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: codeine attending: chief complaint: chest pain major surgical or invasive procedure: pericardiocentesis red blood cell transfusion history of present illness: the patient is a 68-year-old woman with cad s/p des to rca, dchf, htn, diabetes, dyslipidemia, and pvd, who presented to her pcp today with chest discomfort. she has had chest discomfort since 9pm one day pta, which spread across her chest from shoulder to shoulder. it was worse with any movement, especially with lying down, and improved with sitting up and staying still. she did have mild sob pain on inspiration, and she found it suffocating while she had her cpap on overnight. this morning she continued to have pain, as well as some radiation to the back. the pain is different from her angina and from the pain she experienced with her heart failure. at worst it was this morning, and at best . she did not have any associated nausea, lightheadedness, or diaphoresis. she went to see her pcp, found "a change on the ecg" so she was sent to the by paramedics, and received asa 324mg and sl ntg x2sprays en route. on arrival she had increased pain with transfer from gurney to stretcher, and was found to have st elevations in ii, iii, avf. her cardiac enzymes were negative (ck 24, trop <0.01), but she received a plavix load and was started on heparin and integrillin gtts and transferred to the cath lab for emergent cardiac catheterization for stemi. her vs prior to transfer included bp 105/75 and sao2 97% on 3l. . on arrival to the cath lab here, her ecg was felt to be more consistent with pericarditis. stat tte showed a small to moderate sized circumferential pericardial effusion (~2cm in subcostal view, anterior to the rv) with sustained ra collapse c/w low filling pressures or early tamponade, and rv collapse could not be excluded. she reportedly did not have any wall motion abnormalities. cardiac cath was cancelled, and urgent pericardiocentesis was not done. she is being admitted to the ccu for closer monitoring. . of note, the patient had "allergy" symptoms yesterday prior to developing the chest pain. her symptoms included nasal congestion and rhinitis, as well as anorexia, but she denies any cough, rash, fevers, chills, sweats, arthralgias, or myalgias. past medical history: 1. cardiac risk factors: (+)diabetes: x20yrs, previously on metformin/rosiglitazone and insulin, now off meds/insulin weight loss of ~50lbs (+)dyslipidemia (+)hypertension 2. cardiac history: -cabg: none. -percutaneous coronary interventions: cad s/p cypher stent to 90% mid-rca , with untreated 80% lesion in om2 (small vessel) and 30% lmca stenosis, c/b right inguinal av fistula now resolved on u/s -- acute diastolic chf with bnp 2730 and nuclear stress test without evidence of cardiac ischemia -pacing/icd: none. 3. other past medical history: peripheral vascular disease gerd asthma anemia osa on cpap restless legs syndrome depression s/p knee replacement s/p ankle surgery social history: lives with her daughter. retired nurse's aide. -tobacco history: former smoker, quit in . -etoh: none. -illicit drugs: none. family history: unknown as she grew up in care. sister diabetic, died of mi in her 60s. no known family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: vs: t= 98.7f, bp= 120/71, hr= 83, rr= 18, o2 sat= 99% 2l nc. general: wd/wn woman in mild distress and discomfort. oriented x3. mood, affect appropriate. heent: nc/at. perrl/eomi. sclera anicteric. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. dry mm, op clear. neck: supple with jvp of 10 cm, not noted to increase with inspiration. cardiac: pmi located in 5th intercostal space, midclavicular line. rrr, normal s1-s2. faint pericardial friction rub. no m/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: nabs, soft/nt/nd. no hsm or tenderness. extremities: wwp, trace ankle edema bilaterally. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: radial 1+ dp 1+ pt 1+ left: radial 1+ dp 1+ pt 1+ pertinent results: 09:28pm hiv ab-negative 05:45pm glucose-217* urea n-48* creat-1.7* sodium-133 potassium-3.9 chloride-87* total co2-32 anion gap-18 05:45pm alt(sgpt)-14 ast(sgot)-2 ld(ldh)-347* ck(cpk)-24* alk phos-87 tot bili-0.8 05:45pm ck-mb-notdone ctropnt-<0.01 05:45pm albumin-3.3* calcium-8.5 phosphate-3.9 magnesium-1.9 iron-18* cholest-110 05:45pm caltibc-229* vit b12-889 folate-greater th ferritin-112 trf-176* 05:45pm %hba1c-10.1* 05:45pm triglycer-43 hdl chol-65 chol/hdl-1.7 ldl(calc)-36 05:45pm tsh-1.0 05:45pm wbc-14.4*# rbc-3.57* hgb-10.4* hct-31.4* mcv-88 mch-29.1 mchc-33.1 rdw-14.2 05:45pm neuts-78.3* lymphs-17.2* monos-3.8 eos-0.5 basos-0.2 05:45pm plt count-282 05:45pm pt-14.6* ptt-65.9* inr(pt)-1.3* 05:45pm sed rate-83* 05:21pm type-art po2-120* pco2-34* ph-7.48* total co2-26 base xs-3 05:21pm glucose-206* lactate-0.8 k+-4.0 05:21pm hgb-11.7* calchct-35 o2 sat-98 ======================================================== pericardial fluid procedure date of diagnosis: pericardial fluid: negative for malignant cells. numerous neutrophils and lymphocytes. . ======================================================== portable tte (focused views) done at 6:17:09 pm there is a small to moderate sized pericardial effusion. the effusion appears circumferential. there is sustained right atrial collapse, consistent with low filling pressures or early tamponade. . portable tte (complete) done at 2:48:59 pm the left atrium and right atrium are normal in cavity size. the estimated right atrial pressure is 0-5 mmhg. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. the estimated pulmonary artery systolic pressure is normal. there is a trivial/physiologic pericardial effusion. suboptimal image quality. mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. trivial pericardial effusion. increased pcwp. compared with the prior study (images reviewed) of , the pericardial effusion has largely resolved. . portable tte (focused views) done at 3:10:53 pm the estimated right atrial pressure is 0-5 mmhg. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. there is a small pericardial effusion localized posterior to the left ventricle. there are no echocardiographic signs of tamponade. brief hospital course: # pericarditis, pericardial effusion, tamponade: patient transferred from osh for concern for stemi given st elevations in inferior and pre-cordial leads. however, on arrival to ecg felt to be more consistent with pericarditis. a stat tte showed small to moderate sized circumferential pericardial effusion (~2cm in subcostal view, anterior to the rv) with sustained ra collapse c/w low filling pressures or early tamponade, and rv collapse could not be excluded. she reportedly did not have any wall motion abnormalities. cardiac cath was cancelled, and urgent pericardiocentesis was performed. post-procedure echo demonstrated trivial pericardial effusion and echo 24 hrs post-procedure demonstrated small pericardial effusion without evidence of tamponade. clinically, patient stable post procedure. she has continued to have mild chest discomfort relieved with tramadol. given etiology of effusion unclear patient tested for hiv, lyme, mycoplasma, respiratory viral and antigen which were all negative. adenovirus and virus serologies pending at time of discharge. also negative. notably, esr elevated at 83. pericardial fluid was negative for malignant cells. pericardial fluid sent for culture which is preliminarily no growth at time of discharge. patient should follow up with her pcp within the next 2 weeks. she would need a repeat echo if her symptoms of chest discomfort recurred. # coronaries: pt w/ known cad and s/p des to rca lesion in . as noted above, patient was transferred to this hospital for concern that she was having a stemi but we determined her st elevations actually reflected pericarditis. her cardiac enzymes were negative both at the osh and on admission. we continued her on her home regimen of asa, plavix, metoprolol and simvastatin. # pump: patient has history of chf exacerbation in . her echo showed ef >55%. no evidence of volume overload.continued on outpatient regimen of metoprolol and lasix. # rhythm: pt remained in sinus rhythm. # acute renal failure: creatinine elevated on admission to 1.7 and rose as high as 2.1. she was volume resucitated with ivf and creatinine improved back to 1 which is within her baseline range (0.8-1.0). # leukocytosis: patient had leukocytosis on admission with wbc ct of 15. this was likely related to the inflammatory process causing her pericardial effusion. wbc ct trended to normal range. # diabetes: pt w/ dm2 x20yrs, previously on