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: iodine; iodine containing attending: chief complaint: vaginal bleeding major surgical or invasive procedure: plasma pheresis bone marrow biopsy history of present illness: ms. is a 43 year old female with a pmh significant for hepatitis c and cocaine abuse transferred from an outside hospital for anemia and thrombocytopenia concerning for thrombotic thrombocytopenic purpura. the patient initially presented to an outside hospital with menorrhagia that had not resolved 3-4 weeks after onset of menses. her normal menses lasts seven days ans is accompanied by back pain. she describes increased bleeding and passage of blood clots, initially presenting to an osh ed on with plts of 44. she was evaluated by an outside hematologist on with platelets of 29 and prescribed 100 mg prednisone daily that the patient did not take. due to persistent menorrhagia, the patient was admitted to on for a hct 30.4 and platelet count of 27 with a ldh of 1738 and undetectable haptoglobin. she was transfused 2 units prbcs and started on solumedrol 125 mg iv q8h and folate 2 mg daily, and was also treated with ivig for presumed itp. she was also started on oral contraceptives for persistent menorrhagia. she also had a positive hcv antibody (no hcl vl), hbv core but negative for hbv surface antigen and hiv. the day prior to transfer, the patient experienced acute onset of right-sided numbness, slurred speech, and possible facial droop per family report with neurologic symptoms resolving after 25 minutes. a head ct did not demonstrate any acute intracranial process. the patient also underwent a bone marrow biopsy on with slides currently under the review of hematology-oncology. throughout the course of the patient's outside hospital stay, her platelets remained in the 20s, and she remained afebrile with preserved renal function. over concern for thrombotic thrombocytopenic purpura, the patient was transferred to for further evaluation. . at , the patient was evaluated by hematology-oncology and blood bank, who felt plasmapheresis for suspected thrombotic thrombocytopenic purpura was indicated. she was then transferred to the for pheresis catheter placement and urgent plasmapheresis intiation. past medical history: - bipolar disorder - two prior vaginal deliveries; three prior elective terminations; two prior miscarriages; no c-sections - hepatitis c infection (discovered at ) social history: lives with fiancee in . on ssdi. denie etoh use. tobacco - ppd x10 years. illicit - cocaine last snorted 1 week ago. past history of percocet abuse. family history: diabetes, hypertension, and cancer runs in her family physical exam: vs: 98.7 150/80 49 16 99%ra gen: age appropriate female in nad heent: perrl, eomi, sclerae anicteric. mmm, op clear without lesions, exudate or erythema. neck supple. cv: nl s1+s2, no m/r/g. pulm: ctab abd: s/nt/nd +bs, -hsm ext: no c/c/e, 2+ dp bilaterally. skin: multiple echymosses on upper extremities. no rashes noted. neuro: aox3, cn ii-xii intact. 5/5 strength throughout. pertinent results: heme-onc peripheral smear review: "review of the peripheral blood smear demonstrates markedly decreased platelet count, schistocytes per high-powered field as well as bite cells and helmet cells. . osh plt 44 . bun 15 / na 138 / k 4.1 / cl 106 / co2 29 / cr .76 serum iron 65 / tibc 300 / percent saturation 21.7 / ferritin 120 tuberculosis 1.2 / ldh 1768 beta hcg < 2 wbc 12.4 / hct 24.3 / plt 27 . bun 15 na 139 / k 4 / cl 108 / co2 27 / cr .7 ldh inr 1.04 / ptt 26.5 . bun 16 / na 136 / k 4.1 / cl 107 / co2 27 / cr .7 . bun 19 na 136 / k 4.1 / cl 104 / co2 28 / bun 19 / cr .8 . na 136 / k 4 / cl 105 / co2 30 / bun 17 / cr .8 wbc 10.7 / hct 26.4 / plt 28 n 68 / bands 8 / l 15 / m 4 12:28am blood hiv ab-negative 12:28am blood hbsag-negative hbsab-positive hbcab-positive igm hbc-negative 07:10am blood wbc-15.0* rbc-3.56* hgb-10.8* hct-32.4* mcv-91 mch-30.3 mchc-33.3 rdw-20.6* plt ct-62* 09:25am blood wbc-21.1* rbc-3.64* hgb-11.1* hct-32.7* mcv-90 mch-30.4 mchc-33.8 rdw-19.6* plt ct-115*# 06:20am blood wbc-21.2* rbc-3.49* hgb-10.6* hct-32.8* mcv-94 mch-30.5 mchc-32.4 rdw-19.9* plt ct-165 06:30am blood wbc-19.9* rbc-3.31* hgb-10.0* hct-31.3* mcv-95 