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: banana / melon flavor / avocado / iv constrast / lorazepam attending: chief complaint: lower gi bleed/chest heaviness major surgical or invasive procedure: none history of present illness: east hospital onco-medicine attending admission note date: time: 03:30 the patient is a 66 year old female with a pmhx of stage iv cervical cancer, not currently treated with chemo-radiation, with history of nephrostomy tube for ureteral stricture s/p radiation with recent revision , also with history of radiation proctitis and gi bleeds who was recently admitted to micu with fever and urinary tract infection concerning for sepsis also found to have gib requiring blood transfusion and endoscopy with cautery; who now presents with dark stools and fatigue. she reports 3 episodes of dark diarrhea since last night, constant dull, pleuritic chest pain over the past day, which she attributes to "anxiety". she reports having an intermittent dry cough over the past two weeks, which is improved with benzonatate. she also reports pain "neuropathy" in her legs, which has been progressively worsening over the past several weeks. she endorses urinary frequency. she denies n/v, dysuria, hematuria, brbpr, numbness/tingling of the arms/shoulders, exertional symptoms, palpitations, shortness of breath or dysuria. on review of omr, she was admitted to icu/medicine service here for lower gi bleed in relation radiation colitis, for which she received 2 units prbcs in the micu; gi performed a flex sig w/ cautery on , w/ stable hematocrits thereafter. vs: 97.6 90 110/52 16 99% px: a+ox3, 20g piv, port a cath-accessed; guiac positive stool studies: wbc 7.5, hct 23.9, plt 302; na: 126; u/a: rbc 19, wbc 52, bact few, yeast mod, epi <1; trop-t: 0.12 (stable from prior); d-dimer: 2745; ap: 160, tuberculosis: 0.4, alb: 3.0, ast: 54 cta w/ iv (pe protocol) given elevated d-dimer-done -> given pleuritic chest pain -> negative for pe but showed metastatic disease in lungs fluids given: ilns meds given: aspirin 81mg, morphine 5 mg iv, ketorolac 15mg/ml, ciprofloxacin iv 400mg & ceftriaxone 1g iv (for uti), ondansetron 4mg x2, pantoprazole gtt 8mg/hr; 1 unit prbc (hct lower than baseline) consults called: gi aware vs prior to transfer to the floor: 97.9 72 118/49 100ra review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies visual changes, headache, dizziness, sinus tenderness, neck stiffness, rhinorrhea, congestion, sore throat or dysphagia. denies chest pain, palpitations, orthopnea, dyspnea on exertion. denies shortness of breath, cough or wheezes. denies nausea, vomiting, heartburn, diarrhea, constipation, brbpr, melena, or abdominal pain. no dysuria, urinary frequency. denies arthralgias or myalgias. denies rashes. no increasing lower extremity swelling. no numbness/tingling or muscle weakness in extremities. no feelings of depression or anxiety. all other review of systems negative. past medical history: -cervical cancer: followed by dr. , discovered after post-menopausal vaginal bleeding/hematuria and was found to have a cervical mass w/ invasion of the posterior bladder wall. biopsies revealed a locally advanced, stage squamous cell cervical carcinoma. underwent nephrostomy tubes for hydronephorosis. she initiated radiation therapy of pelvis on with her last session . she completed 6 sessions of weekly cisplatin on . -status post resection of a benign pituitary adenoma at age 21 at with resultant hypopituitarism; she was previously followed at , needs endocrine f/u (hasn't seen in some time) -multiple utis since nephrostomy tube placement in : organisms including enterococcus (not vre), mrsa, e.coli (pan-sensative) and resistant gnrs -osteoporosis allergies: banana / melon flavor / avocado / ?iv constrast / lorazepam social history: she grew up in the west end of . she lives in , ma with her husband . they have two daughters, her eldest lives nearby, her daughter lives in new . her sister from , , is back in . hopes to travel to later this spring. the patient smoked approximately one-third to pack per day for 33 years, recently quitting. she had one alcoholic beverage daily until her illness. family history: - brother died of leukemia at age 64 in . pt was a match, donated peripheral blood stem cells. both parents had heart disease. physical exam: admission exam: gen: no apparent distress heent: no trauma, pupils round and reactive to light and accommodation, no lad, oropharynx clear, no exudates cv: regular rate and rhythm, no gallops/rubs, ii/vi sem pulm: clear to auscultation bilaterally, no rales/crackles/rhonchi gi: soft, non-tender, non-distended; no guarding/rebound gu: nephrosomy tube draining yellow urine ext: no clubbing/cyanosis/edema; 2+ distal pulses; peripheral iv present neuro: alert and oriented to person, place and situation; cn ii-xii intact, motor function globally derm: no lesions appreciated discharge exam: unchanged except for the following neuro: sleeping, but arousable to