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: a 37-year-old female with a long prior medical history of polysubstance abuse, depression, anxiety/panic attacks, but no prior suicide gestures, and attempts, and no prior history of mania or psychosis, who is recently () released from mci after a one year incarceration for possession of heroin. on , patient was found down in her mother's bathroom, covered in vomit. she was taken to a hospital ( hospital), where laboratories revealed positive opiates, positive benzodiazepines, positive cocaine, and positive pcp. was subsequently intubated for ards (secondary to aspiration), and transferred to when she was difficult/failed to wean from the ventilator. at , she was treated we levofloxacin/clindamycin from for aspiration pneumonia as well as ceftazidime/vancomycin from for hospital acquired pneumonia. a bronchoscopy done on was negative. in addition, the patient was initiated on tpn during her medical stay. on her transfer to the floor, it was discontinued, and she had been taking po. on , the patient was extubated without event. since then, the patient has exhibited visual/auditory hallucinations, tactile hallucinations which had been waxing and . a psychiatry consult service has been actively following the patient and providing recommendations for this psychosis. the patient was then transferred to the floor. medications on transfer to the floor: 1. morphine 2 mg iv q4h. 2. haldol 2.5 mg po q6h. 3. ativan 1 mg iv q3h. 4. protonix 40 mg po q24h. 5. multivitamin one tablet po q day. 6. folate 1 mg po q day. 7. thiamine 100 mg po q day. 8. nystatin 10 ml po qid. 9. miconazole 2% cream . medications transfer to the floor: 1. morphine 2-8 mg iv q2h prn. 2. haldol 2.5 mg iv q2h prn. 3. cogentin 1 mg im q4h prn. 4. colace 100 mg po bid prn. 5. dulcolax 10 mg po/pr prn. 6. tylenol 325-650 mg po prn. vital signs on transfer: afebrile, heart rate 96-100, blood pressure 110-120/70, respiratory rate 16, and o2 saturation is 97% on room air. physical examination: in general, she appeared preoccupied, mumbling, talking to internal stimuli. heent: pupils are equal, round, and reactive to light, 3 mm bilaterally. extraocular movements are intact. cardiovascular: regular, rate, and rhythm, no murmurs. chest: bilaterally clear to auscultation with poor inspiratory effort, slight crackles at the bases, likely atelectasis, no focal decreased breath sounds or consolidations. abdomen is soft, nontender, nondistended, normoactive bowel sounds. no right upper quadrant tenderness. extremities: 1+ pitting edema. dorsalis pedis bilaterally palpable pulses. left lower extremity is greatly enlarged, much more so than the right lower extremity. her left lower extremity is nontender and did not have any calf tenderness. neurologic: extraocular movements are intact. pupils are equal, round, and reactive to light. three mm constriction. psychiatry: oriented to person only, tangential thought, illogical speech, responding/acting on visual, auditory, as well as internal as well as tactile stimuli. laboratory data on transfer: - white count 11.6, hematocrit 27.5, platelets 371. b12 is 1316, folate greater than 20, tsh 2.9, triglycerides 132, ammonia 18, sodium 137, potassium 4.4, chloride 100, bicarb 23, bun 18, creatinine 0.5, glucose 102, calcium 9.2, phosphorus 4.9, magnesium 1.9, albumin 3.5, alt 246 (increased from 82 on ), ast 161 (increased from 74 on ), alkaline phosphatase 294 (increased from 209 on ), total bilirubin 0.4 stable. haptoglobin, hepatitis b serum antigen, hepatitis b serum antibody, hepatitis b core antibody, hepatitis a antibody, hepatitis c antibody were pending at the time of transfer to the floor. chest x-ray on - multifocal patchy opacities, perihilar haziness, no definitive pleural effusions, or pneumothoraces. assessment: a 37-year-old female status post extubation after ards (secondary to aspiration pneumonia), following a heroin overdose. her delirium after extubation (), x4-5 days and is currently on a benzodiazepine taper. 1. aspiration pneumonia. the patient is status post a 10 day treatment of antibiotics, and antibiotics ended on . no organism has been grown for this. she is breathing well. lungs are clear to auscultation bilaterally. 2. cardiovascular: the patient had an electrocardiogram q am while on haldol. had a three beat run of nsvt on . she was followed on telemetry. 