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: is a 34-year-old african american female with a past medical history significant for a large saddle pulmonary embolus with paradoxical aortic arch embolus s/p embolectomy with patent foramen ovale closure approximately five weeks prior to the time of admission who presented with chest pain and shortness of breath on to the . the patient, as stated, had been admitted to the approximately five weeks prior to admission where she was found to have a massive pulmonary arch of the aorta. the patient underwent pfo closure and embolectomy and was intubated for approximately three days, status post surgery. the post surgical period was evidently complicated by patient noncompliance and although the plan was to begin the patient on coumadin at that time, she had left against medical advice from . at this admission, the patient complains of two weeks of worsening shortness of breath and chest pain. the patient states that she cannot finish a sentence or stand up without worsening dyspnea. the patient describes her chest pain as a " stabbing, burning pain, worsening with motion, nonradiating and alleviated with roxicet," which she has been taking for the ten days prior to admission. the patient did complain of a cough at the time of admission. the patient reports a temperature of 101.5 measured at home for the two days prior to admission with some nausea at home, however, the patient denied vomiting, diarrhea. she did complain of constipation. the patient had been using oral contraceptive pills prior to the time of admission to the which she had discontinued by the time of admission to the . the patient did state that she quit tobacco use approximately two weeks prior to admission. she denied cough/sputum/hemoptysis/leg sxs. past medical history: peptic ulcer disease, pulmonary embolus with patent foramen ovale and thrombus within the arch of the aorta treated at the with pfo closure and embolectomy during of this year, depression, hypotension, cesarean section, ivc filter placed on , status post jaw trauma. depression,ptsd, gerd, chronic back pain,obesity allergies to medications: dystonic reaction to trilafon. medications at the time of admission: coumadin 2 mg po q.h.s., atenolol 25 mg po q.d., lasix 4 mg po q.d., potassium chloride 20 cc po q.d., zanaflex 4 mg po t.i.d., neurontin 600 mg po q.a.m. and 1200 mg po q.h.s., klonopin 3 mg po q.d., risperdal 2 mg po q.h.s., trazodone q.h.s. prn, zoloft 200 mg po q.a.m., hydrocortisone cream. social history: the patient lives with her daughter. physical examination at the time of admission: temperature 98.8. blood pressure 112/91. weight was 271 pounds. pulse oxygen 96% on one liter. respirations were approximately 26. mucous membranes were moist. there was no trauma. there were no lesions in the oropharynx. there was no lymphadenopathy. there was no noted jugular venous distention, however, in this obese patient with a large neck, this determination was difficult. there were noted to be crackles in the left middle lung field and egophony was later noted in the left middle lung field as well. the rate and rhythm were regular without murmurs. there was a question of an extra heart sound. on abdominal examination, this was a markedly obese patient with a soft, nontender abdomen with positive bowel sounds. there was on examination of the chest wall noted to be a small amount of serous drainage from the wound site. laboratory, x-ray, electrocardiogram and other testing: hematocrit at the time of admission was 30.7, white blood cells 6.1, hemoglobin 9.4. the differential was 58.1% neutrophils, 32.8% lymphocytes, 4.2% monocytes, 4.3% eosinophils, 0.6% basophils. platelets at the time of admission were 471. pt at the time of admission was 14.9, ptt was 24.6, inr was 1.5. sedimentation rate measured on was 41. reticulocyte count measured on was 2.2. anti-thrombin iii measured on was 88 with a normal range of 72 to 110, protein c measured on was 78 with a reference range of 67-123. urinalysis on had a specific gravity of 1.011 and was otherwise negative. pleural fluid analysis performed on had 5,800 white blood cells, hematocrit of 2.5%, 11% polys, 49% lymphocytes, 4% monocytes, 8% mesothelial cells and 28% macrophages. chem-7 at the time of admission was as follows: sodium 140, potassium 4.3, chloride 103, bicarbonate 27, bun 10, creatinine 