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: penicillins / aspirin / strawberry / canned tuna attending: chief complaint: chest pain major surgical or invasive procedure: pericardial window and pericardial biopsy history of present illness: ms. is a 64 yo female with a recent admission for posterior pericardial effusion () who presented with a 5 day history of left-sided chest pain. per recent cardiology clinic notes earlier this month, recent right heart cath did not show tamponade. she was discharged from the hospital with the plan for monitoring with serial echos. unfortunately due to allergic reactions to asa and nsaids, anti-inflammatory agents could not be used, and she was started on sole colchicine therapy. steroid therapy was deferred due to the concern for increased recurrence on lone colchicine. she reported to the ed today with 5 days left-sided chest pain. she reports chest pain is getting worse relative to her prior admission on . her pain is pleuritic in nature with deep inspiration and also has a sensation that she cannot take a full breath. she reports mild nausea without emesis. denies fever/chills/diarrhea. denies headache. per ed examination, the patient appeared mildly uncomfortable and anxious with notable tachycardia and tachypnea. faint crackles in the lower lung fields bilaterally. initial vitals were t99.8 hr 131 bp 106/57 rr16 98% and orally reported pulsus of 10. on ekg, she had sinus tachycardia at a rate of 130, with low voltage, and no ste's. bedside ultrasound at that time showed a pericardial effusion without evidence of tamponade. labs showed a leukocytosis of 11.4 without bandemia, and otherwise cmp showed a hemolyzed specimen without any other electrolytes imbalances. cxr showed poor inflation of the lungs with enlarged heart borders consistent with her pericardial efussion. left lower lobe opacity suggestive of efussion and questionable hiatal hernia. transferred to the ccu for further monitoring and probable pericardiocentesis in the am. on transfer bp were 98/60 and patient was tachycardic in the 110's. in the icu, patient is anxious about her procedure tomorrow requesting what time she will have her pericardiocentesis and who will be doing it. she refuses to comply with history and physical exam, saying she is anxious and wants to sleep. past medical history: pericardial effusion dm2 dyslipidemia hypothyroidism x13yrs vocal cord polyp , chronic urticaria social history: lives with her son, , in , ma (one drive hour away). originally from morocoo. primarily speaks french and arabic; understands and speaks some english. smoked 2ppd x 22y, quit in . no etoh. no ivda. family history: no early mi, cmp, arryhthmias, pericardial effusions. physical exam: admission pe: vs: bp=117/67, hr=127, rr=24, o2 sat=100% general: mildly uncomfortable, lying to her side. oriented x3. mood is agitated anxious. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. patient refused rest of phyiscal exam. discharge pe: vitals: 97.5, 124/78, 98, 18, 96 i/o:+1180/-900 general: lying in bed in nad, a&ox3 neck: supple with jvp of 9 cm. cardiac: regular, rate in low 100s, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: reccent surgical incision below l breast dry, non-errythematous, small amount of granulation tiusse, with palpable mass in breast tissue. lungs: respirations were unlabored, no accessory muscle use. ctab, bibasilar rales stable abdomen: soft, ntnd. extremities: trace le edema bilaterally neuro: no gross deficits pertinent results: admission labs 12:25pm blood wbc-11.4*# rbc-4.58 hgb-13.5 hct-40.7 mcv-89 mch-29.4 mchc-33.1 rdw-13.2 plt ct-336 12:25pm blood neuts-79.7* lymphs-14.3* monos-5.5 eos-0.2 baso-0.3 12:25pm blood pt-12.0 ptt-28.3 inr(pt)-1.1 12:25pm blood glucose-136* urean-12 creat-0.8 na-135 k-5.8* cl-97 hco3-25 angap-19 12:28pm blood lactate-1.9 k-4.0 : 12:45pm blood vitb12-180* 12:45pm blood %hba1c-5.8 eag-120 06:10am blood tsh-3.2 06:10am blood free t4-1.3 05:40am blood crp-47.1* 06:10am blood dsdna-negative 06:10am blood -negative 06:10am blood rheufac-11 06:10am blood c3-182* c4-36 discharge labs: 08:05am blood wbc-7.7 rbc-4.00* hgb-11.6* hct-35.9* mcv-90 mch-29.0 mchc-32.3 rdw-13.7 plt ct-442* 08:05am blood pt-11.7 ptt-29.4 inr(pt)-1.1 08:05am blood glucose-99 urean-11 creat-0.4 na-140 k-4.1 cl-102 hco3-27 angap-15 08:05am blood alt-43* ast-27 ld(ldh)-151 alkphos-166* totbili-0.3 08:05am blood calcium-8.8 phos-3.6 mg-2.1 ================================= tee: pre-procedure: no spontaneous echo contrast is seen in the left atrial appendage. overall left ventricular systolic function is normal (lvef>55%). with normal free wall contractility. the ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is a moderate sized pericardial effusion with a great deal of echo dense material, most likely clot around the ra and rv. the effusion itself measures from 1 to 2.5 cm in various locations, but the supposed clot measures up to 3.5 cm across. post-procedure: there is a reduction in fluid anteriorly, but inferiorly and laterally there is little change. moreover, the gelatinous material associated with the rv and ra is little changed. ================================= tte: compared with the prior study (images reviewed) of , the effusion appears similar to slightly smaller in size and may be slightly more echo dense and organized. the effusion is echo dense, consistent with partial organization. cannot exclude mild right ventricular compression apically.the pericardium may be thickened. there are no echocardiographic signs of tamponade. ================================= pleural fluid: pleural analysis wbc rbc polys lymphs monos meso macro other 15:45 575* 3800* 25* 14* 0 14*1 46*2 1*3 -several reactive forms noted -activated forms and foamy histiocytes noted -atypical cells, refer to cytology pleural chemistry totprot glucose ld(ldh) amylase albumin 15:45 4.6 119 169 18 3.3 ================================= pericardial fluid: other body fluid analysis wbc rbc polys lymphs monos 18:48 111* * 86*1 13* 1* other body fluid chemistry totprot glucose ld(ldh) amylase albumin 18:43 5.4 26 3.4 ================================= pericardial tissue: , 3 specimens gram stain: no organisms, pmns (0+, 1+, 2+ for each specimen) koh: negative afb: negative ================================= pericardial fluid cytology: negative for malignant cells. scattered mesothelial cells. pleural fluid cytology: negative for malignant cells. reactive mesothelial cells, macrophages and lymphocytes pathology: 1. substance in pericardium (a): fibrin, blood and inflammatory cells. 2. pericardium: pericardial tissue with fibrinous exudate, fibrosis, hemorrhage with hemosiderin-laden macrophages and acute and chronic inflammation with granulation tissue. ================================= breast ultrasound: findings: limited son images were obtained of the left breast in the region of the patient's pain, which demonstrate no drainable fluid collection or mass. impression: limited study demonstrates no fluid collection to suggest abscess. if there is continued clinical concern for a palpable abnormality, followup with mammography and/or ultrasound is recommended in a dedicated breast imaging clinic. ================================= brief hospital course: 64 year-old female with pmh of diabetes mellitus, hyperlipidemia, and hypothyroidism presenting with chest pain and enlargement of pericardial effusion. active diagnoses: #pericardial effusion: pt presented with pericardial effusion larger than past admission . pericardiocentesis unsuccessful due to significant cell debris so pt taken for pericardial window with pericardial biopsy and removal of 1500cc of gelatinous fluid from the pericardial space. pt tolerated procedure well and remained hemodynamically stable in the cvicu. pt extubated on pod1, chest tube removed pod2 and transferred to the floor. no tamponade physiology during current or past admission. etiology of effusion was unclear. differential included post-viral, infectious (including tuberculosis in setting of recent travel to , as well as parasitic infections), autoimmune, malignancy, hypothyroidism. pericardial and pleural fluid cytology negative. allergy consult was obtained did not feel that her history of urticaria would be contributing to such a presentation. rheumatology consulted but no obvious systemic rheumatologic condition. screening labs including , rf, anti-ds-dna, tsh, complement levels wnl. pathology of pericardium and gelatinous pericardial fluid rather nonspecific showing fibrinous exudate, fibrosis, and acute and chronic inflammation. pt was sent to the ccu for aspirin desensitization. she tolerated it well without any complications. she was sent home on ibuprofen 800mg tid and asa 81 mg daily. # l breast tenderness and redness: pt developed l breast tenderness and redness at the inferior aspect of the left breast around the inframammary incision. the surgical team evaluated the pt and believed the symptoms were likely due to manipulation during surgery. the redness improved. # sinus tachycardia: pt runs in 100s per records, which continued during hospital course. chronic diagnoses: #hld: continue crestor #dm: iss transitioned to po metformin. pt stable on regimen. #hypothyroidism: continue levothyroxine 150mcg. tsh wnl. transitional issues: -continue workup for pericardiac effusion -patient