5.4 rbc-3.88* hgb-11.7* hct-35.1* mcv-90 mch-30.2 mchc-33.4 rdw-14.4 05:05pm neuts-74.4* lymphs-16.4* monos-5.9 eos-2.8 basos-0.4 05:05pm plt count-359 . cxr : findings: consistent with the given history, there has been interval development of bilateral pleural effusions left much larger than right. there is diffuse engorgement of the vascular pedicle and indistinctness of the cephalized vascular flow. findings suggest superimposed volume overload in addition to the bilateral pleural effusions. the aorta remains markedly tortuous though incompletely evaluated given the large left effusion. calcified plaque is seen at the arch. cardiac silhouette size is difficult to assess but is presumed stable and remaining enlarged. clips are present in both axillary regions. deformities of multiple left posterolateral ribs are stable. impression: interval development of bilateral pleural effusions left much larger than right. there is superimposed pulmonary edema as well. . cxr findings: in comparison with the study of , the left pleurx catheter remains in place and there is no evidence of pneumothorax or recurrent effusions. small right effusion persists. continued prominence of indistinct pulmonary vessels, consistent with some elevation in pulmonary venous pressure. enlargement of the cardiac silhouette with tortuosity of the aorta persists, as well as multiple surgical clips in the axillary regions bilaterally. . discharge labs: . 06:35am blood wbc-6.6 rbc-3.32* hgb-10.5* hct-31.1* mcv-94 mch-31.7 mchc-33.9 rdw-14.2 plt ct-265 05:05pm blood neuts-74.4* lymphs-16.4* monos-5.9 eos-2.8 baso-0.4 06:35am blood glucose-100 urean-16 creat-0.7 na-126* k-4.7 cl-94* hco3-25 angap-12 06:35am blood alt-5 ast-13 alkphos-55 totbili-0.5 06:35am blood calcium-8.2* phos-4.6* mg-1.7 05:58pm urine osmolal-587 05:58pm urine hours-random urean-633 creat-214 na-73 k-53 cl-88 brief hospital course: 81f with hx of metastatic breast cancer and recurrent left malignant hydrothorax who presented with increasing dyspnea over a week, found to have increased bilateral pleural effusions on the left. . # dyspnea: patient presented with dyspnea, tachypnea, and mild hypoxia consistent with increasing malignant hydrothorax. the patient had a pleurex catheter placed on . we monitored her for signs of infection. the patient's symptoms improved; however, she remained sob with ambulation throughout her stay. . # hyponatremia: on admission, we found her initial serum na to be 125. we followed her urinary electrolytes along with her serum sodium. we deemed her results to indicate siadh. we placed her on fluid restrictions, however, noticed that she was taking minimal fluids as is. we monitored her sodium and it remained stable around 125. . # uti - the patient was found to have e coli growing in her urine. she was treated with a course of ciprofloxacin. . oncology - breast cancer s/p lumpectomy and node dissection on each breast on 2 different occasions. the patient refused any chemotherapy. . # htn: patient stable on home medications. . # hyperlipidemia: stable on home medications. . # hypothyroid: patient's tsh was found to be high. her levothyroxin dose was increased. medications on admission: levothyroxine - 100 mcg tablet - 1 tablet(s) by mouth once a day lisinopril - 40 mg tablet - 1 tablet(s) by mouth once a day metoprolol succinate - 25 mg tablet extended release 24 hr - 1 tablet(s) by mouth once a day simvastatin - 40 mg tablet - 1 tablet(s) by mouth at bedtime medications - otc cholecalciferol (vitamin d3) - (prescribed by other provider) - dosage uncertain multivitamin - (prescribed by other provider; otc) - capsule - 1 capsule(s) by mouth discharge medications: 1. levothyroxine 112 mcg tablet sig: one (1) tablet po daily (daily). tablet(s) 2. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. multivitamin tablet sig: one (1) tablet po daily (daily). 4. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain: pre-medicate prior to draining pleurx catheter. 5. lisinopril 40 mg tablet sig: one (1) tablet po once a day. 6. metoprolol succinate 25 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. discharge disposition: extended care facility: nursing home - discharge diagnosis: primary: 1. recurrent left sided malignant hydrothorax 2. metastatic breast cancer secondary: 1. urinary tract infection 2. hyponatremia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear ms. , you were admitted to the hospital for dyspnea. you underwent pleurex catheter placement on the left side for your fluid accumulation around the lungs. medication changes: - increase levothyroxine to 112 mcg. - start oxycodone as needed for pain followup instructions: provider: , rn phone: date/time: 11:00 provider: , : date/time: 9:30 provider: , md phone: date/time: 9:30 procedure: insertion of intercostal catheter for drainage diagnoses: other iatrogenic hypotension urinary tract infection, site not specified unspecified essential hypertension unspecified acquired hypothyroidism secondary malignant neoplasm of pleura personal history of malignant neoplasm of breast other and unspecified hyperlipidemia other disorders of neurohypophysis other and unspecified escherichia coli [e. coli] malignant pleural effusion 

Answer: The patient is high likely exposed to