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 / cimetidine attending: chief complaint: weakness, vomiting, diarrhea major surgical or invasive procedure: central venous line placement and removal history of present illness: this is a 79 year old female with pmh of htn, breast cancer s/p lumpectomy 8 years ago, urticaria currently on prednisone, eczema, osteoporosis, esophageal spasm, and recent 3 day hospitalization at in for with creatinine up to 3 secondary to cimetidine induced ain, now with baseline creatinine of 1.1-1.3 presenting for further evaluation of general malaise, fevers and less than 5 episodes of non bloody vomiting/diarrhea for the last day. she reports having sick contact with several family members who also had gi symptoms last week. she has been npo for the last 2 days due to nausea. her last episode of emesis was yesterday afternoon and her last loose bowel movement was yesterday morning. as far as her prednisone, she had a month's course in with resolution of her urticaria. she was restarted on prednisone 3 weeks ago for an urticarial flare and was also started on dapsone 50mg daily. . in the ed, initial vs were: t=101.2, hr=76, bp=109/63, rr=18, pox=100% ra. labs were unremarkable. blood and urine cultures were sent and a foley was placed. a cxr was significant for hyperexpanded lungs with mild cardiomegaly. ekg is normal sinus rhythm and otherwise unremarkable. during her ed course her blood pressures fell to the 70s-80s systolic. she was asymptomatic and mentating well with these pressures. she was given 4 liters of ivfs without significant bp improvement (systolic in the 80s). therefore, right subclavian access was placed in addition to 2 pivs and she was started on levophed to maintain map greater than 60. her cvp in the ed was 7 after the fluid resuscitation and she is making adeqate urine. she was also given dexamethasone, vanco, and cefepime. . on the floor, she reports having some hives remaining mostly on her back and faintly on her chest and abdomen which are no longer pruritic. she denies any nausea, vomiting, or diarrhea over the last 12 hours and says that she is hungry. she also denies feeling any different with her hypotension; specifically no dizziness, lightheadedness, or change in vision. she was not confused at any point and was able to answer questions appropriately. . review of sytems: (+) per hpi (-) denies headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. denied chest pain or tightness, palpitations. denied constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. denied arthralgias or myalgias. . past medical history: hypertension (diagnosed 2-3 years ago) osteoporosis esophageal spasm breast cancer s/p lumpectomy 8 years prior urticaria eczema osteoarthritis s/p knee replacement social history: lives alone although frequently visits family nearby. no smoking; occasional alcohol use. family history: one daughter has itp; no renal disease in family. physical exam: vitals: t: 98.6, bp: 100s-110s/50s-60s, p: 60s, r: 18, o2: 95% ra general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi 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: foley in place skin: patchy, discrete erythematous patches scattered mostly across upper back and more faintly on chest and abdomen consistent with urticaria ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema discharge: general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi 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: foley in place skin: improvement in previously patchy, discrete erythematous patches scattered mostly across upper back and more faintly on chest and abdomen consistent with urticaria ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: 08:00pm blood wbc-9.8 rbc-5.03 hgb-14.8 hct-45.7 mcv-91 mch-29.4 mchc-32.3 rdw-14.2 plt ct-227 03:44am blood wbc-7.3 rbc-4.01* hgb-12.1 hct-37.0 mcv-92 mch-30.3 mchc-32.8 rdw-13.5 plt ct-201 05:44am blood wbc-9.6 rbc-3.98* hgb-12.0 hct-36.5 mcv-92 mch-30.1 mchc-32.8 rdw-14.3 plt ct-183 08:00pm blood neuts-92.0* lymphs-5.2* monos-1.6* eos-0.9 baso-0.4 08:00pm blood pt-12.0 ptt-22.1 inr(pt)-1.0 08:00pm blood plt ct-227 03:44am blood plt ct-201 05:44am blood plt ct-183 08:00pm blood glucose-98 urean-38* creat-1.1 na-135 k-4.8 cl-99 hco3-25 angap-16 03:44am blood glucose-123* urean-29* creat-0.9 na-139 k-3.8 cl-110* hco3-21* angap-12 02:46pm blood glucose-133* urean-24* creat-0.9 na-142 k-4.2 cl-113* hco3-21* angap-12 05:44am blood glucose-109* urean-22* creat-0.9 na-141 k-4.2 cl-110* hco3-25 angap-10 08:00pm blood alt-25 ast-45* alkphos-63 totbili-1.3 03:44am blood alt-17 ast-17 alkphos-50 totbili-1.0 08:00pm blood lipase-28 03:44am blood albumin-3.1* calcium-6.8* phos-2.6* mg-1.9 