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: patient recorded as having no known allergies to drugs attending: chief complaint: shortness of breath major surgical or invasive procedure: none history of present illness: 82 yo female with hx of afib s/p ablation x2 on amiodarone and coumadin, cad, htn, hyperthyroidism, chronic cough who presents with cough and sob. pt was recently hospitalized for rapid afib suspectedly due to hyperthyroidism induced by amiodarone toxicity. she was started on methimazole, prednisone and metoprolol and completed 2 wks of methimazole but was continued continued on a prednisone taper although increased back to 15mg from 10mg due to climbing freet4. she presented to her pcp for increase in her baseline cough and change in the quality of her sputum to thick and green but no fever or chills. he held on antibiotics and obtained a cxr which revealed blunted cp angles with interstitial prominence but no infiltrate. this am she noticed irregular pulse so called her endocrinologist dr. who consulted with her cardiologist dr. and told her to go to the ed. her irregular pulses lasted 2 hours and resolved spontaneously before getting to the ed. she denied cp, ct, pnd, orthopnea but did have increasing doe. she also reports for the last 2 wks some nocturia with incontinence, but no frequency, urgency or dysuria during the day. in the ed, she was afebrile and vs were stable with cxr revealing rml opacity so she was given 750mg of levofloxacin, tessalon pearles and tylenol with codeine and admitted for pna. past medical history: 1. cv: ---atrial fibrillation, status post two ablations last in ' on amiodarone chronically as well as coumadin. ecg in with sinus bradycardia. ---pump: echo from with mild ar, mild mr, preserved lv function. ---cad: stress ecg in with borderline ekg evidence of myocardial ischemia in the absence of anginal symptoms with 6min on . 2. hypertension 3. hypercholesterolemia 4. status post total abdominal hysterectomy 5. chronic cough followed by dr. 6. anxiety 7. back pain - djd of l4-l5 and l5-s1 and spondylolisthesis followed by dr. of ortho. . social history: she lives alone but in the same building that her son. she has never smoked, does not drink alcohol and had her flu shot in 11/. she also denies any tuberculosis contacts. family history: positive for migraines, no heart disease, no lipid disorders, sister died of lung cancer, mother with breast cancer physical exam: t 100.1 hr 70 bp 112/60 rr 20 o2sat 89% ra 96% 2l nc gen-mild resp distress heent-perrly, op clear, mmm, overiding v waves hrt-rrr ns1s1 hsm at lusb and llsb, sm at apex rad to axilla lungs-rt ant crackles but otherwise no crackles or wheeze abd-soft, tympanitic, nt, mod distended, no cva tenderness extrem-1+ dp pulses, 2+ rad pulses, chronic venous stasis changs of shins bilat, no le edema neuro-a and o x3, cn ii-xii intact, ue and le strength skin--mild erthema of upper chest and back without rash pertinent results: k:5.1 t3: pnd chem & 129 97 24 185 agap=16 6.4 22 1.0 . mcv 79 wbc 18.7 hgb 11.6 plt 239 hct 33.9 n:94.2 l:2.9 m:2.5 e:0.3 bas:0.2 . pt: 20.4 ptt: 32.5 inr: 2.0 . ecg-brady sr at 55, nl axis, lvh, q in iii, twi iii, 0. dep in v4-6 which is old . cxr-1. ill-defined right middle lobe opacity may represent early pneumonia. clinical correlation recommended. 2. no evidence for pulmonary edema. . tte-no recent . ett-equivocal st dep inferiorly and v5-6 w/o symtoms . tsh <.02 t4 2.1 brief hospital course: 1) respiratory failure: patient was admitted for suspected pneumonia with positive rhinovirus by bronchoscopy bal and presumed bacterial superinfection. this escalated to ards requiring micu admission and intubation. she was treated with steroids, fluconazole, cefepime/flagyl for a 10 day course. shortly after tapering steroids she developed increased dependence on the ventilator and so steroids were increased. she was shortly thereafter given a tracheostomy and peg due to inability to wean from vent. within the first few days she was improving, able to breath at trach mask only for several hours per day, however, over -23 she had increased secretion and difficulty weaning pressure support with increasing leukocytosis. on she was restarted on vancomycin and cefepime for planned 10 day course. sputum has only ever grown yeast. as of she had increased secretions and underwent another bronchoscopy. this confirmed that the trach was mechnically intact. in review of her respiratory failure, the micu team also considered amiodarone toxicity, although seemed unlikely given acute time frame. she had a bronchoscopy on , pcp was negative but rhinovirus positive. patient was placed on assist-control at night for comfort while sleeping, and pressure support during the day, and may continue this at rehab. . 2) afib- tachy/brady symdrome: followed in house by patient's cardiologist dr. . through course pt had several episodes of afib/aflutter with additional episodes of rvr with aberrancy. best controlled on metoprolol 25 mg po bid. decision was made to discontinue her amiodarone early in the hospital course as this was causing hyperthyroidism which was exacerbating her afib, aflutter. when on smaller doses of metoprolol, pt developed tachycardia with hypotension and increased work of breathing. she had been on digoxin briefly but this was discontinued in the setting of bradycardic episodes to the 30's. prior to hospitalization she was on coumadin 1 mg po qd. patient with heart rate in the 40s intermittently, but remains hemodynamically stable. . she has been maintained well on metoprolol 25 mg q6h. when she does not take her metoprolol, her heart rate goes into the range of 130-140. when she is given metoprolol and she is resting, her heart rate will suddenly decrease dramatically to 30's. she was asymptomatic with a hr 30s. . 