3. gi: patient's lfts were trending upward. her lfts subsequently stabilized, thus right upper quadrant ultrasound was not done. 4. lower extremity edema. her left lower extremity was greatly edematous, much more so than the right side. left lower extremity noninvasive doppler was obtained which showed that she had echogenic material in the superficial and popliteal veins. in addition, there was partial flow seen in the proximal superficial femoral vein and the popliteal veins, however, they were not compressible. the leni indicated that there was a partial thrombus at the level. however, the official read said that there is a deep venous thrombosis in the superficial femoral to popliteal veins. the proximal superficial femoral vein and popliteal veins are partially thrombosed, while the mid distal superficial femoral veins are completely thrombosed. the patient was started on lovenox, and then was initiated on coumadin for appropriate anticoagulation. 5. delirium. the patient continued to remain in delirium for almost a week postextubation. the psychiatry service followed her closely, and they felt that her delirium was resolving slowly, however, she remained disoriented and nonsensical. when patient's mental status was clearing, we discontinued her standing haldol, and only had prn haldol. this was discussed with psychiatry, the patient's need for continued haldol, and it was felt that this patient was not likely need an antipsychotic after her mental status had cleared for any long-term duration. the prn haldol was just for short term behavioral control. 6. polysubstance abuse: her taper of ativan and morphine was continued very slowly, and decreased by approximately 20% per day. 7. history of anxiety/panic disorder. the patient reports her anxiety as well as panic disorder being controlled in the past with effexor. she was started on effexor xr 37.5 mg po qd for complaints of anxiety. the patient was in her acute delirium on the floor, she had a one to one sitter. this sitter stayed with the patient and kept the patient oriented to person as well as place. 8. hepatitis. because the patient's lfts were rising, but then stabilized, hepatitis serologies were checked. these serologies revealed a negative hepatitis b surface antigen, negative hepatitis b surface antibody, negative hepatitis b core antibody, negative hepatitis a antibody, positive hepatitis c antibody. there is a question that the patient did not remember being diagnosed with hepatitis c before, and this was likely a new diagnosis for her. patient was instructed to followup with gi doctor as an outpatient, to follow up his hepatitis. this was discussed with both the patient and her mother prior to discharge. 9. status post fall. on at 7 pm, patient became entangled in her sheets. her legs were wrapped up in the sheets, and she was unable to become entangled. she subsequently fell off the bed and hit her head on the floor. her last ptt was 88.9. in addition, as she fell, her left picc was pulled out. there is no obvious head or skull fracture, or any open wounds on her head. a stat ct scan of the head without contrast was obtained, and the read was no fractures, no intracranial bleed, it was a normal study. 10. mobility: physical therapy consult was placed, and they felt that the patient was functionally independent and was cleared for discharge home. she was obviously deconditioned after her prolonged micu course, and she exhibited a rapid increase in heart rate for a low level of activity. however, this should resolve within the next 2-4 weeks if she was compliant with her walking program. physical therapy cleared her from a standpoint at which she could function at home. disposition: the patient was discharged home with prescriptions to have her inr checked q1-2 days, to keep her inr therapeutic between . she was arranged with pcp followup with dr. . she was also given a psychiatric outpatient followup as well. she needs to be continued on her effexor. the patient was also given the number for gi to followup for evaluation/plus-minus treatment for her hepatitis c. at the time of discharge, the patient had resolved change in mental status secondary to polysubstance abuse, and she exhibited no signs of delirium/mental status changes at all. she is alert, awake, oriented x4. pulmonary status was back to baseline, status post her aspiration pneumonia/ards/status post extubation. addendum: regarding the patient's left lower extremity deep venous thrombosis, the patient was initially started on heparin. she was later changed from heparin to lovenox and was bridged over on lovenox until she became therapeutic on coumadin. patient was therapeutic on coumadin, and was to have a coumadin followup as an outpatient until she saw her primary care physician, . . dr., 12-986 dictated by: medquist36 d: 16:12 t: 07:39 job#: procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances other bronchoscopy diagnoses: other pulmonary insufficiency, not elsewhere classified other, mixed, or unspecified drug abuse, unspecified candidiasis of mouth pneumonitis due to inhalation of food or vomitus other alteration of consciousness 

Answer: The patient is high likely exposed to