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: cough, hypoxia major surgical or invasive procedure: none history of present illness: 65 yo with metastatic breast cancer with known lung and brain mets admitted on for cough and hypoxia. a week and a half prior to presentation she had whole brain radation. since that treatment she had been very fatigued. also started coughing up green sputum and increased doe. her husband apparently was sick before. endorses fevers to ~100.3 each morning that she has been treating with alleve. she was given z-pack 5 days ago without improvement and she got 1 dose of augmentin in clinic on the day of presentation. of note, she just finished a dexamethasone taper on the day of presentation after her whole brain radiation. she was stable the night of admisison but the next day she was put on a non-rebreather for hypoxia and transferred to the micu. in the micu she was diuresed, had a negative cta, and was started on vanc/cefepime/tamaflu. tamaflu was stopped after negative flu cultures. in clinic, 98.8 121/76 78 18 87% on ra - she came up to 94 % on 3 l nc - patient received fluids. on ros, patient endorses mild nausea and constipation for 7 days. she denies chest pain, headaches, abdominal pain, vision changes, swelling or pain in calves. past medical history: <b>oncologic history</b> <u>initial diagnosis:</u> stage i breast cancer (er positive, pr positive, her-2 negative by fish, grade , lymph node negative. <u>treatment:</u> s/p lumpectomy and sentinel lymph node biopsy followed by xrt and then arimidex which was stopped after 2 months because the patient developed chest pain which was determined non-cardiac. she was not placed on any hormonal therapy. <u>recurrence:</u> in , ct scan of the chest that showed multiple lung lesions and cytology showed adenocarcinoma. - ihc: + gross cystic fluid protein, - ttf-1, stereotactic biopsy on that showed an the <u>treatment/disease course:</u> - : trial of fulvestrant(faslodex) but taken off when ct showed new liver mets - -: kept on faslodex and aromasin and xomeda added - : developed neurological symptoms and mri showed >25 metastatic lesions, started on decadron - : completed course of whole brain xrt - : completed decadron taper social history: she is married and works in health promotion. she is a former smoker, having quit approximately 30 years ago. prior to this, she smoked up to 2 packs of cigarettes per day for 20 years. she does have asbestos in her basement, although there have been no attempts of removal. she has no drug allergy. family history: with respect to her family history, her father was diagnosed with emphysema and her mother has copd. physical exam: hr 79 bp 112/55 rr 22 o2 92% on 4l nc and showel mask gen: nad cv: rrr, no m/r/g resp: poor air movement, crackles at bases bilaterally, no wheezing or rhonci abd: soft, nt, nd, + bs ext: no edema neuro: cn 3-12 intact, grossly oriented, 5/5 strength x 4, coordination intact pertinent results: discharge labs: wbc-7.5 rbc-2.99* hgb-8.9* hct-26.4* mcv-88 mch-29.8 mchc-33.8 rdw-13.9 plt ct-519* glucose-108* urean-7 creat-0.5 na-139 k-3.7 cl-105 hco3-27 angap-11 alt-36 ast-31 ld(ldh)-289* alkphos-77 totbili-0.6 albumin-2.8* calcium-8.1* phos-3.1 mg-2.4 . cxr : - marked deterioration of the radiographic image. - preexisting lung nodules have increased in size - neralized reticular pattern that was previously invisible is seen, together with newly appeared small bilateral pleural effusions - pattern suggests the presence of lymphangitic carcinomatosis. - in the medial aspect of the middle lobe, a small area of hypoventilation has newly appeared. - despite the multiple lytic bone lesions seen on the ct examination from , none of these lesions is detectable on the chest radiograph. . cta 1. worsening of interstitial and bilateral ground-glass opacity in a perihilar and upper lobe distribution, given rapid interval progression, may represent pulmonary edema or multifocal bronchopneumonia. recommend short term follow-up to document resolution given known underlying metastasis. no evidence of pulmonary embolism. 2. unchanged diffuse osseous, hepatic and pulmonary metastases. brief hospital course: # hypoxia: the patient was tranferred to the due to hypoxia requiring a non-rebreather to stabilize her oxygen sats. she had a convincing story for a viral infection as her and her husband had uri symptoms and cough for the past few weeks. the differential initally was broad and she was started on a heparin gtt due to concern for pe. she was also started on broad spectrum antibiotics and anti-flu (vanc, cefepime, and tamiflu). induced sputum was sent to rule out pcp as she had recently been weaned off steroids in the setting of undergoing whole brain irradiation. sputum was negative for pcp. urinary legionella antigen was sent and was negative. ekg had no ichemic changes and cardiac enzymes were negative