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: no known allergies / adverse drug reactions attending: chief complaint: dyspnea major surgical or invasive procedure: none history of present illness: ms. is a y/o female with cad/ chf, afib, diabetes, presenting from clinic with dyspnea: : corneal transplant. 10 days ago: increasing dyspnea/ orthopnea 5 days ago: markedly worse dyspnea and chills, can no longer walk without dyspnea. 1 day ago: shoulder pain relieved with lidocaine. at her baseline she is legally blind and ambulates with a cane; she has had falls in the past. denies weight gain, cough, chest pain, n/v. has subjective chills at home. positve right shoulder pain as above. patient also states that she has not been drinking more water than normal or eating more salt than normal. she also states that she has not had any stepwise changes in her dyspnea. no sick contacts. patient was referred from clinic where her respiratory rate was 36 and was labored. her pulse was 105 and irregular. her o2 sat was between 89% and 91% on room air. in the ed, initial vs were: t 97.5, hr 117, bp 116/78, and she triggered for rr 36, pox 95%. she was noted to have moderate respiratory distress. exam revealed rales bilaterally. labs notable for wbc 12.1 (89% n, no bands), cr 1.8 (no prior baseline in omr), bnp , lactate 2.3. cxr showed mild pulmonary edema, small left pleural effusion, and left lung base atelectasis vs. infiltrate. she was given ceftriaxone and azithromycin (no cultures drawn prior), and was admitted to medicine for pna vs. chf. vs prior to transfer were: on arrival to the floor, patient reports continued dyspnea. otherwise, no acute complaints. ros: some fatigue and chills without fevers. she does report that she has numbness and muscle weakness and pain in many joints. occasional headaches, abdominal pain. denies night sweats, vision changes, rhinorrhea, congestion, sore throat, cough, chest pain, nausea, vomiting, diarrhea, constipation, brbpr, melena, hematochezia, dysuria, hematuria. all other 10-system review negative in detail. past medical history: diabetes atrial fibrillation coronary artery disease hypertension hyperlipidemia. recent had a corneal transplant. legally blind. social history: she is retired professor at the in . she lives alone, but is frequently monitored by her daughter who lives close by. she has never smoked cigarettes, she drinks socially, and does not do drugs. family history: non contributory, patient does not recall cardiac disease in parents. physical exam: admission: vs 95.3, 116/87, 96, 26, 95% 3l, fs 352 gen alert, oriented, tachypnic heent ncat mmm eomi sclera anicteric, op clear neck supple, no jvd, no lad pulm tacyhpnic, good aeration, ctab no wheezes, rales, ronchi> i didn no cv rrr normal s1/s2, no mrg abd soft nt nd normoactive bowel sounds, no r/g ext wwp 2+ pulses palpable bilaterally, no c/c/e neuro cns2-12 intact, motor function grossly normal skin no ulcers or lesions discharge: n/a, deceased pertinent results: admisson: 10:45am blood wbc-12.1* rbc-4.86 hgb-14.4 hct-46.3 mcv-95 mch-29.7 mchc-31.2 rdw-15.0 plt ct-239 07:22am blood wbc-10.2 rbc-4.38 hgb-13.3 hct-41.9 mcv-96 mch-30.3 mchc-31.7 rdw-15.0 plt ct-239 10:45am blood neuts-89.0* lymphs-7.7* monos-2.8 eos-0.2 baso-0.2 10:45am blood pt-13.9* ptt-43.5* inr(pt)-1.3* 10:45am blood glucose-348* urean-58* creat-1.8* na-140 k-5.2* cl-109* hco3-16* angap-20 07:22am blood glucose-141* urean-60* creat-1.9* na-143 k-4.3 cl-110* hco3-19* angap-18 03:00pm blood ck(cpk)-59 10:45am blood probnp-* 10:45am blood ctropnt-0.01 03:00pm blood ck-mb-4 ctropnt-<0.01 07:22am blood calcium-8.9 phos-4.0 mg-1.7 10:45am blood tsh-1.1 10:45am blood free t4-1.6 12:06pm blood lactate-2.3* 05:20am urine color-yellow appear-clear sp -1.011 05:20am urine blood-neg nitrite-neg protein-tr glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg 05:20am urine rbc-<1 wbc-2 bacteri-few yeast-none epi-1 05:20am urine casthy-17* micro: -blood cx (): pending -urine cx (): negative -urine legionalla ag (): negative -urine cx (): pending ekg (): atrial fibrillation with a moderate ventricular response. non-specific st-t wave changes, most notable in leads vi-v2. compared to the previous tracing of atrial fibrillation has replaced sinus bradycardia. the septal t wave changes have been previously noted. tte (): the left atrium is moderately dilated. the right atrium is moderately dilated. