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: this is the former 670 gram product of a 25-4/7 weeks' gestation pregnancy born to a 39- year-old primiparous mother. the pregnancy was unremarkable except for maternal hypothyroidism which was treated with synthroid. the mother presented on to with premature rupture of the membranes and premature labor. she was treated with betamethasone, tocolysis and transferred to the . she completed her course of betamethasone and was monitored on the antepartum floor. on the day of delivery there was concerns for fetal bradycardia prompting delivery by cesarean section. there were no sepsis risk factors except for the premature rupture of membranes. prenatal screens: blood type o+, antibody negative, rubella immune, rpr nonreactive, hepatitis b surface antigen negative, group beta strep status unknown. at delivery, the infant emerged with decreased tone and respiratory effort. she had a low heart rate with immediate response to bagged mask ventilation. she was intubated with a 2.0 endotracheal tube after attempts to pass a 2.5 endotracheal tube below the cords was unsuccessful. apgars were 4 at one minute, 6 at five minutes and 7 at ten minutes. she was admitted to the neonatal intensive care unit for treatment of prematurity. anthropometric measurements upon admission to the neonatal intensive care unit: weight 670 grams--10th-25th percentile, length 28.5 cm--less than the 10th percentile, head circumference 23 cm--25th percentile. physical exam at discharge: weight 3.9 kg--50th percentile for corrected age of 1 month, length 52 cm--25th percentile for corrected age 1 month, head circumference 37 cm--50th percentile for corrected age of 1 month. general: alert, active infant, pink on nasal cannula o2 at 250 cc/min flow, alert gaze, conjugate and fixated following gaze. head, ears, eyes, nose and throat: anterior fontanel open and flat, sutures apposed, positive red reflex bilaterally, normal ears and nose, palate intact. neck supple without masses. skin warm and dry. color pink, well-perfused, healed scar on the left chest status post patent ductus arteriosus ligation. chest: breath sounds clear, equal, well-aerated, baseline subcostal retractions. cardiovascular: regular rate and rhythm, no murmur, normal s1, s2. femoral pulses +2, well- perfused. abdomen soft, nontender, nondistended, no masses, no organomegaly, cord healed, small umbilical hernia, soft and easily reduced. gu: normal female. spine straight, normal sacrum. musculoskeletal: normal digits, nails and creases, hips stable, clavicles intact. neuro: alert, positive suck, positive grasp, symmetric tone. hospital course by systems including pertinent laboratory data: 1. respiratory: this infant was placed on the conventional ventilator upon admission to the neonatal intensive care unit. she was treated with three doses of surfactant. on day of life #5, with the onset of her patent ductus arteriosus, she required transition to the high- frequency oscillating ventilator. her peak airway pressure requirement was 9 cmh2o. she was transitioned back to the conventional ventilator on day of life #13. she continued on moderate ventilatory support through day of life #55 when she was successfully extubated to continue with positive airway pressure. she remained on the continuous positive airway pressure through day of life 100 when she transitioned to nasal cannula o2 at 1 liter/min. she was able to wean to 250 cc/min flow and has been stable on that flow since . her chest x-ray is consistent with evolving chronic lung disease. at the time of discharge, she is breathing comfortably with a respiratory rate of 40-60 breaths/min with baseline subcostal retractions. this infant required treatment for apnea of prematurity with caffeine citrate. the caffeine was discontinued on day of life #71, . she continued to have intermittent episodes of spontaneous apnea and bradycardia. on , a 24-hour pneumogram was performed showing no central apnea, no reflux and spontaneous bradycardic drops to 70-80 beats per minute. on the day of discharge, she has been without any episodes of spontaneous apnea or bradycardia for five days. this infant will be followed in the pulmonary clinic at by dr. and she has a follow-up appointment scheduled for at 9:15 a.m. her baseline arterial blood gas at discharge is 7.38, pco2 56, po2 103 hco3 34 in nc flow as described above. she has benefited from administration of albuterol at times. 