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: the patient is a 67 year old female with a long medical history including atrial fibrillation without coumadin (the patient declined), supraventricular tachycardia post ablation times two, multiple sclerosis, myasthenia , migraines, and prescription medication abuse who presented to the emergency room on complaining of episodic speech arrest for two days and nausea, diarrhea and headache for one day. the patient was in her usual state of health until , when she experienced several episodes of speech arrest while in the car with her husband. the next day, she awoke with severe headache and nausea with diarrhea and vomiting times four in addition to her episodic speech arrest. her primary care physician saw her and drew blood which revealed a potassium of 2.9. mri showed periventricular white matter changes by the inferior of the right lateral ventricle as well as left mastoiditis. her symptoms continued the next day with headache and vomiting times two as well as speech arrest. the patient went to the emergency department. in the emergency room, her vital signs were temperature 97.0 f.; blood pressure 155/74; pulse 72; respiratory rate 16; oxygen saturation 94%. she was alert and oriented times three. her examination was nonfocal except for asymmetric patellar reflexes and difficulty word finding. the patient was given p.o. potassium and started on clarithromycin. while receiving an eeg from neurology, the patient had a tonic-clonic seizure. she received one gram total of dilantin over a one hour time period. on hour following her seizure, she received 30 mg of diltiazem, 10 mg of lisinopril and 28 mg nadolol. an hour after receiving all three of those medications, her systolic blood pressure dropped to the 80s, her heart rate dropped to the 50s and she had decreasing mental status. she received 28 mg of calcium gluconate intravenous, atropine 3 mg intravenously and 500 cc. of normal saline. her ekg at the time showed a narrow junctional rhythm at 54 beats per minute, t wave inversions in leads iii and avf. the patient received more calcium as well as glucagon and was intubated for airway protection. pacing pads were placed. labs in the emergency room showed a normal cbc, normal pt and ptt, normal urinalysis, normal liver function tests, normal ck and troponin. labs were notable for a potassium of 2.9. her toxicology screen was negative. a lumbar puncture showed no cells in the cerebrospinal fluid. ct scan of the head done on showed mucosal thickening in her bilateral maxillary and ethmoid sinuses. chest x-ray showed minimal bilateral atelectasis. mra was normal. mri of the head showed mild changes due to small vessel disease. medical intensive care unit course: the patient was transferred to the medical intensive care unit on dopamine, propofol and glucagon intravenously. her initial ekg showed sinus rhythm at 77 beats per minute, normal axis, normal intervals. shortly after her admission to the medical intensive care unit, the patient was extubated. mri was repeated and showed no focal abnormalities. mra showed no abnormalities. on her first day in the medical intensive care unit she experienced multiple episodes of atrial fibrillation with rapid ventricular response followed by five second pauses. her blood pressure decreased and was restored with 1 mg of atropine. a cardiology consultation came and placed a pacing wire. pulmonary artery catheterization revealed no association between her heart rate, blood pressure and mvo2, therefore, there was suspicion for autonomic dysfunction. dopamine was weaned off. she was seen by electrophysiology who determined that she had sick sinus syndrome and implanted a pacemaker on . an echocardiogram was also done on . this showed a mildly dilated left atrium, normal left ventricular thickness, left ventricular ejection fraction greater than 55% and one plus mitral regurgitation. despite treatment of her bradycardia, episodes of hypotension continued times two, requiring ivf of 250 cc. plus midodrine 10 mg times one. she was seen by the congestive heart failure service who recommended diltiazem for her blood pressure control. the patient had one episode of shortness of breath on in the morning which was resolved with lasix. her mental status improved to the point where she was conversational on , however, she became confused and began speaking nonsensically that evening. on the morning of admission to cc7, the patient underwent a ct scan of the head. ct scan was consistent with the prior examination. results from her most recent eeg revealed no seizures but an irregular rhythm was noted on the cardiac monitor. coumadin and aspirin were begun for prophylaxis against atrial fibrillation related stroke. her team determined that she was stable for transfer to cc7. physical examination: temperature 97.3 f.; blood pressure 148/72; pulse 80; respiratory rate 18; o2 saturation 97% on room air. in general, in no acute distress, resting