for mi. she underwent a cta showed no evidence of pe, but did show a marked worsening of interstitial and bilateral ground-glass opacity in a perihilar and upper lobe distribution. lenis were also negative for dvt. tamiflu was stopped when her flu dfa returned negative. on exam she did not appear volume overloaded. a tte was done and showed and ef of 75% and no evidence of wall motion abnormalities. she was given standing albuterol and ipatropium nebs. her hypoxia slowly improved and she was satting in the mid 90's on 6l nc. upon abmulating she sated 95% on 6l and 91% on 4l. she was discharge on home o2 and vna services. she will follow up with dr. . . # breast cancer: patient received one treatment of chemotherapy while hospitalized. she tolerated the treatment well. she was discharged on zofran, ativan, compazine for possible post-chemotheraphy nausea. . # code status: prior to transfer she was dnr/dni. upon discussion, she was willing to be intubated for acute pneumonia but specifically states that she does not want to be on a ventilator long term. she has discussed this decision with her hcp, her husband. medications on admission: hydrocodone-acetaminophen 5 mg-500 mg tablet tablet(s) by mouth every 6-8 hours lorazepam 0.5 mg tablet 1 tablet(s) by mouth every 6 to 8 hours as needed ergocalciferol (vitamin d2) 1,000 unit capsule 1 capsule(s) by mouth once a day (otc) multivitamin discharge medications: 1. multivitamin tablet sig: one (1) tablet po daily (daily). 2. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for sob/wheezing. disp:*120 2.5mg/3ml* refills:*2* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. disp:*60 capsule(s)* refills:*2* 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. disp:*60 tablet(s)* refills:*2* 5. fluticasone 50 mcg/actuation spray, suspension sig: two (2) spray nasal (2 times a day). disp:*60 50mcg* refills:*2* 6. zofran 8 mg tablet sig: one (1) tablet po three times a day as needed for nausea. disp:*90 tablet(s)* refills:*2* 7. lorazepam 0.5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for anxiety/nausea. disp:*120 tablet(s)* refills:*1* 8. fexofenadine 60 mg tablet sig: one (1) tablet po bid (2 times a day) as needed: for nasal congestion. disp:*60 tablet(s)* refills:*2* 9. sodium chloride 0.65 % aerosol, spray sig: sprays nasal (2 times a day) as needed for dryness. disp:*1 bottle* refills:*2* 10. ipratropium bromide 0.02 % solution sig: one (1) nebulized inhalation q6h (every 6 hours) as needed for wheezing/sob. disp:*120 nebulized* refills:*2* 11. hydrocodone-acetaminophen 5-500 mg tablet sig: 1-2 tablets po every 6-8 hours as needed for pain. 12. oxgen please provide the patient with oxygen. she is on 4-6l continuous. 13. compazine 10 mg tablet sig: one (1) tablet po every six (6) hours as needed for nausea. disp:*120 tablet(s)* refills:*2* discharge disposition: home with service facility: vna care of discharge diagnosis: primary diagnosis: 1) viral pneumonia 2) breast cancer discharge condition: stable discharge instructions: you were admitted to the hospital for hypoxia. you were treated with antibioitcs for a likely infection in your lungs. we think an infection is what caused your breathing difficulty. you will be discharged on oxygen with nursing and pt services. you were also given 1 round of chemotherapy while you were hospitalized. you tolerated this treatment well. . we have made the following changes to your medications: 1) albuterol sulfate 2.5 mg /3 ml solution for nebulization. one (1) inhalation q6h (every 6 hours) as needed for sob/wheezing. 2) docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). as needed for constipation 3) senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 4) fluticasone 50 mcg/actuation spray, suspension sig: two (2) spray nasal (2 times a day) for nasal congestion 5) zofran 8 mg tablet sig: one (1) tablet po three times a day as needed for nausea. 6) fexofenadine 60 mg tablet sig: one (1) tablet po bid (2 times a day) as needed: for nasal congestion. 7) sodium chloride 0.65 % aerosol, spray sig: sprays nasal (2 times a day) as needed for dryness. 8) ipratropium bromide 0.02 % solution sig: one (1) nebulized inhalation q6h (every 6 hours) as needed for wheezing/sob. please seek medical care if you have shortness of breath, chest pain, nausea/vomiting, diarrhea, fevers/chills, dizziness, fainting. followup instructions: provider: , md phone: date/time: 12:30 provider: , rn phone: date/time: 1:30 procedure: injection or infusion of cancer chemotherapeutic substance diagnoses: malignant neoplasm of liver, secondary unspecified pleural effusion other pulmonary insufficiency, not elsewhere classified personal history of malignant neoplasm of breast secondary malignant neoplasm of brain and spinal cord other constipation secondary malignant neoplasm of lung viral pneumonia, unspecified 

Answer: The patient is high likely exposed to