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: humira / toradol / certolizumab pegol / meperidine attending: chief complaint: neck swelling major surgical or invasive procedure: flow study for port-a-cath history of present illness: patient is a 33 year - old female with a past medical history of crohn's disease s/p ileostomy and infliximab therapy, history of dvt in left neck, history of 8 prior portacaths who presented to this morning with increasing abdominal, sob, and increased ostomy output that started two days ago. of note, on presentation, her face was swollen, she was tachypneic and tachycardic. her labs were notable for a wbc of 4.4, hemoglobin 8.4, and hematocrit of 25. she was given iv morphine for her abdominal pain, when she subseuqently broke out in a rash, which diminshed with benadryl. ct abd/pelvis showed no acute process and she was admitted to the medicine service for treatment of a crohn's flare. for her sob, she was initially treated with iv levofloxacin. on arrival to the medicine floor, her porta cath was not drawing back and there was concern for clot in the svc with subsequent svc syndrome causing her facial swelling. due to her tachycardia and tachypnea, there was concern for pe. they could not get a peripheral iv on her, and given possible pathology in her neck, a groin femoral line was placed. because they could not protocol the contrast for a ctpa with a groin line, a v/q scan was done, which was low probability for pe. she was emperically started on a heparin gtt and is being transferred her for concern of porta-cath clot, svc syndrome, and ctpa. on arrival to the micu, patient was complaining of sever abdominal pain. she had apparently received zofran en route by ems. while she was writhing in pain, she did state that the pain is consistent with her prior crohn's disease flares, the last of which was six months ago. she is passing liquidy green stool through her ostomy with some gas. past medical history: crohn's disease - had previously been on inflixamab, but could not afford the medication. no prior workup could be obtained as there was no record of patient in prior hopsitals which she said she was admitted to pe - about 5-6 months ago dvt - in neck likely related to access issues social history: lives with husband, moved from 5-6 months ago. the patient didnt have any insurance even though she was in mass since few months. her husband also has insurance which she was not on board on. family history: no significant gi or heme history physical exam: general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred, finger-to-nose intact physical exam on dc: vs: 98.9 bp 97-112/60-69 hr 118-127 rr 20 97% on ra general - nad, who appears comfortable, appropriate neck - supple, no jvd, appears to be back to baseline. lungs - ctab. heart - pmi non-displaced, tachycardic, no mrg, nl s1-s2 abdomen - no masses or hsm, no rebound/guarding, bs+ve, pain 0-1. skin - eccyhmoses on arms corresponding to peripheral iv attempts. no rashes or lesions neuro - awake, a&ox3. pertinent results: admission labs: 10:40pm type- temp-36.9 po2-61* pco2-41 ph-7.39 total co2-26 base xs-0 10:40pm lactate-0.9 10:40pm freeca-1.07* 10:15pm glucose-97 urea n-4* creat-0.5 sodium-140 potassium-3.8 chloride-106 total co2-22 anion gap-16 10:15pm estgfr-using this 10:15pm alt(sgpt)-29 ast(sgot)-23 ck(cpk)-22* alk phos-83 amylase-23 tot bili-0.3 10:15pm ck-mb-1 ctropnt-<0.01 10:15pm albumin-3.7 calcium-8.3* phosphate-3.0 magnesium-1.8 10:15pm wbc-4.3 rbc-3.15* hgb-8.0* hct-26.7* mcv-85 mch-25.3* mchc-29.7* rdw-19.8* 10:15pm neuts-76.9* lymphs-18.3 monos-3.9 eos-0.6 basos-0.2 10:15pm plt count-159 10:15pm pt-19.6* ptt-63.7* inr(pt)-1.9* discharge labs: 05:08am blood wbc-4.6# rbc-3.18* hgb-7.6* hct-25.0* mcv-79* mch-23.7* mchc-30.2* rdw-19.1* plt ct-154 05:08am blood pt-13.9* ptt-47.2* inr(pt)-1.3* 05:08am blood glucose-91 urean-3* creat-0.5 na-134 k-3.7 cl-105 hco3-21* angap-12 05:08am blood mg-2.2 03:21am blood caltibc-385 ferritn-46 trf-296 03:21am blood tsh-3.7 06:56pm blood 25vitd-7* 04:06am blood cortsol-11.9 05:32am blood hbsag-negative hbsab-positive 06:56pm blood crp-12.4* 11:54am blood hiv ab-negative 08:15pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 09:00pm urine bnzodzp-neg barbitr-neg opiates-neg cocaine-neg amphetm-neg mthdone-neg 09:32am stool