1. cardiovascular: this infant has maintained normal heart rates and blood pressures during her neonatal intensive care unit admission. a murmur was noted on day of life #5 and the infant was treated with a course of indomethacin. an echocardiogram performed on day of life #7 after the second course of indomethacin showed no patent ductus arteriosus with good biventricular function. the infant then had a murmur noted again and on was noted to have a moderate patent ductus arteriosus with continuous left-to-right flow. she was taken to patent ductus arteriosus ligation on . she had an echocardiogram repeated on which showed no right ventricular hypertension, a patent foramen ovale with left-to-right flow. at the time of discharge, she has an intermittent murmur noted with a baseline heart rate of 110-130 beats per minute, recent blood pressure of 78/33 mmhg, mean arterial pressure 49 mmhg. 1. fluids, electrolytes and nutrition: this infant initially had umbilical arterial and venous catheters placed. she received total parenteral nutrition. enteral feeds were initiated on day of life #10 and gradually advanced to full volume. she was made n.p.o. for her patent ductus arteriosus ligation and feeds were resumed three days postoperatively and again advanced to full volume. she had a percutaneously inserted central catheter for approximately two weeks. her maximum caloric density was breast milk fortified to 30 cal/oz with additional beneprotein. this infant had difficulty transitioning to all oral feeds. the pediatric feeding team from was consulted and had no additional suggestions and felt that the infant was advancing normally. they remained available for consultation with the after discharge should any feeding issues arise. the infant was started on prilosec and reglan for symptoms of gastroesophageal reflux. weight on the day of discharge is 3.9 kg. her discharge formula is enfacare fortified to 28 cal/oz by concentration. serum electrolytes were checked frequently during admission and were within normal limits. 1. infectious disease: due to the premature rupture of membranes and her prematurity, this infant was evaluated for sepsis upon admission to the neonatal intensive care unit. a complete blood count and differential were within normal limits. a blood culture was obtained prior to starting intravenous ampicillin and gentamicin. the blood culture was no growth and the antibiotics were discontinued at 48 hours. on day of life #5, with the onset of her patent ductus arteriosus and clinical instability, this infant was reevaluated for sepsis with a complete blood count and blood culture. she was started on vancomycin and gentamicin. that second blood culture was no growth and the antibiotics were discontinued 48 hours later. at two other episodes during her neonatal intensive care unit admission, the infant was concerning for possible sepsis. blood cultures on both of those occasions were no growth. 1. hematological: this infant is blood type o+, direct antibody test negative. she required seven transfusions of packed red cells during her neonatal intensive care unit admission. her most recent hematocrit was 33% with a reticulocyte count of 2.9% performed on . she is being discharged home on supplemental iron. 1. gastrointestinal: this infant required treatment for unconjugated hyperbilirubinemia with phototherapy. peak serum bilirubin occurred on day of life 2 at 4 mg/dl. she was treated with phototherapy for approximately three weeks. her final serum bilirubin on day of life 23 was 3.1 mg/dl. as previously noted, she is being treated for gastroesophageal reflux with prilosec and reglan. 1. renal: this infant had onset of hematuria on . a renal ultrasound performed on showed bilateral renal calculi. the infant was evaluated by the nephrology service at . a repeat renal ultrasound on showed increase in the number and size of the renal calculi especially on the left side. at the recommendation of the nephrology team. she was started on diuril p.o. b.i.d. repeat ultrasound on showed decrease number and size of the renal calculi with significant improvement. she is being discharged home on diuril and would be followed up by the nephrology team with an appointment scheduled for at 1:00 p.m. 1. endocrine: this infant was noted to have low t4 levels. she was evaluated by the endocrinology service at and was felt to have sick euthyroid syndrome. she was not treated and the thyroid levels normalized. 1. neurological: the initial head ultrasound performed on this infant on day of life #1 showed absence of the cavum septum pellucidum. there was no intraventricular hemorrhage or other abnormalities noted. repeat head ultrasounds on and were without change. the infant was evaluated by the neonatal neurology service for who recommend a magnetic resonance imaging test to be done as an outpatient. she will be followed in the neonatal neurology program at . the referral has been made and they will contact the with the appointment. the infant's neurological exam has been within normal limits with some mildly increased tone noted in the lower extremities. 