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: sulfa (sulfonamides) attending: chief complaint: syncope major surgical or invasive procedure: bronchoscopy right ij line arterial line intubation history of present illness: 55yof with metastatic breast ca (mets to bone, cns) p/w syncope today. patient stepped out of car and was walking to her front door with her dtr and felt lh and ? palpitations and "blacked out." noted that she remembered her eyes going "black" and her legs giving out. did not remember hitting the ground. she fell forward and hit the front of her head. + loc x 5 minutes. ? "shaking" seen by her dtr. bit her tongue. dtr noted eyes deviated upward. no convincing post-itcal state per dtr and pt. no urinary or bladder incontinence. + feelings of near-syncope x weeks -> reports that she generally feels unsteady. sits on edge of bed x15 minutes before getting up. denies vertigo, positional nausea. also c/o increasing + doe x weeks (cta chest on showed small pulm embolus, decision made to not anti-coag). denies cp, n/v/d/abd pain. + constipation, + low grade temp, 100.0, 3 days ago. no cough, no dysuria. no changes in medication, states she has been taking her meds. past medical history: 1. breast cancer- extensive history. pt was diagnosed in at whihc time she was treated with a lumpectomy, chemotherapy, and radiation. her tumor was er positive and her2 negative. in , the pt was found to have mets to the l spine which were treated with radiation therapy. in , the pt developed vertigo, headache, decreased hearing on the left, tinnitus, and diplopia. she was found to have adenocarcinoma in the csf. mri of the brain was significant for meningeal enhancement but no parenchymal lesions. an ommaya shunt was subsequently placed in and was treated with three cycles of intrathecal doxil. pt also had ten rounds of whole brain radiation. pt's chemotherapy has recently been switched to velban which she last received on . 2. pe seen on cta on - acute right sub segemental in the lower lobe on cta obtained by pt's oncologist. she was not started on anticoagulation given the small infarct size and her thrombocytopenia. 3. thrombocytopenia 4. crohn's disease social history: college graduate. she is divorced and has 2 daughters. she is a social smoker for 5 years. she does not drink. she did smoke some pot some time ago. family history: mother died at 56 of non-hodgkin's lymphoma. father died at 54 of mild myelodysplasia. sister died at 41 of non-hodgkin's lymphoma. she has two daughters, 30 and 34, in good health. physical exam: vs 98.9 151/74 88 20 94% 2l and 89% ra; orthostatics = gen: well appearing although clearly dyspneic during exam, in nad heent: wearing patch over l eye. perrl, unable to abduct l eye. no papilledema noted on fundoscopic exam. 6 cm jvp. no lad cv: regular s1,s2. no m/r/g chest: lca b/l abd: +bs. soft. nt. nd. extr: 2+ le edema. no clubbing cyanosis. neuro: alert and oriented x3. cn iii-xii intact 2+ biceps dtrs 1+ patellar dtrs ankle jerks absent downgoing toes b/l le strength b/l ue strength b/l sensation intact to lt touch over lower ext, incl l5 pertinent results: 11:50am blood wbc-7.0 rbc-4.00* hgb-11.7* hct-35.4* mcv-89 mch-29.2 mchc-33.0 rdw-21.0* plt ct-17*# 09:26pm blood wbc-4.3 rbc-3.36* hgb-10.2* hct-29.7* mcv-88 mch-30.4 mchc-34.5 rdw-21.6* plt ct-23* 03:10am blood wbc-9.6# rbc-2.82* hgb-8.7* hct-24.7* mcv-88 mch-30.7 mchc-35.1* rdw-23.7* plt ct-52* 03:10am blood neuts-43* bands-5 lymphs-41 monos-7 eos-0 baso-0 atyps-1* metas-2* myelos-1* nrbc-37* 11:50am blood plt ct-17*# 03:10am blood plt smr-very low plt ct-52* 10:10am blood fibrino-313 d-dimer-3713* 11:24pm blood fdp-160-320* 11:50am blood urean-23* creat-0.9 na-143 k-3.9 cl-107 hco3-22 angap-18 03:10am blood glucose-137* urean-35* creat-1.1 na-147* k-3.8 cl-113* hco3-16* angap-22* 05:30pm blood alt-128* ast-246* ld(ldh)-3090* alkphos-307* amylase-56 totbili-1.2 05:57pm blood ck-mb-5 ctropnt-0.18* 11:24pm blood ck-mb-5 ctropnt-0.34* 03:10am blood ck-mb-6 ctropnt-0.28* 11:50am blood albumin-3.9 calcium-9.3 phos-3.7 mg-1.9 03:10am blood cortsol-9.5 06:35am blood type-art po2-35* pco2-33* ph-7.41 calhco3-22 base xs--2 03:39am blood type-art temp-35.9 rates-16/10 tidal v-500 peep-5 fio2-50 po2-75* pco2-25* ph-7.46* calhco3-18* base xs--3 -assist/con intubat-intubated 06:35am blood lactate-2.2* 03:41am blood lactate-4.9* 03:41am blood o2 sat-45 12:37am blood freeca-1.09* . cxr ()- cardiac and mediastinal contours are stable. interval increase in pulmonary vascular congestion and upper zone vascular redistribution consistent with mild pulmonary edema. no pleural effusions or pneumothorax. . cta ()- remains a subcentimeter potential filling defect in a segmental branch to the right lower lobe medially. new, major finding is the interval developement of multifocal areas of angiocentric ground glass attenuation predominantly in the upper lobes and is most probably the cause of the current