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is low normal (lvef 50%). the right ventricular free wall is hypertrophied. right ventricular chamber size is normal with depressed free wall contractility. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is at least moderate pulmonary artery systolic hypertension, with evidence of right ventricular pressure overload and consequent ventricular interaction. there is a very small pericardial effusion. there are no echocardiographic signs of tamponade. ap portal chest x-ray (): 1. mild pulmonary edema and small left pleural effusion. 2. ill-defined opacity in the left lung base is nonspecific, but could reflect an area of atelectasis, or possibly infection. pa/lateral chest x-ray (): there is unchanged cardiomegaly. there is persistent atelectasis versus developing infiltrate at the left lung base. this is stable. there are no signs for overt pulmonary edema or pneumothoraces. overall, there has been no interval change. pa/lateral chest x-ray (): cardiac silhouette is enlarged. there is some atelectasis at the lung bases. there are no signs for overt pulmonary edema. there is some prominence of some of the interstitial markings and atelectasis of the left lung base which is stable. there is minimal wedging of several mid thoracic vertebral bodies. ap portable chest x-ray (): lung volumes are lower today, exaggerating relative caliber of distended mediastinal veins and the extent of moderate cardiomegaly. thoracic aorta is quite tortuous and aneurysm is not really evaluated by this study. pleural effusion is minimal if any. no pneumothorax. v/q scan (): multiple mismatched perfusion defects bilaterally consistent with very high likelihood ratio of acute pulmonary embolus. brief hospital course: ms. is a y/o female with cad/ chf, afib, diabetes, presenting from clinic with dyspnea. # dyspnea secondary to pulmonary embolism: initially attributed to diastolic chf based on age, history of diabetes, jvp of 10-12cm and pleural effusion on cxr and bnp >10k, although dry mucus membranes and no edema peripherally. diastolic dysfunction was confirmed by echo. also initially considered was pna given hypothermia, but no history of cough and only mild leukocytosis to 12.1k. initially troponins negative x2 and no evidence of ischemia by ekg. pulmonary embolism was also initially considered, but other etiologies including diastolic dysfunction were more likely initially and despite vague shoulder pain, no frank chest pain and no stepwise changes in dyspnea; patient described it as progressive shortness of breath. patient treated on admission with 40iv lasix and was 1l negative and the following day treated with 80mg po lasix. this was repeated as the patient was not negative with 60mg iv lasix. patient was also emperically started on ceftriaxone 1g iv q24h and azithromycin 500mg po q24h on admission. she was then switched to po levoquin and dyspnea continued, with desaturations to the 80s with ambulation. when patient did not improve with aggressive diuresis and leukocytosis increased to 20k, other etiologies were reconsidered. repeat troponins were not consistent with an acute ischemic event. agb was consistent with primary metabolic acidosis, with normal anion gap, with superimposed respiratory alkalosis and an aa gradient of approximately 50. vq scan was consistent with right > left sided pulmonary embolism. patient was started on iv heparin and warfarin po. her troponins began to increase and her urine output decreaed. the evening of , patient's entered atrial fibrillation with rvr with decreasing o2 saturations, decreasing blood pressure to 80s systolic and no urine output. patient was transferred to the icu for further care. on arrival to the icu patient was hypotensive to 80s, tachycardic