blood-negative ct abdomen/pelvis, non-con : bibasilar streaky consolidations at both lung bases. no free air, free fluid, drainable collection, or atelectasis is seen. prio colectomy with right lower quadrant ileostomy. ingested contrast material extends to the ostomy bag with no evidemce for bowel obstruction. mild stranding of the mesenteric fat of uncertain significance. a right femoral venous catheter is noted. on this unenhanced exam, the liver, gallbladder and biliary tree, pancreas, spleen, adrenal glands, kidneys and collecting systems, ureters and urinary bladder unremarkable. interus is midline and unremarkable. no adenexal abnormality is seen. conclusion: 1. steaky bibasilar consolidations. 2. status post colectomy with no evidence for bowel obstruction or obvious bowel inflammatory focus. 3. mild mesenteric fat stranding of uncertain significance. 4. no drainable collection identified. . v/q scan: low probability. . cxr: no acute cardiopulmonary process. . ekg: sinus tachycardia, twi v1-v5 ct neck : 1. large retropharyngeal fluid collection with mildly enhancing margins, concerning for retropharyngeal abscess. in addition to an appropriate surgical consult, given proximity to the vertebral bodies, mr of the cervical spine and neck is recommended to evaluate for spinal involvement. 2. non-opacification of the left internal jugular vein with mediastinal collaterals and possible thrombus. no soft tissue mass identified. 3. hypodensity in the svc surrounding the distal portion of a right chest wall port catheter may represent a non-obstructive clot, although significant artifact limits the certainty of this finding. mri c-spine : 1. large amount of fluid anterior to the vertebral bodies of c2, c3, c4, and c5 with evidence of mild surrounding linear enhancement as previously described on ct from . there is no evidence of vertebral body or epidural involvement. findings may represent a retro-pharyngeal abscess/phlegmon versus edema. 2. degenerative changes of the cervical spine as described in detail above. portacath flow study : successful uncomplicated flow study of a double-lumen port. a fibrin sheath around the port was demonstrated. video swallow : 1. limited study demonstrating normal oropharyngeal swallowing. 2. prevertebral soft tissue swelling is better assessed on ct of . tte : the left atrium and right atrium are normal in cavity size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). the estimated cardiac index is normal (>=2.5l/min/m2). right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (?#) appear structurally normal with good leaflet excursion. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: resting tachycardia. no structural heart disease or pathologic flow identified. brief hospital course: 33 year - old female with a history of crohn's, multiple dvts and portacath thromboses who presented from with likely portacath clot with svc syndrome. however, patient was found to have patent portacath. however, her port-a-cath was functioning well and she had no evidence of svc syndrome. she was found to have a retropharyngeal fluid collection that was assessed to be either a hematoma or effusion d/t chornic left ij occlusion. #. retropharyngeal fluid collection/hematoma: pt initially presented with a 'neck swelling' and inability to access port a cath at with concern for svc syndrome. however, her port a cath was found to be functioning well and while she did have a left sided ij clot, it was chronic with extensive collaterals. she was incidentally found to have a retropharyngeal fluid collection that was initially thought to be an abscess and the pt was started on abx but were dc/ed after the pt continued to have no clinical signs of infection. ent was consulted for assistance in decision making with this issue. they agreed that this was likely a hematoma and not infection. pt did have pain on swallowing but she passed a speech and swallow study and was tolerating pos for a few days before discharge. #. crohn's disease: patient has no prior records from previous hospitalizations. she initally refused to provide authorization to the gi team to access her forms. however, afterwards, she evetually gave us permission. she asked us to access health center in ny but they had no records of her. per patient, she has been on multiple monoclonal