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: hydralazine attending: chief complaint: retroperitoneal bleed major surgical or invasive procedure: pfo repair history of present illness: 53 year old hatian creole spaaeking woman s/p percutaneous pfo repair by dr. on complicated by retroperitoneal bleed and new onset a-fib. for a full hpi please see h&p from vascualr surgery . briefly mrs. underwent percutaneous pfo closure on and was discharged on therapeutic lovenox and plavix. the morning of she felt lightheaded and weak and presented to an osh where she was noted to have a hct of 16 and evidence of an rp bleed. she was transfused 1 unit prbcs and transferred to . she was admitted to the cvicu where she was stabilized with ivf, 8 units prbc and 6 u plts. her hematocrit responded appropriately and stabilized around 26-27. he lovenox and plavix has been dc'd. she is currently on asa. on she was noted to be in a-fib which is new for her. she was seen by cardiology who recommended amiodarone which converted her rhythm back to nsr. she has been in nsr since 2am on . on transfer to her vitals were: t99.3 hr 94 (nsr), bp 166/66, rr 30 o2sat 98% on 3l o2. her i/o status is +2.3l from admission. she curently denies any cp, abd pain, le edema or pain. she says that her breathing has improved. past medical history: - prior cva p/w with l arm weakness now resolved. though from pfo. - h/o pfo now s/p percutaneous repair, for hope to come off warfarin - htn - hypercholesterolemia - vitreal bleed secondary to coumadin therapy - h/o colonic polyp - mild diverticulosis - gerd - cataract surgery - ? hysterectomy social history: absence of tobacco, alcohol, illicit drug use. she is a homemaker. physical exam: admision exam t99.3 hr 94 (nsr), bp 166/66, rr 30 o2sat 98% on 3l o2. gen: hatian creole (no english) speaking woman in nad. heent: eomi perrl mmm neck: jvd at 10 cm pulm: diminished lung sounds from bases to mid lung fields r>l, no obvious wheezing cv: rrr 2/6 sem rusb, no r/g abd: obese, soft, 5-8 cm ecchymoses over r flank, large ecchymosis over r groin ext: no cce pulses: 2+ dp pulses . discharge exam vs: t 97-100.3 bp 100-125/60-81 hr 60-85 rr 20-30 o2 sat 94% 2l i/o: -1100cc/24 hours gen: nad, sitting up in bed heent: mmm, midline tongue, perrl, eomi heart: rrr, grade 2 systolic murmur heard best at 2ics, no radiation lung: decreased breath sound on the right, fine crackles at right lung base, no wheeze or rhonchi abd: soft, nontender, distended, +bs, no mass palpated ext: warm, nontender, no pitting edema, peripheral pulse 2+ bilaterally neuro: a/ox3, non focal pertinent results: admission labs 05:40pm wbc-18.1* rbc-2.63* hgb-7.6* hct-21.3*# mcv-81* mch-28.9 mchc-35.8* rdw-16.1* 05:40pm neuts-87.2* lymphs-10.6* monos-1.9* eos-0.1 basos-0.2 05:40pm plt count-157 05:40pm pt-12.5 ptt-45.8* inr(pt)-1.1 06:05am urea n-14 creat-0.7 sodium-141 potassium-3.4 chloride-106 06:05am ck-mb-4 . discharge labs 10:30am blood wbc-16.3* rbc-3.28* hgb-9.7* hct-28.9* mcv-88 mch-29.4 mchc-33.4 rdw-17.0* plt ct-445* 10:30am blood plt ct-445* 06:14am blood ret aut-4.8* 10:30am blood glucose-136* urean-29* creat-1.1 na-137 k-3.7 cl-95* hco3-34* angap-12 10:30am blood calcium-10.1 phos-2.3* mg-2.1 . relevant studies cxr (): cardiomediastinal contours are unchanged with stable cardiomegaly. vascular congestion has resolved. small right pleural effusion is unchanged. right lower lobe collapse has improved. the left lung is clear. there is no pneumothorax. . tte (): a septal occluder device is seen across the interatrial septum. left ventricular wall thicknesses and cavity size are normal. left ventricular systolic function is hyperdynamic (ef>75%). right ventricular chamber size and free wall motion are normal. there is moderate pulmonary artery systolic hypertension. there is a very small circumferential pericardial effusion. compared with the prior study (images reviewed) of , biventricular systolic function is now more dynamic and the heart rate is higher. the pericardial effusion is similar. a right pleural effusion is now seen (not specifically examined for in the prior study). . ct abdomen (): 1. 16.7-cm right retroperitoneal hematoma with hematocrit level and layering hyperdensity suggests active extravasation with peripheral stranding superiorly adjacent to the right kidney and extending into the right groin without direct relationship to the right iliac/femoral vessels. trace fluid is also seen adjacent to the duodenum in the retroperitoneal space. 2. small pericardial effusion, right greater than left small pleural effusions, small free pelvic fluid and trace perihepatic fluid. 3. stranding in the left lower pelvis/groin soft tissues could reflect small hematoma. . ct pelvis (): 1. 16.7-cm right retroperitoneal hematoma with hematocrit level and layering hyperdensity suggests active extravasation with peripheral stranding superiorly adjacent to the right kidney and extending into the right groin without direct relationship to the right iliac/femoral vessels. trace fluid is also seen adjacent to the duodenum in the retroperitoneal space. 2. small pericardial effusion, right greater than left small pleural effusions, small free pelvic fluid and trace perihepatic fluid. 3. stranding in the left lower pelvis/groin soft tissues could reflect small hematoma. brief hospital course: primary reason for admission: this is a 56 yo haitian creole speaking female s/p percutaneous pfo repair, presented 2 days post-op with dizziness and was found to have a retroperitoneal bleed likely a complication from the procedure. . active issues # retroperitoneal bleed this is likely a complication of percutaneous pfo repair on . patient presented with a hct of 15.4, hypotension and dizziness. patient was admitted to cvicu. initially, patient's hct responded to the transfusion but not as robust as expected, suggesting persistent slow bleeding. patient was seen by cardiology and surgery, and decision was made to treat medically. antiplatelet treatments were held initially except for aspirin, which was started at 81 mg, but later increased to 162 mg daily. patient received a total of 8 units of rbc and 15 units of platelets. her