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: chief complaint: fever, leg redness history of present illness: this is a 36-year-old female with a history of bipolar disease, schizophrenia, possilbe mental retardation, and two recent hospitalizations at and for swelling, pain and erythema of her right leg with fevers. at , she had an extensive infectious workup that was reportedly negative. further mri showed extensive myositis at . there was concern that this was related to her antipsychotic medication, and was neuroleptic malignant syndrome, and the symptoms improved there with her neuroleptic medications being held and the patient receiving bromocriptine. the patient also had a muscle biopsy that showed inflammatory myopathy without organisms. her father states that she did well recently until one week prior to admission, which also coincided with the restarting of her geodon and seroquel when she started having fevers, pain in her right leg. the patient's father states that, on discharge from , she had a course of penicillin which made her rash improve. no fevers, no headache, no neck stiffness, no indigestion, no abdominal pain, no dysuria, no back pain, no rashes outside of her red leg. past medical history: anemia, schizophrenia, bipolar disorder, recent myalgia and myositis at . medications on admission: seroquel 300 mg by mouth daily at bedtime, geodon 20 mg by mouth once daily, potassium 20 meq by mouth daily at bedtime, klonopin 1 mg daily at bedtime, atenolol 25 mg by mouth once daily. allergies: no known drug allergies, but question of reaction to antipsychotics. social history: question mentally retarded. attends day program. no tobacco. lives with her parents. family history: noncontributory. physical examination: vitals on admission: temperature 104.1, and later 99.8, heart rate 114, blood pressure 100/49, oxygen saturation 96% on room air. general: awake, oriented to place, season and self. head, eyes, ears, nose and throat: no thrush, anicteric, no oral lesions. cardiovascular: tachycardic, no murmurs. respiratory: clear to auscultation bilaterally. abdomen: normal active bowel sounds, soft, nontender, nondistended. extremities: right greater than left swelling with erythema and pain to palpation. skin: erythematous bilateral lower extremities, right greater than left. erythema and swelling over calves and pre-tibial region as well as anterior thigh. no onychomycosis or stigmata of endocarditis. neurologic: no nuchal rigidity, no stiffness of limbs, right side with decreased range of motion secondary to pain. laboratory data: on admission, white count 16,600, 87% polys, 6% bands, 5% monos, hematocrit 30.5, platelets 195, mcv 96. sodium 130, potassium 4.3, chloride 93, bicarbonate 23, bun 14, creatinine 0.8, glucose 107. ck 1389. urinalysis: trace blood, leukocyte negative, nitrate negative, ketone negative, leukocyte esterase negative, 0 red blood cells, occasional bacteria, no epithelial cells. urine culture pending. film of her right femur: no fracture, no destructive changes. chest x-ray: no acute processes. lower extremity ultrasound: negative for deep venous thrombosis. double-stranded dna reportedly positive at . hospital course: this is a 36-year-old female with a history of bipolar disorder/schizophrenia/possible mental retardation, status post recent admission x 2 at for fevers, leg swelling, edema, pain and muscle biopsy at and mri there showing inflammatory myopathy without organisms. 1. myositis: ms. had an extensive workup of her lower extremity swelling, erythema, tenderness and fevers. the first few days of her admission showed her swelling and erythema in the right greater than left calf region and right upper thigh. her psychiatric medications, seroquel and geodon, were held on admission. on hospital day two, she was started on bromocriptine for a two day course for initial suspected neuroleptic malignant syndrome as was diagnosed at . also in the differential diagnosis was infectious pyomyositis vs autoimmune myositis vs drug reaction. on admission, the patient was started on empiric staphylococcus and streptococcus coverage for a question of cellulitis/myositis that was discontinued on hospital day two. she did have an infectious disease workup which included negative blood cultures x 3. she did have an mri of her lower extremities performed here. this showed edema of the gastrocnemius and right abductor thigh muscles and the left gastrocnemius muscles with signs of inflammation and evidence of myositis and fascitis. because of this mri finding, the patient's leukocytosis with bandemia, and fevers, the patient was then restarted on her antibiotics to cover possible myositis and fascitis. she was continued on oxacillin and clindamycin. a muscle biopsy was obtained one day after antibiotics were started. this showed a question of positive gram staining for positive cocci and extensive muscle necrosis without any clear sign of autoimmune inflammatory myositis. because of the above evidence, the patient was treated for presumed gram-positive infectious pyomyositis and fascitis of her bilateral lower extremities. in order to also evaluate for question of autoimmune myositis, and double-stranded dna, which had been positive at , were sent. both of these were negative during this admission. the patient did have an esr that was elevated to 145, which was thought to be secondary to her large myositis. the patient also had electromyogram studies that were nondiagnostic. it was thought very unlikely that this presentation was consistent with neuroleptic malignant syndrome. the patient did not have rigidity, and the patient did have only lower extremity involvement which is also rare. her upper extremities were not affected during this presentation. because of this low likelihood, and because of her profound psychosis, ms. was restarted on geodon 20 mg by mouth twice a day. her bromocriptine was also discontinued after two days of treatment. the patient's condition seemed to improve rapidly after antibiotics were started, as her cks returned to range, her white count returned to range, and she was afebrile. her examination was also significant for a marked improvement, including a reduction in the erythema, edema, and tenderness to her gastrocnemius. the patient will be continued on a two week course of oxacillin for discharge, and is currently awaiting a picc line placement for outpatient intravenous antibiotics. 