mch-30.4 mchc-32.1 rdw-19.4* plt ct-197 07:20am blood wbc-20.6* rbc-3.31* hgb-10.0* hct-31.9* mcv-96 mch-30.2 mchc-31.4 rdw-19.2* plt ct-255 07:20am blood wbc-21.9* rbc-3.23* hgb-10.1* hct-30.4* mcv-94 mch-31.2 mchc-33.3 rdw-19.0* plt ct-299 06:20am blood pt-12.2 ptt-23.3 inr(pt)-1.0 07:20am blood glucose-129* urean-18 creat-0.8 na-137 k-4.9 cl-99 hco3-31 angap-12 09:15pm blood alt-231* ast-95* ld(ldh)-659* alkphos-70 totbili-1.9* dirbili-1.1* indbili-0.8 07:20am blood ld(ldh)-199 06:30am blood calcium-8.5 phos-3.7 mg-2.2 09:15pm blood caltibc-324 hapto-<20* ferritn-299* trf-249 07:20am blood hapto-152 adamts13 activity: <5% adamts13 inhibitor level: 0.6 (normal <0.4) trans vaginal pelvic ultrasound : findings: limited images of the kidneys are unremarkable. by transabdominal imaging, the uterus measures 9.0 x 5.1 x 5.7 cm and is anteverted. endometrial stripe measures 6 mm. the right ovary is not visualized. the left ovary is unremarkable. by transvaginal imaging, the endometrial stripe measures 7 mm. there is no evidence of increased flow to the endometrium. there is a 2.3 x 1.5 x 2.4 cm posterior fibroid which is partially exophytic. the remainder of the myometrium is unremarkable. the right ovary is normal, measuring 1.3 x 2.6 x 1.3 cm, with normal follicular pattern. the left ovary demonstrates a normal follicular pattern and measures 2.0 x 2.2 x 1.8 cm. there is no free fluid in the pelvis. impression: partially exophytic posterior fundal fibroid, measuring up to 2.4 cm. normal endometrial stripe, without evidence of increased vascular flow brief hospital course: ms. is a 43 year old female with history of bipolar disorder and recent cocaine use transferred from in with persistent vaginal bleeding, anemia and thrombocytopenia later diagnosed with idiopathic thrombotic thrombocytopenic purpura requiring icu level care for a day and subsequently stabilized following four days of plasma exchange with restoration and stabilization of platelet count. her initial blood work showed evidence of hemolysis with schistocytes on smear, low haptoglobin, anemia, and thrombocytopenia, without renal involvement. of note, her adamts13 activity was <5% (normal > 67%), with elevated level of adamts13 inhibitor (0.6, with normal level <0.4), consistent with acute idiopathic ttp. elevated level of adamts13 can be congenital or immune mediated. severe congenital adamts13 deficiency ( syndrome) is an autosomal recessive condition which may present in children or adults as episodes of ttp. in these patients however, the inhibiting antibody level is low. the presence of elevated in this patient suggests the diagnosis of idiopathic (immune) ttp. her platelet count recovered from 33 on to 255 on after four days of plasmapheresis. her platelet continued to rise to 299 on more than 24 hours after her last plasmapheresis. her pheresis line was changed from femoral to internal jugular vein after two days out of concern for infection in the setting of her continued vaginal bleeding. concurrent with her plasma exchange, she was treated with prednisone 60mg from to , and transitioned to 40mg after that. her vaginal bleeding was assessed by gyn consult, and a pelvic ultrasound showed a 2.5cm exophytic fibroid which should not have attributed to her persistent (>5 wk) of vaginal bleeding. her vaginal bleeding improved with restoration of her platelet level. she will be followed up with dr. , hematologist at , within a week of discharge to trend her cbc and monitor her prednisone therapy. her adamts13 activity and adamts13 inhibitor level should be rechecked, as persistence of severe adamts13 deficiency during remission is associated with an increased risk for recurrent clinical episodes of ttp. patient's hepatitis c history is confirmed in this hospitalization. her liver enzymes were initially elevated on presentation, but subsequently resolved following initiation of plasmapheresis. her hcv viral dna is negative. during her hospitalization, she developed hyperglycemia with glucose as high as 180's. her glucose was controlled with 10 unts of lantus in the morning in addition to insulin sliding scale, and her sugar ranged between 160 to 180. as such, upon discharge, her lantus was increased to 15 units on