3) amiodarone induced secondary hyperthyroidism: improved to normal function on steroids. endocrine team suggests slow taper of prednisone and she is currently at prednisone 15 mg po qd. goal dose is to get her off of steroids over the next 1-1.5 months. she will need -weekly tfts and to follow up with her outpatient endocrinologist by . family can schedule appointment. . 4) hyperglycemkia: pt required sliding scale regular insulin while on steroids. . 5) gerd: cont protonix and prm reglan . 6)tube feeds given through peg tube. . 7) prophylaxis: pt does not need heparin sc while inr on coumadin > 2.0. she does require a proton pump inhibiotor. . 8) access: a picc line was placed and confirmed by x ray on , this unfortunattely clotted off and a new picc was placed on the left side that is functional. . 9) code: full code - should be re-discussed with patient at rehab. . 10) contact is health care proxy: daughter medications on admission: 1. warfarin 1 mg qd 2. pantoprazole 40 mg qd 3. amlodipine 2.5 mg qd 4. amiodarone 200 mg qod 5. amiodarone 300 mg qod alternating with 200mg 6. prednisone 15mg qd just increased 1 wk ago 8. metoprolol tartrate12.5 9. mvi 10. actonel 1x/wk 11. ca and glucosamine discharge medications: 1. acetaminophen 325 mg tablet : 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 2. docusate sodium 50 mg/5 ml liquid : one (1) po bid (2 times a day). 3. alprazolam 0.25 mg tablet : one (1) tablet po bid (2 times a day) as needed for anxiety, insomnia. 4. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 5. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed. 6. ipratropium bromide 17 mcg/actuation aerosol : six (6) puff inhalation q4h (every 4 hours). 7. albuterol 90 mcg/actuation aerosol : four (4) puff inhalation q4h (every 4 hours) as needed. 8. bisacodyl 5 mg tablet, delayed release (e.c.) : one (1) tablet, delayed release (e.c.) po daily (daily) as needed. 9. guaifenesin 100 mg/5 ml syrup : 5-10 mls po q6h (every 6 hours) as needed for thick secretions. 10. calcium carbonate 500 mg tablet, chewable : three (3) tablet, chewable po bid (2 times a day). 11. omega-3 fatty acids 550 mg capsule : one (1) capsule po bid (2 times a day). 12. miconazole nitrate 2 % powder : one (1) appl topical tid (3 times a day) as needed for rash. 13. fentanyl 25 mcg/hr patch 72 hr : one (1) patch 72 hr transdermal q72h (every 72 hours). 14. clonazepam 0.5 mg tablet : one (1) tablet po qhs (once a day (at bedtime)). 15. heparin flush cvl (100 units/ml) 1 ml iv daily:prn 10ml ns followed by 1ml of 100 units/ml heparin (100 units heparin) each lumen qd and prn. inspect site every shift 16. metoclopramide 5 mg/ml solution : ten (10) mg injection q6h (every 6 hours) as needed. 17. metoprolol tartrate 25 mg tablet : one (1) tablet po q6h (every 6 hours). 18. quetiapine 25 mg tablet : one (1) tablet po hs (at bedtime). 19. prednisone 10 mg tablet : one (1) tablet po daily (daily) for 14 days. 20. prednisone 5 mg tablet : one (1) tablet po once a day for 14 days: start: . 21. prednisone 2.5 mg tablet : one (1) tablet po once a day for 14 days: start: . discharge disposition: extended care facility: & rehab center - discharge diagnosis: pneumonia -rhinovirus with secondary bacterial atrial fibrillation/ tachy-brady syndrome hyperthyroidism discharge condition: out of bed in chair spending several hours per day on trach mask discharge instructions: please follow plan of care as determined by physician at rehab. you will be sent back to the emergency room with new chest pain, shortness of breath, persistent fever, or low blood pressure. patient may be placed on ventilator settings of assist-control at night to allow her to sleep more comfortably. patient with heart rate in the 30s with blood pressure in the 80s at times from her tachy-brady syndrome, but remains asymptomatic with quick return to normal hr and blood pressures. patient should always be on telemetry. patient cannot be on amiodarone or digoxin. amiodarone causes thyroid problems. followup instructions: provider: , md phone: date/time: 10:50 patient should follow up with her endocrinologist. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances non-invasive mechanical ventilation percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy closed [endoscopic] biopsy of bronchus bronchoscopy through artificial stoma transfusion of packed cells transfusion of other serum diagnoses: hypocalcemia esophageal reflux congestive heart failure, unspecified unspecified essential hypertension long-term (current) use of steroids other specified disorders of pancreatic internal secretion adrenal cortical steroids causing adverse effects in therapeutic use unspecified septicemia severe sepsis candidiasis of other urogenital sites atrial fibrillation acute respiratory failure septic shock hyperosmolality and/or hypernatremia chronic ulcer of other specified sites bacterial pneumonia, unspecified cardiac rhythm regulators causing adverse effects in therapeutic use thyrotoxicosis of other specified origin without mention of thyrotoxic crisis or storm rhinovirus infection in conditions classified elsewhere and of unspecified site 

Answer: The patient is high likely exposed to