2. bilateral gastrocnemius contractures: the patient developed plantar flexion bilaterally of her feet, with inability to dorsiflex them on hospital day three. mixed histories were obtained from the family regarding the patient's baseline functional status and ability to walk. the family did say that she had been bedridden over the course of a month. records were obtained from admission two months ago, which showed that she was walking at that time, and did not have these contractures then. it is unknown how long these contractures were present, although they most likely were not present on admission here. she was followed by physical therapy and occupational therapy to treat these contractures and, at the present time, will likely be arranged to have splints fit for her feet. 3. anemia: the patient's hematocrit remained in the 23 to 30 range throughout this hospitalization, and varied throughout this range, depending on her intravenous fluid hydration. the workup of this anemia did show an anemia of chronic disease picture. this included a total iron binding capacity of 157, normal b12 and folate, and negative studies for hemolysis. she was guaiac negative this admission. her peripheral smear was evaluated by hematology for question of blasts seen on differential. no blasts were seen on review by hematology smear, who believe that these were actually atypical lymphocytes, consistent with left shift from systemic inflammation. 4. sinus tachycardia: the patient initially had a sinus tachycardia to the 140s to 160s on admission. this improved down to the low 100s with normal saline fluid boluses. ms. did have an echocardiogram to evaluate for any possible cardiomyopathy as a cause of her sinus tachycardia, and this was a normal study. it is likely her sinus tachycardia is a result of her anemia, dehydration, and systemic inflammation. 5. psychiatric: ms. does have a history of bipolar disorder and schizophrenia, according to her outpatient psychiatrist, dr. . our psychiatry team did follow her throughout her hospital stay. they had received a history that she did have auditory hallucinations, and this was why she needed to be on antipsychotic medications. she also frequently asked psychotic questions, such as "am i dead?," and "can you bring me a mirror to see if i am the real ?" with the low suspicion of neuroleptic malignant syndrome, she was restarted on geodon 20 mg twice a day during this hospitalization. she was also continued on clonazepam 1 mg by mouth three times a day. dr. phone number in is . 6. social: the patient's baseline functional status was difficult to obtain during this hospitalization. various histories have been obtained from the parents and brother that lives at home. the patient is currently being followed by social work, and has had her case registered with the department of mental retardation for possible protection services. her current baseline mental status seems to be that of a young child with an inability to care for herself in terms of feeding and washing herself. according to her parents and brother, in the past she has performed such tasks as driving a car or going to day programs in the community. it is unknown if or when the patient began to decline, although the family says about five months ago she became sick and has been in and out of hospitals since then. it is unknown when she was no longer able to walk, as she is now. numerous attempts were made to meet with the parents for family meeting to discuss her past status as well as her current situation and disposition planning, and her parents and family repeatedly mentioned that they could not attend these meetings. 7. fluids, electrolytes and nutrition: her electrolytes were stable throughout this hospitalization after intravenous fluid hydration. she was maintained on a regular house diet. for prophylaxis, she was maintained on subcutaneous heparin because she was bedridden with her bilateral gastrocnemius contractures with plantarflexion. she was seen by physical therapy and occupational therapy, who did get her out of bed to chair with great assist. disposition: the patient will likely be discharged to a long- term care facility for rehabilitation of her contractures and care for her activities of daily living. she had been followed in the past by dr. at , who is a rheumatology fellow. her phone number is . she does say that she has ordered electron microscopy on her pathology at . ms. will need follow-up after discharge. medications at the time of this dictation: geodon 20 mg twice a day, clonazepam 1 mg by mouth three times a day, oxacillin 2 grams intravenously every four hours, multivitamin one capsule by mouth once daily, subcutaneous heparin every 12 hours, folic acid 1 mg by mouth once daily, acetaminophen as needed. the patient's final discharge plan and remaining hospital course, as well as discharge medications, will be dictated at a later date upon discharge. , m.d. dictated by: medquist36 procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures biopsy of bone marrow open biopsy of soft tissue open biopsy of soft tissue injection or infusion of oxazolidinone class of antibiotics other change in muscle or tendon length diagnoses: anemia, unspecified other specified cardiac dysrhythmias toxic myopathy bipolar i disorder, most recent episode (or current) unspecified unspecified intellectual disabilities schizophrenic disorders, residual type, chronic other antipsychotics, neuroleptics, and major tranquilizers causing adverse effects in therapeutic use acute myocarditis, unspecified contracture of tendon (sheath) 

Answer: The patient is high likely exposed to