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: sulfonamides / iodine; iodine containing / levofloxacin attending: chief complaint: bilateral lower extremity and abdominal petechiae/ecchymoses, recent onset right low back pain, and increasing weakness. major surgical or invasive procedure: central line placement. history of present illness: the pt. is a 56 year-old female with metastatic breast cancer who presented with bilateral lower extremity and abdominal petechiae/ecchymoses, recent onset right low back pain, and increasing weakness. the patient stated that she began to develop low back pain on the right approximately seven days pta. she described the pain as dull in quality, constantly present, and has not increased in severity since the time of onset. there is no history of trauma to the area. she also noted petechiae over her abdomen and lower extremities for the past two days pta. she has never experienced this in the past. the pt. also complained of increasing weakness for the past week pta. she stated that she has found it difficult to get out of bed and is able to walk without assistance. she noted that the weakness has been progressive since onset. she added that the weakness is generalized. the patient was seen by vna who noticed petechiae and advised the patient to see her oncologist who sent her to the ed. on review of systems, the patient denied recent fever, chills, shortness of breath, chest pain or pressure, n/v/d, constipation, abdominal pain, brbpr, hematuria, dysuria, arthralgias, or myalgias. she denied headache, visual changes, sensory disturbances, imbalance. she did admit to diffuse weakness, but not in any one particular area. she has had no recent change in her appetite. she did admit to one episode of lightheadedness on the morning of admission after urinating. she did not experience loc or fall. this has not recurred. in the ed, the patient was found to have a low hematocrit and platelet count. she received one liter of normal saline. in addition, the patient was discovered to be hypoxemic to 89% on room air. a v/q scan was performed, as was a ct of the torso. oncologic hx: the pt. was first diagnosed with breast cancer in status post right mastectomy, chemotherapy, radiation, autologous marrow transplant in . she has metastatic lesions to , liver, and lungs. she has recently discontinued from zometa because of elevated creatinine, metastasis to the , liver, and lung. hospitalized in , with dizziness for five days and slurred speech. mri showed cerebellar and pituitary lesions, which were felt to be metastasis from her breast primary. neurosurgery felt that given the patient's poor prognosis, aggressive measures were not indicated. the patient was started on temodar with whole brain radiation. she did whole brain radiation from to . recently tapered down on her decadron over concern for developing myopathy. repeat mri on showed substantial but incomplete regression of cerebellar and pituitary metastases with leptomeningeal enhancement. past medical history: 1. metastatic breast cancer first diagnosed in status post r mastectomy, chemotherapy, radiation, auto marrow transplant in , metastatic to , , liver, and lungs. s/p xeloda toxicity, was recently stopped from zometa elevated creatinine. 2. anemia of chronic disease, baseline hct in mid-30's 3. status post tram flap 4. h/o lue dvt in setting of picc line, was not anticoagulated 5. vt arrest, felt prolonged qt in setting of levaquin 6. herpes zoster 7. polio: as child, no residual neurologic deficits social history: she lives alone in , has part-time aid. she is a graphic designer. nonsmoker, occasional alcohol use, no other drug use. family history: grandmother with breast cancer. father with parkinson's disease and a stroke. physical exam: vitals: t: 98.9f p: 103 r: 20 bp: 123/65 sao2: 89% ra -> 94% on 3l nc general: awake, alert, nad. heent: nc/at, perrl, eomi without nystagmus, no scleral icterus noted, mm dry, no lesions noted in op neck: supple, no jvd or carotid bruits appreciated pulmonary: lungs cta bilaterally without r/r/w cardiac: tachycardic, rr, nl. s1s2, no m/r/g noted abdomen: soft, mimimal tenderness in llq without rebound or guarding, normoactive bowel sounds, no masses or organomegaly noted. back: no spinal or cva tenderness, no grey- sign bilaterally extremities: trace pitting edema of le bilaterally, 2+ radial, dp and pt pulses b/l. lymphatics: no cervical, supraclavicular, axillary or inguinal lymphadenopathy noted. skin: scattered petechiae over abdomen and le with small ecchymoses located over le bilaterally. rectal: guaiac negative per ed note neurologic: -mental status: alert, oriented x 3. able to relate history without difficulty. -cranial nerves: ii-xii intact -motor: normal bulk and tone throughout. no abnormal movements noted. strength delt. tri wr ext io ip quad ham ta r: 5 5 5 5 5 4+ 5 5 5 5 5 l: 5 5 5 5 5 4 4 4 5 5 5 -sensory: no deficits to light touch throughout. -cerebellar: no nystagmus, dysarthria, dysdiadochokinesia noted. fnf and hks wnl with subtle dysmetria bilaterally. -dtrs: 2+ biceps, triceps, brachioradialis, patellar and 1+ ankle jerks bilaterally. plantar response was equivocal bilaterally. pertinent results: labs on admission: 12:40pm wbc-2.3* rbc-1.61*# hgb-5.8*# hct-18.4*# mcv-114*# mch-36.2*# mchc-31.7 rdw-19.2* 12:40pm plt smr-very low plt count-44* 12:40pm neuts-81* bands-4 lymphs-5* monos-7 eos-0 basos-0 atyps-0 metas-2* myelos-1* nuc rbcs-27* 12:40pm pt-13.2 ptt-21.5* inr(pt)-1.1 12:40pm glucose-87 urea n-19 creat-1.1 sodium-139 potassium-4.1 chloride-104 total co2-23 anion gap-16 12:40pm d-dimer-6812* 03:50pm urine color-straw appear-clear sp -1.004 03:50pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.0 leuk-neg micro data: blood cx 4/4 bottles no growth urine cx mixed flora blood cx 4/4 bottles positive mssa blood cx 2/4 bottles positive mssa fungal pending and one with mssa blood cx 4/4 bottles no growth blood cx 4/4 bottles no growth ct torso : impression: 1) small scattered bilateral pulmonary nodules, which are less prominent than in . 