discharge, and patient was given prescription to continue lantus at home. she was instructed to follow up with her pcp for glucose management. medications on admission: home medications: - seroquel 150mg po daily . transfer medications: - pantoprazole 40 mg po daily - aygestin ocps once daily - hydromorphone 2 mg iv q2h prn - methylprednisolone 125 mg iv q8h since - nicotine patch 21 mg - quetiapine 150 mg qhs - folic acid 2 mg daily - docusate 100 mg - senna 2 tabs qhs discharge medications: 1. quetiapine 150 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po qhs. 2. prilosec otc 20 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 3. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for constipation. 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. folic acid 1 mg tablet sig: four (4) tablet po daily (daily). disp:*120 tablet(s)* refills:*2* 6. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily): apply to back for 12 hours at a time, remove for 12 hours before placing new patch. disp:*60 adhesive patch, medicated(s)* refills:*2* 7. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 8. prednisone 20 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* 9. lantus 100 unit/ml cartridge sig: fifteen (15) units subcutaneous qam. disp:*1 cartridge* refills:*2* 10. one touch glucometer measure glucose each morning before breakfast. do not administer insulin if glucose is under 100 11. outpatient lab work please have cbc and fasting glucose measured the morning of . the results should be faxed to your primary care physician's office at 12. one touch suresoft lancing dev misc sig: one (1) device miscellaneous once a day. disp:*1 device* refills:*0* 13. one touch ultrasoft lancets misc sig: one (1) lancet miscellaneous once a day. disp:*60 lancets* refills:*0* 14. one touch ultra test strip sig: one (1) strip in once a day. disp:*60 strips* refills:*2* 15. percocet 5-325 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain for 7 days. disp:*28 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: 1. acute idiopathic thrombotic thrombocytopenic purpura 2. vaginal bleeding 3. hyperglycemia discharge condition: good discharge instructions: you were admitted to the hospital because of thrombotic thrombocytopenic purpura (ttp) and persistent vaginal bleeding. your platelet count recovered with five days of plasma exchange, and it stayed well above normal after you were weaned off from the plasma exchange. your blood glucose during this hospitalization was elevated because of the prednisone and was lowered with insulin. your insulin therapy will need to be continued with the assistance of your pcp. will need to continue with lantus 15 units of insulin each day. you will need to measure your glucose every morning. if the glucose level is under 100 it is advised that you not inject the insulin. you were started on prednisone 40mg po twice daily. you should continue this until instructed to stop by your hematologist/oncologist. you should continue to take omeprazole to prevent symptoms of heartburn. you should continue with the lidocaine patch to help your back pain. you were given 7-day prescription of percocet as well. please have fasting labs drawn the morning of . these results should be faxed to your pcp. not eat anything after midnight the evening before. please call your physician or return to the hospital if you experience chest pain, shortness of breath, bleeding, fever, lightheadedness, or any other concerning symptom. followup instructions: md: dr. specialty: pcp date and time: 3:00pm location: , phone number: md: dr. specialty: hematology oncology date and time: 3:45pm location: , phone number: procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified biopsy of bone marrow therapeutic plasmapheresis diagnoses: long-term (current) use of steroids chronic hepatitis c without mention of hepatic coma iron deficiency anemia secondary to blood loss (chronic) cocaine abuse, unspecified long-term (current) use of insulin other acquired absence of organ bipolar disorder, unspecified immune thrombocytopenic purpura other specified noninflammatory disorders of vagina hepatitis b carrier tubal ligation status 

Answer: The patient is high likely exposed to