hypoxia. differential includes developing alveolar hemorrhage in the setting of thrombocytopenia and alveolitis. number of ovoid hypodense lesions are visualized in the included portion of the superior right lobe of the liver strongly suspicious for mets. multifocal sclerotic bony mets in the included axial and extra axial skeleton. . bilateral le us ()- no evidence of acute or chronic dvt from the common femoral through to the proximal tibial veins. . eeg ()- largely normal eeg in the waking state. no areas of persistent focal slowing and no epileptiform features. . mri ()- leptomeningeal deposit seen in the right high anterior frontal region and positive enhancement in the posterior portion of the right occipital . these are new findings from the mri on . no intraxial lesions were seen. slight enlargement of the ventricles. no significant mass effect or edema. right frontal ommaya in place. . . ecg- sinus tachycardia at 102 beats per minute. no st-t wave changes from prior studies. brief hospital course: 55 y/o female with pmh significant for metastatic breast ca, pe by cta on , and thrombocytopenia transferred originally admitted after a syncopal episode and later transferred to the for hypoxia. pt was admitted to on following a five minute episode of loc. on the day of admission, the pt had come in for blood work. when she arrived home, she became "heavy headed" and felt as if she was going to loose consciousness when she got out of the car. she felt her knees buckling and herself falling but cannot remember anything after this. her daughter was present and notes that the pt fell forward, hit her head on the ground, and her eyes "rolled back" in her head. the daughter noted rhythmic, low amplitude shaking movements of the upper extremities for two to five minutes with associated tongue biting. no urinary incontinence. pt was able to answer questions upon regaining consciousness and was back to her baseline shortly. in the ed, the pt's vs were 98.9 151/94 88 20 94% ra. pt had a head ct which was negative for any acute process. neurology was consulted and the pt was seen on the floor by her neuro oncologist dr. . given the negative eeg and mri, it was felt that the pt had most probably not had a seizure. her symptoms were contributed to progression of her disease. she described having presyncopal symptoms over the past month. . pt's hypoxia and increasing doe were also evaluated. pt had a cta which was significant for interval development of multifocal areas of angiocentric ground glass attenuation predominantly in the upper lobes. no progression of her pe or further clot was visualized. a pulmonary consult was obtained on . there was a concern for pcp and the pt was taken for a bronch on . the bronch was significant for petechia in the airways. lavage revealed some blood tinged fluid but no franc blood. following this procedure, she was started on treatment for possible pcp. . upon return to the floor after the bronch, the pt was noted to have increasing respiratory distress. her sat was 88% on 6l nc (had been 92% on 4l nc). pt was placed on a 7l face mask with an increase in her oxygen saturations to 90-93%. pt was noted to be tachypneic at 40-50 breaths per minute and tachycardic at around 110. she was given 40 mg iv lasix after which she put out 1200 cc of urine in 30 minutes. she also noted chest pain which had been present since morning. an ecg was checked but there were no changes. cxr was obtained and showed an increase in bilateral fluffy infiltrates. abg was 7.52/26/57. the was called at this time and the decision was made to transfer the pt to the unit. upon arrival in the unit, the pt was noted to be becoming increasingly somnolent and she continued to be tachypneic. there was concern that the pt was tiring and the decision was made to proceed with intubation. this was done then a right ij line was placed under us guidance for additional access. she was started on broad spectrum antibiotics including fungal coverage and stress dose steroids to treat for sepsis given her hypotension and elevated lactate. despite fluid boluses, she remained hypotensive and was started on pressors with sbps back up to the high 90's to low 100's. it was reconfirmed with the patient's daughter that she was dnr/dni. patient became more hypotensive and rapidly became bradycardic to the 30's and died on . . discharge disposition: expired discharge diagnosis: metastatic breast cancer discharge condition: expired discharge instructions: none followup instructions: none procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube closed [endoscopic] biopsy of bronchus transfusion of packed cells diagnoses: thrombocytopenia, unspecified malignant neoplasm of liver, secondary personal history of malignant neoplasm of breast hypoxemia secondary malignant neoplasm of bone and bone marrow secondary malignant neoplasm of other parts of nervous system 

Answer: The patient is high likely exposed to