to 150s (afib with rvr), satting in high 80s on nrb. she was noted to have dusky, cool, pulseless lle, possibly arterial thrombus showered from atrium in setting of rvr. failed rate control with beta blockade. she was started on peripheral norepinephrine and levophed drips for hypotension. as her presentation was consistent with massive pe causing hemodynamic instability, lysis with tpa was attempted. before this, icu team spoke with daughter (hcp) in detail about risks/benefits of tpa. daughter specified she did not want central line placed, and updated code status to dnr/dni in light of severity of her illness. over the next six hours after tpa infusion, patient's oxygen requirements continued to increase and she became increasingly hypotensive with rising pressor requirements and agonal breathing. in light of her failure to respond to lysis, spoke with family again and patient was transitioned to cmo with morphine drip for comfort. she passed away at 11:49 am with family by the bedside. # presentation hypothermia: 96.2/35.6 rectally, not quite meeting sirs criteria of <35. ? infection as above versus other process as hypothyroidism or poor cardiac output. ua is clear except for protein. tsh and free t4 normal. resolving the following day with antibiotics and diuresis as above. patient was normothermic during the remainder of the hospitalization. # cad: per history. no evidence of q waves on ekg. echo without wall motion abnormalities. patient was continued on asa 81mg qd and simvastatin 40 mg daily # dm complicated by protinuria. patient was treated with an insulin sliding scale, lantus 10 units subcutaneously every morning, which was increased to 14 units prior to transfer to the unit for sugars in the 250 range. we held glipizide 5 mg daily # atrial fibrillation: chads 2 of 4, although not anticoagulated due to risk. at home, on toprol xl 50 mg daily. prior to discovering the pulmonary embolism, we increased metoprolol succinate 75mg qd for heart rate control to attempt to improve forward flow and asa 81mg qd # hypertension: fair control initially. we held isosorbide mononitrate 10 mg daily as patient is normotensive and substituted lisinopril 5mg qd in place of fosinopril 10 mg daily. this was discontinued on when patient entered into from combination of diuresis and pulmonary embolism # recent corneal transplant with history of glaucoma. we continued: - brimonidine (alphagan) p 0.1 % eye drops: 1 drop each eye - prednisolone acetate 1 %: 1 drop to right eye tid # transitional medications on admission: aspirin 81 mg 2-3 times per week toprol xl 50 mg daily isosorbide mononitrate 10 mg daily fosinopril 10 mg daily simvastatin 40 mg daily lantus 10 units subcutaneously every morning glipizide 5 mg daily omeprazole 40 mg daily prn qvar 80 mcg/actuation aerosol inhaler: 2 puffs brimonidine (alphagan) p 0.1 % eye drops: 1 drop each eye prednisolone acetate 1 %: 1 drop to right eye tid senna 8.6 mg daily beclomethasone dipropionate 80 mcg aerosol 2 puff(s) twice a day (using 3 puffs, 4-5x/day as emergency med) discharge medications: n/a, deceased discharge disposition: home with service facility: homecare discharge diagnosis: n/a, deceased discharge condition: n/a, deceased discharge instructions: n/a, deceased followup instructions: n/a, deceased md procedure: injection or infusion of thrombolytic agent arterial catheterization diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery esophageal reflux congestive heart failure, unspecified acute kidney failure, unspecified atrial fibrillation acute on chronic diastolic heart failure other and unspecified hyperlipidemia diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled long-term (current) use of insulin encounter for palliative care do not resuscitate status other pulmonary embolism and infarction legal blindness, as defined in u.s.a. pain in joint, shoulder region mixed acid-base balance disorder benign essential hypertension proteinuria hypothermia not associated with low environmental temperature cornea replaced by transplant 

Answer: The patient is high likely exposed to