02:46pm blood calcium-7.5* phos-2.0* mg-2.0 05:44am blood calcium-8.2* phos-2.5* mg-2.1 03:44am blood tsh-0.54 03:44am blood cortsol-19.2 05:44am blood cortsol-2.9 06:20am blood cortsol-17.2 07:00am blood cortsol-20.6* 05:44am blood anca-negative b 10:59pm blood lactate-0.8 01:33am blood lactate-0.9 02:46pm blood tryptase-pnd brief hospital course: this is a 79 year old female with pmh of htn, breast cancer s/p lumpectomy 8 years ago, urticaria recently started on prednisone and dapsone, eczema, osteoporosis, esophageal spasm, and recent 3 day hospitalization at in for with creatinine up to 3 secondary to cimetidine induced ain, now with baseline creatinine of 1.1-1.3 presenting for further evaluation of general malaise, fevers, non bloody vomiting/diarrhea for the last day being transferred to the icu for hypotension #. hypotension. most likely volume depletion. initially was on levophed and required pressure support with ivf as well. patient was febrile in the ed to 101.2,, so sepsis was considered as well, however lactate within normal limits. pt was also npo x 2 days. adrenal insufficiency was considered given her steroid use at home, so prednisone was swithced to dexamethasone in order to stim test however it was only 24 hours after prednisone was stopped so serum cortisols likely not reliable and may need outpatient stim test. also considered was a systemic process related to her chronic urticaria, as below, given her rash at time of admission. she was able to be weaned off pressors with improved systolic bps and was continued on her home medications for her chronic urticaria. she was not orthostatic at time of discharge and was able to ambulate well. she was dishcarged home with outpatient f/u with pcp, , and dermatology. #. urticaria. this problem started 1 year ago and she is on steroids, dapsone, and loratadine. she was evaluated by dermatology and consult services. dermatology recommended no biopsy as this appeared to be chronic urticaria, and she was recommended to continue her home meds, zyrtec and , along with dapsone and dexamethasone (changed from prednisone as above). urticaria resolved during admission. she should be weaned off of dexamethasone as an outpatient as per her allergist's recommendations and will follow up with and dermatology as above #. code: full medications on admission: 1. hyoscyamine sulfate 0.125 mg tablet, rapid dissolve oral 2. claritin 10 mg tablet sig: one (1) tablet po once a day. 3. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily) 4. vitamin e complex oral 5. vitamin b-12 oral 6. prednisone 20 mg daily decreasing to 10mg tomorrow. 7. dapsone 50mg daily discharge medications: 1. dapsone 100 mg tablet sig: 0.5 tablet po daily (daily). 2. dexamethasone 1.5 mg tablet sig: two (2) tablet po daily (daily) for 14 days. disp:*28 tablet(s)* refills:*0* 3. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). 4. claritin 10 mg tablet sig: one (1) tablet po twice a day. 5. zyrtec 10 mg tablet sig: one (1) tablet po twice a day. 6. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). 7. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 8. cyanocobalamin (vitamin b-12) 100 mcg tablet sig: one (1) tablet po daily (daily). discharge disposition: home discharge diagnosis: chronic urticaria hypotension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were seen in the hospital for low blood pressure, most likely related to dehydration from vomiting and diarrhea, which improved with iv fluids. you were also noted to have a rash, which was evaluated by the dermatology and teams here, who recommended continuing the medications you take at home and switching from prednisone to a different steroid, called dexamethasone. please follow up with dr. and dr. as listed below. changes to your medications: -stop taking prednisone -start taking dexamethasone 3 mg daily followup instructions: name: , location: - address: , , phone: we are working on a follow up appointment in 1 week. the office will contact you at home with an appointment. if you have not heard within 2 business days or have any questions please call the office. name: , md department: dermatology address: ., , phone: appointment: tuesday 3:15pm name: , location: asthma & affiliates, inc. address: , phone: appointment: monday 11:30am procedure: venous catheterization, not elsewhere classified diagnoses: long-term (current) use of steroids personal history of malignant neoplasm of breast hypotension, unspecified osteoporosis, unspecified dehydration knee joint replacement osteoarthrosis, unspecified whether generalized or localized, lower leg volume depletion, unspecified other specified urticaria 

Answer: The patient is high likely exposed to