0.9, glucose 94, alt measured on was 19, ast on the same date was 18, alkaline phosphatase on the same date was 155, total bilirubin was 0.2. ggt measured on was 137, reference range of 8 to 35. a troponin measured on was less than 0.3. tibc measured on was 311, ferritin 132, transferrin 239, haptoglobin measured on was 338, homocystine measured on was 5.3 with a reference range of 4.5 to 12.4. tsh was 1.6 on with a free t4 of 4.8. hiv antibody measured on was negative. toxicology screen was negative. pleural chemistry in addition to the above had a total protein of 3.3, a glucose of 120, and an ldh of 289. multiple arterial blood gases were done during this admission. please see the computer record for further details. lactate measured on was 1.8 falling to 1.1 by . hematocrit at the time of this dictation is 31.2 on , however, hematocrit has been as low as 23.4 on during a period when the patient was anticoagulated. pt at the time of the current dictation is 14.7 with an inr of 1.2, ptt of 78.1 and the patient is on heparin. fibrinogen measured on was 654. gram stain from lingular transbronchial biopsy performed on showed no pmns and no microorganisms. broth from tissue did however grow out coag negative staph, no acid fast bacilli were seen on direct smear. no fungus was isolated. bronchial alveolar lavage performed on yielded 1+ pmns, no microorganisms, sparse oral pharyngeal flora were seen, no acid fast bacilli were seen on direct smear and no fungus was isolated. pcp was not seen on immunofluorescent tests. bronchial washings taken from showed 1+ pmns and no microorganisms with sparse oropharyngeal flora growth on culture and no fungal growth. pleural fluid from had no pmns and no microorganisms with no growth on the culture media. blood culture from had no growth and that is the final report as did a set of blood cultures from . testing for factor 5 leiden was done and was negative for mutation. imaging studies: chest ct performed on showed the following: impression: 1. left upper lobe and left lower lobe pneumonia with a moderate left pleural effusion. 2. a filling defect in the pulmonary artery going to the left lower lobe consistent with a thrombus which is age indeterminate. this thrombus is nonocclusive given the history of chronic pulmonary embolus and the consolidation of left lung. the desaturation is probably due to the superimposed infection. ct of the chest was repeated multiple times. the latest at the time of this dictation was from which showed the following: 1. extensive ground glass opacity and reticulation throughout the right lung with only minimal involvement of the left lung. the findings are nonspecific and could reflect a symmetric distribution of hemorrhage, edema or diffuse alveolar damage in the appropriate clinical setting. 2. an enlarged main pulmonary artery and question of small emboli in the branch of the left pulmonary artery, but no large central obstructing embolus evident, although ct angiography techniques were not employed limiting this study. multiple chest x-rays were performed during this admission and will not be reviewed here except for the following admission test x-ray pa and lateral on which showed a left basilar opacity with alveolar bronchograms suggesting an infectious process or atelectasis. there was also a pleural effusion on the right basilar subsegmental atelectasis was noted. ultrasound performed on of the liver and gallbladder had an impression of no gallstones. additional chest films will be reviewed in brief, although the reader should refer to full reports for additional information. a chest film performed on of the right and left lateral decubitus positions were performed which showed "free flowing left-sided pleural effusion. there may be a small right-sided pleural effusion as well." incomplete dictation , m.d. dictated by: medquist36 d: 10:29 t: 10:29 job#: procedure: venous catheterization, not elsewhere classified thoracentesis arterial catheterization closed endoscopic biopsy of lung diagnoses: pneumonia, organism unspecified anemia, unspecified unspecified pleural effusion congestive heart failure, unspecified depressive disorder, not elsewhere classified unspecified disease of pericardium acute respiratory failure iatrogenic pulmonary embolism and infarction hemorrhage of gastrointestinal tract, unspecified 

Answer: The patient is high likely exposed to