has been desensitized to nsaids including aspirin -patient has follow up with allergy, rheumatology and cardiology with cardiac mr scheduled prior to cards follow up. -if mass in left breast does not resolve will need proper diagnostic mamography. medications on admission: 1. colchicine 0.6 mg po bid 2. crestor 10 mg po daily 3. synthroid 150 mcg po daily 4. zyrtec *nf* 10 mg oral prn seasonal allergies 5. metformin (glucophage) 500 mg po bid discharge medications: 1. colchicine 0.6 mg po bid 2. crestor 10 mg po daily 3. metformin (glucophage) 500 mg po bid 4. synthroid 150 mcg po daily 5. zyrtec *nf* 10 mg oral prn seasonal allergies 6. cane *nf* large base quad cane miscellaneous 1 rx *cane please use for ambulation 1 large based quad cane disp #*1 unit refills:*0 rx *cane please use for ambulation 1 large-based quad cane disp #*1 unit refills:*0 7. aspirin 81 mg po daily rx *adult low dose aspirin 81 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*5 8. docusate sodium 100 mg po bid rx *docusate sodium 100 mg 1 capsule(s) by mouth twice a day disp #*30 tablet refills:*0 9. ibuprofen 800 mg po q8h duration: 2 weeks rx *ibuprofen 800 mg 1 tablet(s) by mouth three times a day disp #*42 tablet refills:*0 10. oxycodone-acetaminophen (5mg-325mg) 1 tab po q6h:prn pain rx *percocet 5 mg-325 mg 1 tablet(s) by mouth three times a day disp #*33 tablet refills:*0 11. omeprazole 40 mg po daily rx *omeprazole 40 mg 1 capsule(s) by mouth daily disp #*14 tablet refills:*0 12. outpatient lab work please have liver function tests with albumin and bilirubin as well as well as creatinine and potassium checked in 1 week. results faxed to dr. at ( discharge disposition: home with service facility: all care vna of greater discharge diagnosis: primary diagnosis: pericardial effusion secondary diagnoses: hyperlipidemia hypothyroidism diabetes mellitus type ii (non-insulin dependent) discharge condition: clear and cohent. alert and interactive. ambulatory - requires minimus assistance. discharge instructions: dear ms. , it was a pleasure taking care of you at . you came into the hospital because of chest pain due to the fluid around your heart (called a pericardial effusion). you had to have surgery to remove some of this fluid. the cause of this fluid is still not clear, but tests have been sent off to try to find the cause. your heart doctor will follow-up on these results and share them with you. you were seen by our allergists and our rheumatologists to help diagnose this mystery. it was felt that you would benefit from several weeks of ibuprofen treatment and given your history of allergy were sent to the intensive care unit for a desensitization procedure. please have your blood work checked in 1 week, a prescription has been provided for you. several medications have been changed please refer to your medication list for the details of your medications. please make sure to keep your follow up appointments listed below. also you will need to have a follow up mri of your heart, please call 2 weeks prior to your appointment with dr. on to ensure it has been scheduled. please shower daily including washing incisions gently with mild soap, no baths or swimming. look at your incisions daily. please no lotions, cream, powder, or ointments to incisions. followup instructions: name: -,maysabel location: healthcare group address: , , , phone: when: wednesday, :30 pm *it is advised that you are also followed for wound care. please discuss this with your pcp. cardiac surgery: dr. tuesday, , 1:00pm medical office building department: echo lab when: wednesday at 1 pm with: echocardiogram building: gz building (felbeerg/ complex) campus: east best parking: main garage department: cardiac services when: wednesday at 3:00 pm with: , md building: sc clinical ctr campus: east best parking: garage department: div of allergy and inflam when: wednesday at 11:15 am with: , md building: one place (, ma) campus: off campus best parking: parking on site department: rheumatology when: thursday at 3:30 pm with: , md building: lm bldg () campus: west best parking: garage procedure: pericardiocentesis pericardiotomy diagnoses: diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism personal history of tobacco use need for desensitization to allergens other and unspecified hyperlipidemia other specified cardiac dysrhythmias nausea alone obesity, unspecified personal history of allergy to analgesic agent adhesive pericarditis tachypnea personal history of malignant neoplasm of larynx other specified urticaria personal history of allergy to penicillin body mass index 33.0-33.9, adult allergy to other foods 

Answer: The patient is high likely exposed to