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: zestril attending: chief complaint: shortness of breath on exertion major surgical or invasive procedure: pericardectomy history of present illness: 52 year old woman wiht history of htn and depression, with known pericardial effusion and pericardial constriction attributed to an antecedant viral illness, who reports worsening exercise tolerance and le edema (rt. greater than lt.) since . she had previously been evaluated on the cmi service for elective rhc on . catheterization at that time showed moderate diastolic left and right ventricular dysfunction and constrictive physiology. shortly after her cardiac catherization she developed r leg pain and noted an increase in swelling of the both legs but right greater than left. she also noted that her dyspnea on exertion also worsened shortly after her catherization. . pericardial effusion attributed to viral illness as follows: . diagnosed initially in after what was described as "the flu" (note: there was no antecedent travel, tick bite) - this was likely a viral uri or other, but very unlikely to have been influenza per se given timing. she had a negative ppd and cxr, negative and ?negative rf. she did well until per pt when she was started on lasix w/o effect. she then underwent rhc on . she went to her outpatient cardiologist (dr.) wed , complaining of the above noted, worsening le edema and sob etc. dr. dr. of cardiac surgery here who asked for her to be admitted to for evaluation for surgery (pericardial stripping). past medical history: pmh/psh: pericardial effusion/pericarditis ( tte: ef55%, small effusion; cath: ci 1.9, no coronary dz; osh workup for sle/tuberculosis negative, presumed viral etiology), pe in rul/rml/lul, bilateral dvts, depression, htn social history: lives w/ husband. denies substance use, tob, etoh. family history: father with aneurysm of right iliac artery, spinal stenosis, normal pressure hydrocephalus. father also had a dvt in the setting of decreased mobility. physical exam: on admission: 99.1, 110, 156/98, 20, 95 room air, 195 pounds general: no acute distress, well-developed heent: moist mucous membranes, eomi neck: no lymphadenopathy lungs: decreased right breath sounds cardiac: sinus tachycardia, no murmur or rubs abd: soft, nontender/nondistended, normoactive bowel sounds ext: warm, 2+ edema neuro: grossly intact pertinent results: cardiology: echo: 1. the left atrium is mildly dilated. 2. the left ventricular cavity size is normal. overall left ventricular systolic function cannot be reliably assessed. 3. there is a trivial pericardial effusion. 4. compared with the findings of the prior study (images reviewed) of , the estimated pulmonary artery pressure has decreased. echo: left ventricular wall thicknesses are normal. the left ventricular cavity is unusually small. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is low normal (lvef 50-55%). the right ventricular cavity is dilated. there is severe global right ventricular free wall hypokinesis. there is abnormal septal motion/position consistent with right ventricular pressure/volume overload. the aortic valve leaflets (3) are mildly thickened. the mitral valve leaflets are mildly thickened. there is a small posterior pericardial effusion. compared with the prior study (images reviewed) of , the right ventricle is now markedly dilated and hypokinetic and the left ventricular cavity is now small. 05:00pm glucose-102 urea n-13 creat-0.6 sodium-140 potassium-4.9 chloride-104 total co2-21* anion gap-20 05:00pm calcium-9.4 phosphate-3.6 magnesium-1.7 05:00pm wbc-10.8# rbc-5.76*# hgb-15.0 hct-44.3# mcv-77* mch-26.0* mchc-33.8 rdw-17.9* 05:00pm plt count-281 05:00pm pt-26.3* ptt-32.2 inr(pt)-2.7* hematology complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 05:36am 7.5 4.05* 10.6* 31.5* 78* 26.2* 33.7 17.3* 353 basic coagulation (pt, ptt, plt, inr) pt ptt plt ct inr(pt) 05:55am 15.6*1 37.6* 1.4* 1 note new normal range as of 12:00am .;abnormal prothrombin time (pt) increased due to;laboratory change to a more sensitive pt .;inr values remain the same. monitor warfarin based on inr only! : inr 1.6 chemistry renal & glucose glucose urean creat na k cl hco3 angap 05:55am 93 22* 1.3* 137 4.0 97 30 14 enzymes & bilirubin alt ast ld(ldh) ck(cpk) alkphos amylase totbili dirbili 03:08am 29 30 123* 0.7 green top chemistry totprot albumin globuln calcium phos mg uricacd iron 05:55am 8.2* 4.2 1.8 radiology: cxr: the bilateral pleural effusions are similar-to- slightly larger since the prior study. the cardiac contour is difficult to evaluate, but there is probably again associated bibasilar atelectasis, as seen on a recent ct. there is no pneumothorax. leftward conve thoracolumbar scoliosis is again noted, with a similar appearance. cxr: there is slightly increased moderate-sized bilateral pleural effusion with atelectasis in both lower lobes. the lung volume is small. there is continued mild cardiomegaly. the patient is status post pericardiectomy with median sternotomy and multiple drains overlying the mediastinum and bilateral chest tubes. no evidence for pneumothorax is identified cxr: comparison is made with the next previous similar study of . during the interval, the right internal jugular vein central venous line has been removed. a right-sided chest tube located at the right base also has been removed. no other interval changes can be identified and no pneumothorax has developed after the tube removal. with the exception of some linear densities on the left base, no other pulmonary abnormalities are identified. pathology: i. "pericardium for frozen section": fibrosis and chronic inflammation; no evidence of malignancy. ii. "pericardium": fibrosis and chronic inflammation; no evidence of malignancy. microbiology: pericardial fluid: presumptive propionibacterium acnes. rare growth. brief hospital course: this is a 53 year