medical therapy with metformin / rosiglitazone and insulin, but has been off medications and insulin due to weight loss of ~50lbs in setting of lifestyle changes. notably, blood sugars were elevated on this admission and her hba1c is 10.1. we have restarted her on metformin 500mg . she will need to have her blood sugars monitored and medication changes made as needed. # hypertension: pt remained normotensive on home regimen of metoprolol, hctz and lasix. # dyslipidemia: patient's ldl 36, hdl 65, total 110, trig 43. possible that low lipid levels reflect an inflammatory process, which we are suspecting already given her pericardial effusion. she was continued on her outpatient regimen of simvastatin. # pvd: no active issues. she was continued on plavix and asa. # gerd: patient switched to ranitidine given interaction between plavix and omeprazole (which she was previously taking at home). # anemia: iron studies indicate iron deficiency anemia given iron level of 18. would consider further work-up as an outpatient, especially colonoscopy if she is not utd, and would also consider starting an iron supplement. # asthma: stable on this admission. she was continued on home singulair and miacalcin. # osa: she was continued on cpap per her home regimen. # restless legs syndrome: continued on home regimen of requip. # depression: continued on home regimen of fluoxetine. patient was a full code during this admission. medications on admission: - aspirin ec 325mg po daily - fluoxetine 40mg po daily - gabapentin 200mg po bid - hctz 25mg po daily - lasix 20mg po daily - metoprolol 25mg po bid - miacalcin 200unit/actuation nasal spray aerosol nasal - multivitamin po daily - omeprazole 20mg po daily - plavix 75mg po daily - requip 4mg po daily - singulair 10mg po daily - simvastatin 80mg po daily - tramadol 50mg po tid prn pain - tylenol 300mg - topicort 0.25% discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. gabapentin 100 mg capsule sig: two (2) capsule po bid (2 times a day). 3. hydrochlorothiazide 12.5 mg capsule sig: two (2) capsule po daily (daily). 4. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 6. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. ropinirole 1 mg tablet sig: four (4) tablet po hs (at bedtime) as needed for restless legs. 8. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 9. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 10. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 11. multivitamin tablet sig: one (1) tablet po daily (daily). 12. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 13. tramadol 50 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for pain (not chest pain). disp:*90 tablet(s)* refills:*0* 14. fluoxetine 40 mg capsule sig: one (1) capsule po once a day. discharge disposition: home discharge diagnosis: primary: pericarditis with pericardial effusion . secondary: coronary artery disease chronic diastolic heart failure anemia diabetes mellitus hypertension dyslipidemia peripheral vascular disease discharge condition: stable discharge instructions: the following changes were made to your medication regimen: 1) added: tramadol - take this medication as needed for any chest discomfort over the next few weeks 2) added: metformin - take this medication for your diabetes, as your sugars were noted to be high during this admission 3) added: rantidine - take this medication for your acid reflux 4) stopped: omeprazole . please call your doctor immediately if you develop any symptoms of shortness of breath, lightheadedness or dizziness, syncope, worsening lower extremity edema, or weight gain of > 3 lbs (weigh yourself daily). followup instructions: please arrange to see your pcp, . , in approx 2 weeks to follow up on your diabetes and pericarditis . please call microbiology lab in approximately one week to follow up on labs that were still pending for you at the time of discharge. please discuss any abnormal results with your primary care physician. procedure: pericardiocentesis diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified asthma, unspecified type, unspecified percutaneous transluminal coronary angioplasty status unspecified disease of pericardium iron deficiency anemia, unspecified chronic diastolic heart failure restless legs syndrome (rls) 

Answer: The patient is high likely exposed to