antibody regimens. was having abdominal pain consistent with prior crohn's flare. however, did not have any evidence of active flare on ct abdomen. we controlled her pain initially with iv and then po dilaudid. # pain: patient appeared to have pain in her back, chest, abdomen, neck, over her port a cath site and even in her peripubic area. however, no clear organic source of pain was found. patient also continued to demand iv dilaudid to be pushed rather than given as a drip, which made suspicion for narc seeking even more clear. she was dc/ed on po dilaudid. # history of venous thromboembolism: pt has hx of dvts, pe 6 months ago and was on warfarin on admission but inr was subtherapeutic. pe was ruled out w/ v/q scan at the osh but because of her consistent tachycardia, pt was started on heparin gtt, also given her ij thrombus. at dc the pt was bridged with lovenox to coumadin. she was subtherapeutic on warfarin 5mg. thus, this dose was increased to 7.5 mg daily. she will require close inr monitoring and warfarin dose adjustment on follow up. #anxiety: pt was found to be very anxious, and at one point threatened to leave ama after her dilaudid was not being given as a push instead of over 30 minutes as a drip. pt was not started on benzodiazepines die to risk for addiciton as well as her tenuous airway. pt remained tachycardic throughout the stay which was liekly in the setting of anxiety as no other cause could be found. # sinus tachycardic: patient had persistent tachycardia to 100-130s, sinus. there was no evidence of ischemia . ekg was otherwise unremarkable. echo was normal without effusion. tsh was normal. it is possible that she suffered a subclinical pe given her chronic dvt, although osh v/q scan was low probability for pe. she was treated with above as well as supportive care. should this persist, cardiology and/or pulmonary referral should be considered. transitonal issues: pt was bridged on lovenox to coumadin. doesnt have insurance so being seen by . really needs insurance stat for warfarin. medications on admission: coumadin 6 mg once a day, moxifloxacin eye drops discharge medications: 1. enoxaparin 80 mg/0.8 ml syringe sig: one (1) syringe subcutaneous q12h (every 12 hours) for 7 days. disp:*14 syringe* refills:*0* 2. warfarin 2.5 mg tablet sig: three (3) tablet po once daily at 4 pm. disp:*90 tablet(s)* refills:*2* 3. hydromorphone 2 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*10 tablet(s)* refills:*0* discharge disposition: home facility: hospital - discharge diagnosis: primary diagnosis: - retropharyngeal hematoma secoondary diagnoses: - crohn's disease - past pulmonary embolism and deep vein thrombosis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mrs. , you were admitted to for concerns of a clot blocking your port-a-cath. our interventional radiologists investigated that and found that your port a cath was functioning well. our gastroenterologists saw you and did not start you on any new medications for your crohn's disease. we were also initially concerned about your throat pain and swelling. we found a fluid collection there that did not appear infected and was likely a hematoma (a small collection of blood). please note the following changes in your medications: start lovenox 80mg twice daily start dilaudid 2mg every 4 hours as needed for pain increase warfarin from 6mg every day to 7.5mg every day. you will need to get your inr checked at and the dose of your warfarin will be adjusted accordingly. followup instructions: please follow up with dr at community health center at 3pm on . procedure: phlebography of other specified sites using contrast material diagnoses: anxiety state, unspecified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure regional enteritis of unspecified site other specified cardiac dysrhythmias other diseases of pharynx, not elsewhere classified other complications due to other vascular device, implant, and graft long-term (current) use of anticoagulants personal history of noncompliance with medical treatment, presenting hazards to health obesity, unspecified anticoagulants causing adverse effects in therapeutic use ileostomy status personal history of pulmonary embolism other dysphagia chronic venous embolism and thrombosis of internal jugular veins 

Answer: The patient is high likely exposed to