voice, aaox3, appropriate pertinent results: 05:40pm urine color-yellow appear-hazy sp -1.015 05:40pm urine blood-mod nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.5 leuk-lg 05:40pm urine rbc-19* wbc-52* bacteria-few yeast-mod epi-<1 05:40pm urine hyaline-3* 05:40pm urine mucous-occ 05:25pm lactate-1.0 05:20pm glucose-107* urea n-11 creat-0.7 sodium-126* potassium-3.5 chloride-89* total co2-24 anion gap-17 05:20pm alt(sgpt)-37 ast(sgot)-54* alk phos-160* tot bili-0.4 05:20pm ctropnt-0.12* 05:20pm albumin-3.0* 05:20pm d-dimer-2745* 05:20pm wbc-7.5 rbc-2.65* hgb-7.7* hct-23.9* mcv-90 mch-28.9 mchc-32.1 rdw-15.2 05:20pm neuts-90.9* lymphs-5.9* monos-2.8 eos-0.4 basos-0.1 05:20pm plt count-302 chest (pa & lat): pending radiology cta chest w&w/o c&recon: prelim impression: 1. no evidence of pulmonary embolism or acute aortic injury. 2. moderate right pleural effusion. additionally, there is mild ground-glass opacities as well as septal thickening suggestive of mild pulmonary edema. correlation with bnp is recommended. 3. there are new bilateral pulmonary nodules in the right upper lobe and the left lower lobe. these findings are suspicious for metastatic disease. additionally, the degree of peribronchovascular thickening appears slightly out of proportion for mild pulmonary edema and lymphangitic spread must be excluded. as a result, dedicated a chest ct is recommended after resolution of symptoms to assess the degree of metastatic disease. ecg: nsr 88 bpm, v1-v3 twi echo : the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. left ventricular systolic function is hyperdynamic (ef>75%). there is a mild resting left ventricular outflow tract obstruction. right ventricular chamber size and free wall motion are normal. the aortic valve is not well seen. there is no aortic valve stenosis. the mitral valve leaflets are mildly thickened. physiologic mitral regurgitation is seen (within normal limits). there is borderline pulmonary artery systolic hypertension. there is a small to moderate sized pericardial effusion. the pericardium may be thickened. there is right ventricular diastolic collapse, consistent with impaired fillling/tamponade physiology. on subcostal supine and 45 degree head-up views, there is a <1 cm (in diastole) rim of pericardial fluid between the visceral pericardium/fat overlying the right ventricle and the diaphragm. a larger rim of pericardial fluid (upto ~1.7 cm in diastole ) is seen apical to the apical right ventricular free wall. discharge labs 05:01am blood wbc-10.6# rbc-3.76* hgb-10.9* hct-32.9* mcv-88 mch-28.9 mchc-33.0 rdw-15.0 plt ct-316 05:01am blood neuts-80* bands-0 lymphs-12* monos-5 eos-3 baso-0 atyps-0 metas-0 myelos-0 05:01am blood pt-15.1* ptt-33.7 inr(pt)-1.4* 05:01am blood glucose-56* urean-5* creat-1.1 na-129* k-3.5 cl-93* hco3-20* angap-20 05:01am blood calcium-6.9* phos-3.5 mg-1.6 brief hospital course: 66f with hx of stage squamous cell cervical cancer, s/p combined chemoradiation with nephrostomy tube and recent history of urosepsis from klebsiella pan-sensitive and lower gi bleed related to radiation proctitis who presented with dark stools and 3 point drop in her hct, now found to have new pulmonary metastases and early cardiac tamponade. # goals of care discussion - after it was determined that the patient had signs of cardiac tamponade, family meetings were held with the patient, her husband, daughters, and palliative care. the patient made the decision that she did not want to undergo chemotherapy again and did not want invasive therapies such as a pericardiocentesis. the decision was made to move towards hospice care and the patient will be discharged to a hospice house with focus on comfort care. # cardiac tamponade - pericardial effusion noted on ct, then tamponade confirmed with echocardiography. patient was never hd unstable - this finding prompted goals of care discussion as above given need of pericardiocentesis and then window if treatment desired. #. headaches: severe, somewhat responsive to narcotics - did not tolerate cyclobenzaprine. differential included chronic daily headache vs tension. pain service was consulted. they offered neck injection but patient declined. they recommended to try tizanidine 2mg tid prn headache for relief. # gi bleed - the patient initially presented with dark stool - she had no hematochezia so gi felt this was less likely related to her radiation proctitis. there was an initial plan to attempt further laser therapy, but this was decided against after the goals of care discussions. #. chest pain, pleuritic: have been related to pericardial effusion. treated symptomatically. #. cough/right pleural effusion: likely due to new lung mets. treated with anti-tussives and narcotics. #. urinary tract infection: completed 3 days of cipro. culture returned positive for yeast as has priors - likely a colonization. #. hyponatremia: monitored, per family has been long term issue. #. stage iv cervical cancer - ct on admission showed new