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: history of present illness: this is a 27 year old spanish-speaking woman diagnosed with myasthenia in . she is status post thymomectomy . she now presents with increased weakness in her right arm, "eyelid partly closing" on the right, and some increased shortness of breath over the past two weeks. she says that she has noticed the problems usually beginning three hours after taking the mestinon dose. she says she has felt well throughout this time without fevers, chills, nausea, vomiting, dysuria, headaches, cough, or chest pain. per patient as well as in the old notes, she has been having some abdominal pain and diarrhea after mestinon dose and so the dose was decreased. following this, she began to have double vision so the dose was increased back to 60 mg q4 hours. she says that she has not been short of breath while walking so much as when lying in bed. she has not had any difficulties with walking or swallowing. the left arm has not been weak. she says that she currently feels well and that after one course of plasmapheresis, she believes the weakness in her right arm has improved. she also says that she has no shortness of breath currently. past medical history: 1. myasthenia . 2. acetylcholine receptor antibody positive diagnosed . 3. status post thymomectomy . 4. ppd positive in the past status post bcg. medications: 1. mestinon 60 mg q4 hours. 2. prednisone 120 mg by mouth daily. 3. pepcid 20 mg twice a day. 4. cellcept mg twice a day. 5. calcium carbonate. 6. isoniazid. 7. b6. allergies: no known drug allergies. social history: married with two children. no alcohol or tobacco. primarily spanish speaking. this was immediate family plus mother and brother. physical examination: temperature 99.3; pulse 75 to 103; blood pressure 103-124/50-60; oxygen saturation rate 95-99% on room air. in general, her physical examination is unremarkable; vital capacity was 1.9 on admission, however, increased to 3.2 by and was still 2.6 on ; nifs negative 80. neurological examination: with last dose of mestinon almost three hours prior to examination, mental status alert and oriented times three, says months of year backwards accurately in spanish, speech fluent, speaks limited english but fairly good, tells a detailed history and answers questions appropriately, no dysarthria, speech not significantly nasal. cranial nerves - pupils equal, round, reactive to light, eoms full with some nystagmus on upgaze and occasionally horizontal gaze, very minimal right ptosis at rest, but significantly worsened with sustained upgaze, however this improved by the date of discharge. ptosis could not be brought out after sustained upgaze. no diplopia, fascial sensation intact, facial movement and strength intact. palate moves symmetrically, tongue protrudes midline. sternocleidomastoid and shoulders shrug 5 out of 5. motor - very mild pronator drift to the right that improved by the date of discharge, by the date of discharge, the right and left upper and lower extremities were 5 out of 5 bilaterally, sensation intact to light touch, pin prick and temperature in all extremities bilaterally, reflexes 3+ in upper extremities bilaterally and 2+ in lower extremities bilaterally. toes downgoing bilaterally. coordination - finger to nose and rapid alternating movements intact, gait deferred. labs: urine hcg negative; white count 19.3; hematocrit 42.5; platelet count 233; inr 1.1; urinalysis negative; creatinine 138; potassium 3.5; alt 21; ast 21; ldh 184; alk phos 71; amylase 80; total bilirubin 0.4; calcium 9.8; phosphate 5.2; magnesium 1.9. blood cultures taken on were negative; urine culture on showed no growth; chest x-ray showed no evidence of acute cardiopulmonary disease. hospital course: this is a 27 year old woman with myasthenia who presented with worsening right arm weakness and increased shortness of breath, particularly as the mestinon dose is wearing off. she was found to have initially worse pfts than one month ago, however, this significantly increased after her treatment with plasmapheresis during admission. the patient was also started on cellcept for long term immunosuppression in order to eventually taper off the prednisone. the patient did very well with the plasmapheresis and significantly improved by the date of discharge. discharge diagnosis: myasthenic crisis. follow-up: the patient will follow-up with dr. in neurology on at 4:30 and at 4:00 p.m. the patient has completed three courses of plasmapheresis during her hospital course and will complete the second two courses of plasmapheresis at hospital in under the supervision of dr. upon discharge. discharge medications: 1. prednisone 120 mg by mouth once daily. 2. isoniazid 300 mg by mouth once daily. 3. vitamin b6 50 mg once daily. 4. mestinon 90 mg q4 hours. 5. protonix 40 mg once daily. 6. cellcept mg twice a day. discharge condition: good. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified therapeutic plasmapheresis therapeutic plasmapheresis therapeutic plasmapheresis vital capacity determination diagnoses: other acquired absence of organ 

Answer: The patient is high likely exposed to