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: patient recorded as having no known allergies to drugs attending: chief complaint: hypoxemia, hypotension major surgical or invasive procedure: endotracheal intubation, mechanical ventilation arterial/venous line placement history of present illness: 76 yo f with h/o metastatic breast ca on chemotherapy who initially was admitted to the omed service with diarrhea who is now transferred to the for hypotension and hypoxia. patient states she had been feeling constipated for 1 week after chemo on and then took laxatives until she had several large bms. a few days later she develope large volume, non-bloody dairrhea that was associated with some lightheadedness. she denied fevers, chills, rashes. reports poor appetite but states she was drinking lot of water and trying to eat salty foods; however this was limited by worsening mucositis over the past few days. due to concern for dehydration and contniued diarrhea, the patient was admitted directly from the oncology clinic. . upon arrival to the floor, pt af with bp 120/74, hr 116, rr 24, o2 sat 94% 2l nc. she was given 2l ivfs, started on po flagyl empirically for c. diff adn had stool cultures sent for possible ois. upon vitals check at 0400, pt's bp noted to be 78/54, hr 98, rr 20s, o2 sat 86% ra --> 93% 3l nc. given 500 cc ivf bolus x 2 with response in sbp to 86/40s, however, rr rose to upper 20-30s with o2 sats 90% 6l nc --> 95% nrb. abg 7.51/25/114/21. cxr revealed likely pulmonary edema with worsening bilateral pleural effusions and possible retrocardiac opacity. she was transferred to the where code status was confirmed as full and pt was intubated. peri-intubation required dopamine at 20 mcg/kg/min, which was transitioned over to levophed gtt once triple lumen catheter placed. past medical history: past oncologic history: was previously treated for breast cancer in the late . at that time she was diagnosed with a left-sided infiltrating ductal carcinoma on . repeat biopsy showed persistent dcis, and she underwent left mastectomy on . two of three lymph nodes were involved. she was treated with 6 cycles of adjuvant oral cmf chemotherapy, which completed in , and then eight years of tamoxifen as the tumor was er positive, pr negative. since that time ms. was also diagnosed with a left renal cell carcinoma and underwent partial nephrectomy in 03/. her medical course has been complicated by coronary artery disease status post mi in and atrial fibrillation. more recently, a ct of the chest noted ground-glass abnormalities, raising concern for bronchoalveolar carcinoma. this has not been biopsied or formally diagnosed. in liver function studies were noted to be elevated, and liver ultrasound and abdominal ct showed numerous lesions in the liver. ct-guided core liver biopsy on showed metastatic breast adenocarcinoma staining positive for mammoglobin, negative for gcdfp, er, and pr. the tumor overexpressed her-2/neu. tumor markers drawn on were elevated with cea 20 ng/ml and ca 27.29 278 u/ml. pet scan performed on showed numerous heterogeneous liver lesions, sclerotic lesions in the left anterior rib and right ilium that were fdg avid and concerning for metastatic foci, and fdg avid left pelvic side wall lymph node. on mammogram and ultrasound of the right breast showed a 1.9-cm right breast nodule. pathology from a core breast biopsy showed invasive ductal carcinoma grade i that was her-2/neu negative and er/pr positive. ms. , therefore, appears to have a new right breast tumor that is er/prpositive, her-2/neu negative, and liver metastases that are er/pr negative and her-2/neu positive. she began herceptin on , and navelbine was added on . also had l thoracocentesis in with malignant cells (adenocarcinoma) on cytology. . past medical history: 1. history of left-sided breast cancer as discussed above, metastatic to 2. history of renal cell carcinoma status post partial left nephrectomy, 03/. 3. coronary artery disease status post mi with pci x2. 4. atrial fibrillation. 5. diet-controlled diabetes mellitus. 6. hypertension. 7. gerd. 8. hyperlipidemia. 9. history of lung imaging abnormalities concerning for bac. 10. history of a right ovarian dermoid cyst resected at age 32. 11. osteoporosis. 12. history of tmj syndrome. 13. cataracts. 14. h/o c.difficile infection. 15. h/o grp a beta-strep bacteremia. social history: the patient is married and lives in , . she was previously a schoolteacher and is now retired. she denies tobacco or alcohol use, although, admits to a history of secondhand tobacco exposure as a child. family history: there is no family history of breast cancer. the patient's son is currently being treated for metastatic renal cell carcinoma. she has another son who is without health concerns. her mother died of a stroke at 61 years and father died of congestive heart failure at 78 years. physical exam: vitals - 98.5 120/74 116 24 94% on 2l general: moderate distress tachypnea and sob, speaking in full sentences without much difficulty, able to lie flat for foley insertion but with mild difficulty heent: dry mm, + mucositis, no lad, cracked lips, jvp approximately 12 cm above sternal notch cardiac: irregular, ii/vi sem lung: ctab with decreased bs at