comfortably, alert and oriented times three (with effort). heent: pupils are equal, round, and reactive to light and accommodation. extraocular muscles are intact. normocephalic, atraumatic. neck supple, no jugular venous distention, no lymphadenopathy, no thyromegaly. heart: regular rate and rhythm, s1, s2, no murmurs, rubs or gallops. lungs clear to auscultation bilaterally, no wheezes, rales or rhonchi. abdomen soft, nontender, nondistended, plus bowel sounds. extremities warm and well perfused. no cyanosis, clubbing or edema. two plus pulses. neurological: the patient is oriented times three but confused, attempting to place her pencil in her coffee and asking for a number repeatedly perseverating on seeing her rabbi. twitching left leg noted during examination. laboratory: normal cbc. chem-7 notable for potassium of 3.2, normal pt, ptt and inr. normal protein and albumin. chest x-ray showed improved prominence of the vasculature suggesting improvement of her congestive heart failure. bilaterally pleural effusions and atelectasis were noted. no pneumothorax, no consolidation. ekg on showed a sinus and paced rhythm. rate 67. pr zero, qrs 94, qt/qtc 416/431. hospital course: the patient was admitted to on telemetry. she was continued on dilantin for seizure prevention and no further seizures were noted throughout the course of her stay. the cause of the patient's confusion and changing mental status was thought to be possible post-ictal state versus a toxic metabolic syndrome. the cause of the patient's hypotension was never completely elucidated, however, it was thought to be related to autonomic dysfunction. in light of the fact that the patient had been on steroids several years prior to admission, a morning cortisol test was done. the result was 10.2. the patient experienced no further episodes of bradycardia, and no more episodes of hypotension after being transferred to cc7. the patient's main active issue while on cc7 was her mental status. on her first day on cc7, the patient was confused with speech arrest. this was similar to her initial presentation to the emergency room. on the following day, however, the patient was no longer confused but rather was experiencing paranoid delusions regarding her telemetry wires being a recording device and her home being robbed and her husband's phone lines being tapped. the patient was very afraid of these delusions. psychiatry was consulted regarding the patient's change in mental status and felt that the delusions were likely a result of resolving delirium. however, it was discovered that the patient may have a history of bipolar disorder and was treated with zyprexa in the past. it was also discovered that the patient has attempted to commit suicide at least three times in the past and took valium with the intention of killing herself within the last month; thus, it was difficult to elucidate the degree to which her previous psychiatric history was implicated in her current psychiatric symptoms. at the time of this dictation, the patient has been medically stable since her arrival to cc7 with no episodes of bradycardia or hypotension. she has been afebrile throughout her stay. as per psychiatry's recommendation, we feel that the patient should be transferred to a geriatric psychiatric unit to further address her issues of psychosis and suicidality. condition on discharge: medically, the patient is stable for discharge. of note, her mental status has improved significantly since one day ago. discharge status: the patient will be transferred to the center for geriatric psychiatry. discharge diagnoses: 1. bradycardia. 2. hypothyroidism. 3. grand mal seizure. 4. delirium. 5. atrial fibrillation. 6. supraventricular tachycardia status post ablation. 7. multiple sclerosis. 8. myasthenia . 9. migraines. 10. hypertension. 11. hypercholesterolemia. 12. depression. 13. alcoholism. discharge instructions: the patient instructed to follow-up with her caregivers following her stay at . these include: 1. neurologist, at . 2. follow-up with cardiology, , at . 3. device clinic; she has an appointment on at 01:30 p.m. 4. primary care physician, . , at . discharge medications: 1. warfarin 5 mg p.o. q. day. 2. famotidine 20 mg p.o. twice a day. 3. diltiazem 30 mg p.o. four times a day. 4. oxybutynin 5 mg p.o. twice a day. 5. phenytoin 100 mg p.o. three times a day. 6. folic acid 1 mg p.o. q. day. 7. thiamine 100 mg p.o. q. day. 8. tylenol p.r.n. 9. multivitamin one capsule p.o. q. day. 10. atorvastatin 40 mg p.o. q. day. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours spinal tap incision of lung insertion of endotracheal tube initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle pulmonary artery wedge monitoring diagnoses: mitral valve disorders congestive heart failure, unspecified atrial fibrillation other convulsions pulmonary collapse acute respiratory failure sinoatrial node dysfunction multiple sclerosis 

Answer: The patient is high likely exposed to