old female with a history of restrictive pericarditis who presented for operative repair. she had a prior recently diagnosed pulmonary embolus and was therefore admitted several days prior to her operation and started on a heparin drip while coumadin was held. she was taken for a transesophageal echocardiogram on for evaluation and planned possible tapping of pericardial fluid; she was found to have a restrictive pattern with no significant fluid to tap (please see full report in the results section). she was then taken to the operating room on with dr. and dr. for repair (please see the operative note for full details). the patient had an essentially uncomplicated postoperative course which was prolonged due to acute renal failure and resumption of coumadin anticoagulation. she was extubated upon arrival to the intensive care unit after her operation. her pain was well controlled in the post-operative course, initially with a morphine pca and eventually with oral narcotics. she was started on a clear liquids diet on post-op day 1 which was advanced to a regular diet without complication. she had 4 chest tubes placed during the operation-- 2 pleural tubes and 2 mediastinal tubes. the mediastinal drians were removed on . the pleural drains were removed on and . there was minimal residual effusion and no pneumothorax. heparin drip was restarted on post-operative day 2 for anticoagulation for her known pe; coumadin was held for several days until her inr drifted down to sub-therapeutic range at which point it was resumed, with 2 mg given from , 5 mg given on and 2.5 mg given on . heparin was stopped and lovenox was commenced on . from a renal standpoint, the patient initially had several days of low urine output after her operation. this was presumed to be due to some residual restrictive physiology/low-outflow state, with a transthoracic echo on revealing some hypokinesis (please see the full report in the results section). renal consultation was obtained and it was felt that she had some prerenal physiology. therefore, a dopamine drip was started for several days during the intial post-operative course. eventually this was discontinued and lasix diuresis was started to which she responded quite well. she lost approximately 10 kilograms in her 2 week in-hospital post-operative course, placing her at about kilograms above her baseline weight from several months ago. lasix was continued in her outpatient regimen. the patient was discharged in good condition after her 2-week post-operative course. her outpatient regimen included oral narcotics, lasix, potassium chloride, and coumadin. she ambulated with physical therapy and was found safe for home. she had planned follow-up with cardiac and thoracic surgery. all questions were answered to her satisfaction upon discharge. medications on admission: prozac 20' coumadin 5' discharge medications: 1. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed. disp:*10 tablet(s)* refills:*0* 2. fluoxetine 20 mg capsule sig: one (1) capsule po daily (daily). 3. enoxaparin 80 mg/0.8 ml syringe sig: 0.8 ml subcutaneous (2 times a day): subcutaneous injection; injections can stop once your inr is in therapeutic range (). disp:*20 ml* refills:*2* 4. hydrocodone-acetaminophen 5-500 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for pain. disp:*80 tablet(s)* refills:*0* 5. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 6. furosemide 40 mg tablet sig: one (1) tablet po once a day: diuretic pill. disp:*30 tablet(s)* refills:*2* 7. potassium chloride 20 meq packet sig: two (2) packet po once a day: to be taken while you are taking lasix. disp:*60 packet(s)* refills:*2* 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. disp:*10 capsule(s)* refills:*0* 9. coumadin 5 mg tablet sig: one (1) tablet po once a day: you should have your inr checked every 3 days to adjust dose towards therapeutic range 2-3. disp:*30 tablet(s)* refills:*2* 10. lorazepam 0.5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for anxiety. disp:*12 tablet(s)* refills:*0* 11. outpatient lab work you should have your inr checked within 2-3 days of discharge discharge disposition: home with service discharge diagnosis: primary: pericardial effusion and restrictive pericarditis secondary: pulmonary embolus in right upper lobe/right middle lobe/left upper lobe, bilateral deep vein thrombus, depression, hypertension discharge condition: stable. tolerating pos. good pain control. discharge instructions: call dr./thoracic surgery office() for: fever, shortness of breath, chest pain, excessive foul smelling drainage from incision sites. take regular medications as directed. resume coumadin dose as directed w/ discharge instructions. have coumadin/inr/blood test checked monday as previous to hospital. monitor weights daily. if lb weight gain over 1-2 days, call office. take new medications- pain medication as directed and as needed. you may shower when you get home. no tub baths/hot tubs/ swimming for 2-3 weeks. ambulate 4-6 times per day, gradual increase in duration w/ episodes as able. 10-20 minutes each episode. do not lift more than 10lbs for 10 weeks (do not lift more than a gallon of milk. followup instructions: you should see your primary care physician 2-3 days of your discharge to have your inr checked. call dr./thoracic surgery office(for an appointment in days. prior to your appointment you should have an x-ray of the chest taken at 4 radiology-- call for an appointment at . follow-up with dr. (cardiac surgery) in weeks as well. call for an appointment. procedure: pericardiectomy diagnoses: unspecified pleural effusion congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified depressive disorder, not elsewhere classified pulmonary collapse personal history of venous thrombosis and embolism other pulmonary embolism and infarction adhesive pericarditis 

Answer: The patient is high likely exposed to