hct was steadily slowing trending up during the last 72 hours prior to discharge. outpatient issues: - discontinued clopidogrel, enoxaparin - please stop taking olmesartan-hydrochlorothiazide until further discussion with dr. . . # a-fib. patient was found to have new onset atrial fibrillation while in the cvicu. she was initiated on amiodarone and converted successfully. cardiology was consulted. patient remained in normal sinus rhythm throughout the rest of hospitalization. outpatient issues: - started amiodarone 200 mg qd. - started metoprolol xl 100 mg qd . # pulmonary edema after transfer out of the cvicu, patient was found to have increased respiratory distress and tachypnea. she was found to be pulmonary edema based on physical exam and chest x-ray findings. she was transferred to ccu, and received lasix drip for diuresis. patient improved shortly after the initiation of diuresis and was able to maintain o2 saturation in high 90s during ambulation. her drip was weaned and she was maintained on iv lasix with good uop and transitioned to po for discharge. outpatient issues: - started furosemide 40 mg po daily - started spirolactone 12.5 mg po daily . # acute renal failure patient's baseline cr was normal. during this hospitalization, increase of cr to ~1.5 was seen twice, like a result of prerenal hypovolemia in the setting of active bleed. her acute renal insufficiency resolved with adequate transfusion. . # hypotension/hypertension patient has a documented history of hypertension. on admission she was found to be hypotensive given significant hct drop secondary to rp bleed. we held her blood pressure medication initially. after active bleeding resolved, her blood pressure improved. we started her on losartan before discharge, but continued to hold hydrochlorothiazide given active diuresis. outpatient issues: - discontinued olmesartan, hctz; and started losartan 25 mg daily. . # leukocytosis. patient's wbc was elevated throughout this hospitalization, although she remained afebrile throughout this admission. the leukocytosis was felt most like secondary to the rp bleed, but urine culture later grew enterobacter cloace and klebsiella pneumoniae. she was treated with ciproflaxacin for 7 days in the setting of complicated uti (foley associated). her chest x-ray did not show evidence of pneumonia, and her blood culture remained negative to date. outpatient issues - started ciprofloxacin 500 mg for a total of 7 days . chronic issues patient has a documented history of gerd and hypercholesterolemia, both of which remained stable during this admission. . transitional issues - patient maintained a full code during this admission. - patient has followup appointment with dr. and dr. . - patient was instructed to get cbc and chem10 prior to her followup appointment. medications on admission: medications prior to admission: clopidogrel 75 mg enoxaparin 80 mg olmesartan-hydrochlorothiazide 20/12.5 mg potassium chloride 40 meq simvastatin 40 mg aspirin 325 mg discharge medications: 1. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 2. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 3. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 4. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 4 days. disp:*9 tablet(s)* refills:*0* 5. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 6. metoprolol succinate 100 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. disp:*30 tablet extended release 24 hr(s)* refills:*2* 7. losartan 25 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. outpatient lab work please obtain cbc and chem10 discharge disposition: home discharge diagnosis: primary diagnosis patent foramum ovale retroperitoneal bleed pulmonary edema secondary diagnosis hypertension hyperlipidemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms , you came to our hospital for an elective repair of a defect in your heart. you surgery was successfully performed. however, later there was evidence that you had a bleed into the back of your belly from the procedure. because of that, you received a total of 8 units of red blood cells and 15 units of platelets. the multiple transfusion also lead to accumulation of fluid in your lung. you were treated in our cardiac critical care unit for diuresis. you blood count was finally stable, and your breathing improved significantly as well. at this point, we thought that you are stable enough to go home to continue your recovery. please note that the following medications have been changed. - please stop taking clopidogrel until further discussion with dr. . - please stop taking olmesartan-hydrochlorothiazide until further discussion with dr. . - please stop taking enoxaparin until further discussion with dr. . - please stop taking potassium chloride until further discussion with dr. . - please start taking amiodarone 200 mg orally daily - please start taking furosemide 40 mg orally daily - please start taking losartan 25 mg orally daily - please start taking metoprolol 100 mg orally daily - please start taking ciprofloxacin 500 mg orally twice day for another 4 days (finish on ) you will need follow up appointments with dr. and dr. . unfortunately, we could not get the appointments for you on the weekend. we will set up the appointment for you on monday, and let you know early this week. in the meantime, it will be helpful for your doctor if you could measure your daily weight and blood pressure, document them and bring them to your doctor's appointment. it has been a privilege to take care of you here at . we wish you have a speedy recovery. followup instructions: patient will need follow up appointment with dr. and dr. . appointments will be set up on monday. patient should receive phone call early next week about her appointment. md, procedure: other incision of skin and subcutaneous tissue diagnoses: esophageal reflux unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation other and unspecified hyperlipidemia hemorrhage complicating a procedure ostium secundum type atrial septal defect other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation leukocytosis, unspecified 

Answer: The patient is high likely exposed to