2) bilateral pleural effusions, greater on the right. 3) innumerable hepatic metastasis. 4) prominent retroperitoneal lymph nodes. no evidence of retroperitoneal hematoma. 5) likely right renal cyst. 6) diffuse osseous metastatic disease. v/q scan : matched abnormalities at the right lung base are compatible with the chest x-ray findings. although there are no findings particularly suggestive of pulmonary embolism; pulmonary embolism in this location cannot beruled out. cxr : 1. small bilateral pleural effusions. 2. diffuse osseous metastatic disease le dopplers : 1. occlusive thrombus in the right popliteal vein and nonocclusive eccentric thrombus in the right superficial femoral vein. 2. findings suggestive of a nonocclusive thrombus in the left superficial femoral vein. left popliteal vein not evaluated. ct abdomen/pelvis : 1) no evidence of functional bowel obstruction or perforation. 2) unchanged appearance of innumerable hepatic metastases, retroperitoneal lymph node enlargement, and stranding at the root of the mesentery. 3) diffuse subcutaneous edema and new small amounts of indeterminant fluid in the pelvis, and thickening of the gallbladder wall without focal inflammatory change. the gallbladder is not overly distended, and there is no definite evidence of acute cholecystitis. the findings are likely due to fluid overload/third spacing, possibly secondary to hypoalbunemia given the patient's underlying hepatic metastases. 4) worsening bilateral lower lobe consolidations. echo : left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. ruq us : no evidence for cholecystitis, or intrahepatic or extrahepatic biliary ductal dilatation. cxr : unchanged appearance of the chest with extensive predominantly basilar opacities with probable bilateral pleural effusions. brief hospital course: 56 year-old female with metastatic breast cancer who initially presented on with c/o bilateral lower extremity and abdominal petechiae/ecchymoses, about 7 day h/o right low back pain, and increasing weakness. in the ed, the patient was found to have a low hematocrit and platelet count. she received one liter of normal saline. in addition, the patient was hypoxemic with oxygen sats to 89% on room air. a v/q scan was performed and was indeterminate. ct of the torso showed progression of metastatic disease in liver, rp, and abdomen. her lower back pain was thought to be associated with malignancy. patient also noted to have pancytopenia ( presumably related to bm suppression/infiltration of marrow by mets). she was given 2 units prbcs for hct 20. on she was noted to have left-sided pleuritic cp. ekg showed sinus tachycardia. cardiac enzymes were negative. lenis (patient with dye allergy) showed r popliteal occlusive dvt, r sfv non-occlusive dvt and l sfv non-occlusive dvt. anti-coagulation was held in setting of brain metastases and thrombocytopenia. later that evening, she spiked to 101.6. she also complained of increased abdominal pain and was noted to have abdominal distension. kub showed probable psbo with distended loops of small bowel. ngt was placed. at 9pm, patient noted to have sbp 60-80's. she was given 2 l ivf (ns) boluses and sent to micu for further care. from 2pm on, patient in sinus tachy 120-130's. also uop decreased to 100cc over 6hrs. micu course ( - ): blood cultures 4/17 and returned + for g+ cocci (6/6 bottles). the source of bacteremia was not clear. urine culture with mixed flora. the patient was started on vancomycin and zosyn. when the cultures returned with g+ cocci zosyn was discontinued. cxr did not show new infiltrate. the patient had rij line but was bacteremic before line was placed. line was removed on . ct abd/pelvis were done and did not confirm obstruction. per discussion with attending, the patient's code status was changed to dnr, dni and the patient was transferred back to the floor on . the patient was continued on vancomycin which was then changed to oxacillin when the sensitivities results came back. the patient had an episode of acute onset of shortness of breath associated with tachycardia, increased oxygen requirements that was followed by anxiety/agitation that was controlled with ativan. diagnostic investigations were limited by patient having a h/o allergy to contrast. however, given clinical scenario and known le dvt, it was felt that the patient likely did have a pe. given the patient's poor prognosis, limited life expectancy, known brain mets and pancytopenia, the goal of care were readdressed with the family. the goals of care were changed to comfort care only. the patient was started on morphine drip and ativan for comfort. she was initially continued on her other medications to increase the chance for her family to get in town. while her cousins and other family members arrived, antibiotics and other medications were discontinued. the patient expired on . the family declined autopsy. medications on admission: -synthroid 75 mcg alt with 50 mcg daily -ddavp 50 mcg every other day -colace 100mg po tid -decadron 2 mg po bid -senna 2tabs po bid -protonix 40mg po bid -reglan 40mg po bid -dapsone 100mg po daily -glipizide 2.5mg po once daily -mvi 1tab po daily discharge disposition: extended care discharge diagnosis: 1. metastatic breast cancer 2. bacteremia 3. deep vein thrombosis discharge condition: expired procedure: venous catheterization, not elsewhere classified diagnoses: malignant neoplasm of liver, secondary unspecified pleural effusion personal history of malignant neoplasm of breast bone marrow replaced by transplant secondary malignant neoplasm of brain and spinal cord unspecified disorder of kidney and ureter secondary malignant neoplasm of lung secondary malignant neoplasm of bone and bone marrow diabetes insipidus 

Answer: The patient is high likely exposed to