bilateral bases, no wheezes, rhonchi, rales appreciated abdomen: nondistended, +bs, nontender in all quadrants, no rebound/guarding, no hepatosplenomegaly m/s: 2+ le edema bilat with l > r le, moving all extremities well, no cyanosis, clubbing, no obvious deformities neuro: cn ii-xii intact pertinent results: labs on admission: 10:57am blood wbc-0.5*# rbc-3.18* hgb-10.5* hct-29.3* mcv-92 mch-33.2* mchc-36.0* rdw-13.9 plt ct-374# 12:30pm blood pt-32.1* inr(pt)-3.2* 12:30pm blood urean-26* creat-0.7 na-121* k-4.4 cl-84* hco3-26 angap-15 12:15am blood alt-21 ast-33 ld(ldh)-243 alkphos-130* totbili-1.1 dirbili-0.6* indbili-0.5 12:30pm blood albumin-3.4 calcium-8.9 mg-1.5* . urine: 08:48am urine color-yellow appear-clear sp -1.014 08:48am urine blood-neg nitrite-neg protein-30 glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.5 leuks-neg 08:48am urine rbc-1 wbc-4 bacteri-few yeast-none epi-1 08:48am urine hours-random urean-795 creat-89 na-less than . microbiology: bl cx - gnr in bottles . cardiology: tte: conclusions the left atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. there is moderate to severe global left ventricular hypokinesis (lvef = 30 %). no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. the right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. the ascending aorta is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. compared with the prior study (images reviewed) of , biventricular systolic funciton is now significantly depressed. . radiology: lle u/s: impression: no evidence of left lower extremity dvt. . cxr: comparison is made with prior study . mild cardiomegaly is unchanged. mild left pleural effusion has increased. small right pleural effusion is unchanged. there is mild pulmonary edema. there is atelectasis in the right lower lobe. multiple surgical clips are in the left upper quadrant abdomen. there is no pneumothorax. brief hospital course: in short, ms is a 76f with h/o metastatic breast ca c1d15 of navelbine/herceptin admitted with diarrhea and weakness, transferred to in septic shock, expired overwhelming gnr bacteremia. . # septic shock: overwhelming gnr bacteremia w cardiogenic/distributive/hypovolemic components in the setting of febrile neutropenia. ddx for the infection included the gut (given diarrhea) vs the lung vs other. pt treated w aggressive fluid resuscitation, dopamine, norepinepherine and vasopressin pressors, broad-spectrum antibiotics. tte revealed decreased lvef confirming the suspicion of acute heart failure in the setting of sepsis. . # hypoxic respiratory failure: hypoxia progressed relatively rapidly in the setting of receiving ivfs, cxr with evidence supporting pulmonary edema. furthermore, pt's known malignant pleural effusion appears to be worsening and is also likely contributing. no known aspiration events. given neutropenia and other vitals concerning for sepsis, infection also remains on differential. pe also considered, but less likely. treated for sepsis as above. . # hyponantremia: na 120, improved to 130 w fluid resuscitation. does have prior h/o hyponatremia. suspect that hypovolemia is primary etiology. . # diarrhea: possibly infectious etiology given neutropenia vs could be chemo. given refractory hypotension in the setting of sepsis, possibly developing ischemic colitis. . # pancytopenia: likely chemotherapy - neutropenic, anemic w underlying combined iron-deficiency anemia and anemia of chronic disease. no evidence of hemolysis. thrombocytopenia. transfused w prbcs and ffp. . # metastatic breast ca: with known mets to liver and likely to lung and bone based off of pet scan and pleural fluid cytology. . # atrial fibrillation: inr supratherapeutic on admission. afib w rvr on transfer to icu in the setting of hypovolemia, sepsis and pressors. medications on admission: 1. amlodipine 5 mg daily. 2. amoxicillin prior to dental procedures. 3. atenolol 50 mg b.i.d. 4. furosemide 10 mg daily. 5. lisinopril 40 mg daily. 6. potassium chloride 20 meq daily. 7. multivitamin one capsule daily. 8. warfarin 2 mg daily. 9. aspirin 81 mg daily. 10. calcium plus vitamin d b.i.d. 11. glucosamine chondroitin three capsules daily. discharge medications: expired discharge disposition: expired discharge diagnosis: septic shock cardiogenic shock gnr bacteremia repiratory failure metastatic breast cancer atrial fibrillation discharge condition: expired discharge instructions: expired followup instructions: expired procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube arterial catheterization diagnoses: thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery esophageal reflux malignant neoplasm of liver, secondary unspecified essential hypertension hyposmolality and/or hyponatremia severe sepsis atrial fibrillation personal history of malignant neoplasm of breast acute respiratory failure cardiogenic shock septic shock antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use secondary malignant neoplasm of lung personal history of malignant neoplasm of kidney secondary malignant neoplasm of bone and bone marrow neutropenia, unspecified septicemia due to gram-negative organism, unspecified other specified aplastic anemias malignant pleural effusion 

Answer: The patient is high likely exposed to