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: heparin agents / augmentin / lisinopril / metoprolol attending: chief complaint: shortness of breath major surgical or invasive procedure: none history of present illness: 52 y/o woman with severe systemic sarcoid, esrd on hd (tu, th, sa), home o2 3.5l for sarcoid and pulmonary hypertension, presents with shortness of breath. she was in her usual state of health until 3am this morning when she awoke from sleep with painful leg cramp. she sat up in bed and shortly after became suddenly short of breath. she tried increasing her oxygen to 8l without relief. shortness of breath persisted and she presented to dialysis this morning, where because of respiratory distress and hypoxia, she was transferred to the ed prior without a dialysis session completed. she last received dialysis on saturday (3 days prior to admission) and today is 55.3kg (baseline dry weight 51kg). she denies chest pain, palpitations, cough, or shortness of breath. she had a low grade temperature of 99f after dialysis on saturday which resolved spontaneously. . in the ed, initial vs were: 98.5 119 126/69 26 100% 10l. cxr showed right pleural effusion. labs notable for lactate 4.0, cr 9.9, bun 47, k 5.9, trop 0.15. abg 7.42/34/54. nitroglycerin drip was started @ 1mcq/kg/min and she received vanco/zosyn. on bipap doing well. albuterol/ipratropium nebulizers started. nephrology was consulted and plans on dialysis upon admission. vitals prior to transfer: afebrile, hr 110, bp 121/74, rr 26 and 100% on bipap fio2 50%. . on arrival to the micu, she states her sob has resolved and she oxygen saturations are 94% on 4l oxygen via nasal canula. nitrolgycerin gtt was stopped. temperature is 101. she endorses a headache, but no vision changes or neck stiffness. she has mild nausea, but no vomitting. denies abdominal pain, diarrhea, melena/hematochezia. she does not make urine. her leg cramping has resolved. she is alert and oriented and able to detail past medical history and events leading up to admission. she reports a similary event with sob happened 1.5 years ago, increased prednisone and symptoms resolved during hospitalization. past medical history: - systemic sarcoidosis (diagnosed in ) w/ pancreatic and liver involvement and pulm htn (on daily prednisone) - esrd sarcoidosis on hemodialysis t/r/sa - pulmonary hypertension: diagnosed via right heart cath; treated briefly with sildenafil though did not tolerate this medication - heparin-induced thrombocytopenia (hit) - angioectasias of the stomach and colon. - svc thrombosis - chronic pancreatitis, required common bile duct stenting and sphincterotomy in - hypertension - epilepsy, last seizure (bilateral occipital infarct ) - secondary hyperparathyroidism - hyperlipidemia (hl) - anemia - h/o small bowel obstruction - h/o pericardial effusion - h/o line associated rue dvt (formerly on coumadin) - h/o mrsa line infection - h/o cva - no residual weakness social history: she lives with her husband and some of her children and grandchildren. prior to being medically disabled from her illness she was a substance abuse counselor. denies tobacco, etoh and drug use. family history: father: renal failure at age 70. mother: hypertension and breast cancer. physical exam: general: alert, oriented, no acute distress : sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, no lad cv: rrr @100bpm, normal s1 + s2, 3/6 sem at llsb lungs: decreased breath sounds on right way up, coarse crackles at left base, no wheezes or rhonchi abdomen: soft, nt/nd, no hsm ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema, fistula right upper extremity with thrill skin: vitiligo on lower extremities bilaterally neuro: 5/5 strength bilaterally, no sensory deficits, cn grossly intact pertinent results: portable cxr: in comparison with the study of , there are even lower lung volumes. extensive opacification is seen on the right in a patient with continued enlargement of the cardiac silhouette and pulmonary edema. findings are consistent with layering pleural effusion, though the possibility of developing superimposed consolidation can certainly not be excluded in the appropriate clinical setting. . echo: the left atrium is normal in size. the estimated right atrial pressure is at least 15 mmhg. there is mild symmetric left ventricular hypertrophy with normal cavity size. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). the right ventricular cavity is dilated with moderate global free wall hypokinesis. there is abnormal systolic septal motion/position consistent with right ventricular pressure overload. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. there is no aortic regurgitation. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. no mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate to severe tricuspid regurgitation is seen. there is severe pulmonary artery systolic hypertension. there is a trivial pericardial effusion. impression: dilated right ventricle with global hypokinesis. moderate to severe tricuspid regurgitation. severe pulmonary hypertension. normal left ventricular regional and global systolic function. admission labs 07:40am blood wbc-11.1*# rbc-3.17* hgb-9.3* hct-31.8* mcv-100* mch-29.3 mchc-29.2* rdw-17.0* plt ct-208 12:04pm blood pt-14.3* ptt-30.6 inr(pt)-1.2* 07:40am blood glucose-140* urean-47* creat-9.9*# na-133 k-9.7* cl-98 hco3-17* angap-28* discharge labs 12:04pm blood calcium-8.5 phos-3.4 mg-2.8* 06:45am blood wbc-4.1 rbc-3.33* hgb-10.0* hct-32.0* mcv-96 mch-30.0 mchc-31.2 rdw-16.9* plt ct-168 06:45am blood neuts-61.4 lymphs-23.9 monos-7.9 eos-6.2* baso-0.6 06:45am blood glucose-84 urean-41* creat-8.2*# na-141 k-4.9 cl-96 hco3-31 angap-19 06:45am blood calcium-9.0 phos-4.8* mg-3.0* brief hospital course: 52 yo f with severe systemic sarcoidosis, esrd on hd, home o2 3.5l for sarcoid and pulmonary hypertension, presents with shortness of breath. # acute on chronic respiratory distress: initially admitted with hypoxia and dyspnea, related to pulmonary edema and pleural effusions. she also had a 4kg weight gain up from 51kg dry weight. unclear what the etiology of the pulmonary edema is, though it is possible this has been a chronic worsening condition. she was admitted to the micu with bipap and a nitro drip, but nitro was quickly stopped. she underwent hemodialysis with ultrafiltration and removal of 3+ liters. her symptoms resolved significantly and she was called out to the floor. on the floor, she felt her dyspnea has improved to better than she had been in weeks. she underwent dialysis again and then was discharged home. . # fever: she spiked a fever to 101 in the micu on admission. no specific infectious source was identified. she was started on vanc/ceftaz/azithro for coverage of a possible pneumonia, given her fluid overloaded xray that could not rule out pna. she remained afebrile with a normal wbc throughout her admission. when her fluid had cleared, a repeat cxr showed no consolidation or pneumonia. iv antibiotics were stopped. she was discharged home with levaquin to complete a 7 day course. blood cultures showed no growth to date but were pending on discharge. . # hypotension: hypotensive to the 80s while on dialysis. she had received her anti-hypertensive medication the day prior, so this was assumed to be in the setting of ultrafiltration with lingering anti-hypertensives. the blood pressure normalized without intervention. . # hypoxia: overnight in the micu she desaturated to the mid-80s while on 4l nc. this was assumed to be due to sleep apnea. she was started on facemask o2 and her sat improved to 100%. . # systemic sarcoid: possibly responsible for worsening of lung symptoms. continued prednisone 7.5mg daily. consulted pulmonology who recommended continuing steroids. . # esrd on hd: continued dialysis. continued sevelamer, hydroxyzine and nephrocaps. returned to outpatient saturday, monday, weds schedule as an outpatient. . # seizure disorder: last seizure . continued lamotrigine . # hypertension: restarted losartan and nifedipine on discharge. . # hit: history of heparin induced thrombocytopenia. avoided heparin products. medications on admission: epoetin alfa - once weekly folic acid - 1mg daily hydroxyzine hcl - 25 mg lamotrigine - 150 mg lorazepam - 0.5 mg daily prn cramping losartan - 150 mg nifedipine - 90 mg pantoprazole - 40 mg daily prednisone - 7.5 mg daily sevelamer hcl - 2400 mg tid-qid ursodiol - 300 mg tid docusate sodium - 100 mg daily discharge medications: 1. epoetin alfa injection 2. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 3. hydroxyzine hcl 25 mg tablet sig: one (1) tablet po bid (2 times a day). 4. lamotrigine 150 mg tablet sig: one (1) tablet po bid (2 times a day). 5. lorazepam 0.5 mg tablet sig: one (1) tablet po once a day as needed for cramping. 6. losartan 100 mg tablet sig: 1.5 tablets po twice a day. 7. nifedipine 90 mg tablet extended release sig: one (1) tablet extended release po twice a day. 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. prednisone 2.5 mg tablet sig: three (3) tablet po daily (daily). 10. sevelamer carbonate 800 mg tablet sig: three (3) tablet po tid w/meals (3 times a day with meals). 11. ursodiol 300 mg capsule sig: one (1) capsule po tid (3 times a day). 12. docusate sodium 100 mg tablet sig: one (1) tablet po once a day. 13. levofloxacin 500 mg tablet sig: one (1) tablet po after dialysis sessions for 3 doses. disp:*3 tablet(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: primary systemic sarcoid secondary pulmonary hypertension end stage renal disease on hemodialysis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: ms. , it was a pleasure caring for you at . you were admitted with worsening shortness of breath and found to have a fever and fluid in your lungs. we removed some fluid with dialysis and gave you antibiotics. medication changes: # start levaquin 500mg after dialysis sessions for three doses to treat an infection followup instructions: department: when: tuesday at 2:20 pm with: , md building: campus: east best parking: garage department: pulmonary function lab when: wednesday at 9:00 am with: pulmonary function lab building: campus: east best parking: garage department: medical specialties when: wednesday at 9:30 am with: dr. & dr. building: sc clinical ctr campus: east best parking: garage procedure: hemodialysis diagnoses: other iatrogenic hypotension end stage renal disease renal dialysis status other chronic pulmonary heart diseases sarcoidosis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute and chronic respiratory failure epilepsy, unspecified, without mention of intractable epilepsy fever, unspecified secondary hyperparathyroidism (of renal origin) kidney dialysis as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure lung involvement in other diseases classified elsewhere other fluid overload 

Answer: The patient is high likely exposed to