metastatic lesions in the lungs. the patient stated she would not want to undergo further chemotherapy. palliative care was consulted and decision was made for hospice care. #. pan hypopituitarism. hx benign pituitary adenoma s/p resection many years ago. was on levothyroxine and low dose predisone for years as a result of hypopituitarism that followed. continued home levothyroxine and prednisone 5 mg po daily until decision for hospice care. medications on admission: (home medication list reconciled on this admission) butalbital-acetaminophen-caff 50 mg-325 mg-40 mg 1 tab po q4 prn headache ciprofloxacin 500 mg 1 tablet po q12h for 10 days () ergocalciferol (vit d2) 50,000 u 1 cap po qweek levothyroxine 125 mcg 1 po daily lidocaine-prilocaine 2.5% cream 2.5 gm topically to port site as directed prn prior to accessing port olanzapine (zyprexa) 2.5 mg 1-2 tabs po q6h and qhs prn anxiety, insomnia potassium chloride 20 meq 2 packets po bid prednisone 5 mg 1 po daily otc: calcium carbonate 500 mg (1,250 mg) 1 tab po tid discharge medications: 1. morphine 15 mg tablet sig: 0.5 tablet po q2h (every 2 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 2. benzonatate 100 mg capsule sig: one (1) capsule po tid (3 times a day). disp:*90 capsule(s)* refills:*2* 3. acetaminophen 650 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain. disp:*30 tablet(s)* refills:*0* 4. prochlorperazine maleate 5 mg tablet sig: 1-2 tablets po every four (4) hours as needed for nausea. disp:*30 tablet(s)* refills:*0* 5. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po four times a day as needed for nausea/anxiety. disp:*30 tablet, rapid dissolve(s)* refills:*0* 6. tizanidine 2 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for headache. disp:*90 tablet(s)* refills:*0* 7. dextromethorphan-guaifenesin 10-100 mg/5 ml liquid sig: five (5) ml po q4h (every 4 hours) as needed for cough. disp:*500 ml(s)* refills:*0* 8. levothyroxine 125 mcg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 9. prednisone 5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: extended care facility: family hospice discharge diagnosis: primary: metastatic cervical cancer, cardiac tamponade, headache secondary: urinary tract infection, radiation proctitis, hyponatremia discharge condition: level of consciousness: lethargic but arousable. mental status: clear and coherent. activity status: bedbound. discharge instructions: dear mrs. , it was a pleasure getting to meet you and care for you during your hospitalization. you came in because of chest heaviness and dark stools. unfortunately, a cat scan of your chest showed new metastatic lesions from your cancer - it also showed fluid around your heart which was confirmed with an echocardiogram. after discussion with you and your family, it was decided to focus on treating your symptoms and alleviating suffering. to that end, you will be going to a hospice house where they will focus on symptom management. you will have a new medication regimen that will be provided for you there. morphine 7.5mg every 2 hours as needed for pain benzonatate 100mg by mouth three times a dayacetaminophen 650mg every 6 hours as needed pain/fever prochlorperazine 5-10mg by mouth every 4 hours as needed for nausea olanzapine 5mg 1 tablet by mouth every 6 hours as needed for nausea/anxiety tizanidine 2mg by mouth three times a day as needed for headache/neck spasm dextromethorphan-guaifenesin 5ml by mouth every 4 hours as needed for cough followup instructions: none needed. procedure: endoscopic destruction of other lesion or tissue of large intestine replacement of nephrostomy tube diagnoses: urinary tract infection, site not specified acute posthemorrhagic anemia hyposmolality and/or hyponatremia personal history of tobacco use anxiety state, unspecified osteoporosis, unspecified osteoporosis, unspecified old myocardial infarction antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use headache encounter for palliative care angiodysplasia of intestine with hemorrhage secondary malignant neoplasm of lung urinary complications, not elsewhere classified removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation personal history of antineoplastic chemotherapy personal history of irradiation, presenting hazards to health other specified disorders of rectum and anus insomnia, unspecified stricture or kinking of ureter late effect of radiation radiological procedure and radiotherapy as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure anorexia cardiac tamponade other artificial opening of urinary tract status secondary malignant neoplasm of other urinary organs gastroenteritis and colitis due to radiation surgical operation with formation of external stoma causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation polyneuropathy due to drugs iatrogenic pituitary disorders personal history of benign neoplasm of the brain other specified forms of effusion, except tuberculous 

Answer: The patient is high likely exposed to