1. sensory: a. audiology: hearing screening was performed with automated auditory brainstem responses. this infant passed in both ears on . b. ophthalmology: the first initial eye exams were concerning for fixed and dilated pupils versus aniridia. due to the finding of the absence cavum septum pellucidum on the head ultrasound there was concern for potential absence of the optic nerves. the optic nerves were finally visualized on and at that time she was noted to have immature retinal vessels. she proceeded to advance to stage 1 retinopathy of prematurity to zone iii. the retinopathy resolved and she was noted to have mature retinas on /4008. she will require ophthalmology follow-up at age 9 months. c. psychosocial: social work has been involved with this family. the contact social worker is and she can be reached at (. have been vigilant and very involved during their daughter's neonatal intensive care unit admission. condition on discharge: stable. discharge disposition: home with the . primary pediatrician: dr. , , , , phone number (, fax number (. care and recommendations on discharge: 1. oxygen by nasal cannula at 250 cc/min. 2. feeding: ad lib feeding a minimum of 130 ml/kg/d of breast milk or enfacare 28 cal/oz formula. 3. medications: reglan 0.3 mg p.o. q.8h., prilosec 4 mg p.o. once daily, chlorothiazide or diuril 38 mg p.o. q.12h., goldline baby vitamins 1 ml p.o. once daily, ferrous sulfate 25 mg/ml dilution 0.6 ml p.o. once daily. 4. iron and vitamin d supplementation: a. iron supplementation is recommended for preterm and low birthweight infants until 12 months corrected age. b. all infants fed predominantly breast milk should received vitamin d supplementation at 200 international unit (may be provided as a multivitamin preparation) daily until 12 months corrected age. 5. car seat position screening was performed. this infant was observed in her car seat for 90 minutes without any episodes of oxygen desaturation or bradycardia. 6. state newborn screens were sent on and . there was hypothyroidism noted on the initial screens which resolved. 7. immunizations: hepatitis b vaccine was administered on . pediarix was administered on and . haemophilus influenza b was administered on and . pneumococcal 7- conjugate vaccine was administered on / and . 8. immunizations recommended: a. synagis rsv prophylaxis should be considered from through for infants who meet any of the following 4 criteria: 1) born at less than or equal to 32 weeks; 2) born between 32 and 35-0/7 weeks with 2 of the following: daycare during rsv season, a smoker in the household, neuromuscular disease, airway abnormalities or school-aged siblings; 3) chronic lung disease; or 4) hemodynamically significant congenital heart disease. after discussion with the patient's primary pediatrician who noted continued cases of rsv being seen in their practice currently and requested treatment with synagis. the possibility of synagis was considered with the . current aap criteria were reviewed. afetr consideration of these and patient's situation it was decided to administer a dose of synagis prior to disacharge. b. influenza immunization is recommended annually in the fall for all infants once they reach 6 months of age. before this age and for the first 24 months of the child's life, immunization against influenza is recommended for household contacts and out-of-home caregivers. c. this infant has not received rotavirus vaccine. the american academy of pediatrics recommends initial vaccination of preterm infants at or following discharge from the hospital if they are clinically stable and at least 6 weeks but fewer than 12 weeks of age. 9. follow-up appointments: a. appointment with dr. , primary pediatrician, on at 10:00 a.m. b. dr. , pediatric pulmonology, four at , , (, at 9:15 a.m. c. infant followup program , (, appointment for at 8:00 a.m. d. pediatric nephrology, , five, at 1:00 p.m. e. neonatology neurology program, (, eleven, , appointment to be determined. f. genetics, , , ten, (, appointment to be determined. g. pediatric ophthalmology at 9 months of age. discharge diagnoses: 1. prematurity at 25-4/7 weeks' gestation. 2. respiratory distress syndrome secondary to surfactant deficiency. 3. chronic lung disease. 4. suspicion for sepsis ruled out x2. 5. patent ductus arteriosus status post two courses of indomethacin. 6. status post patent ductus arteriosus ligation. 7. apnea of prematurity. 8. anemia of prematurity. 9. retinopathy of prematurity stage 1, resolved. 10.bilateral renal calculi. 11.transient hypothyroidism secondary to sick euthyroid syndrome. 12.unconjugated hyperbilirubinemia. , procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery parenteral infusion of concentrated nutritional substances diagnostic ultrasound of heart insertion of endotracheal tube injection or infusion of other therapeutic or prophylactic substance other phototherapy prophylactic administration of vaccine against other diseases transfusion of packed cells diagnostic ultrasound of urinary system other surgical occlusion of vessels, thoracic vessels diagnoses: single liveborn, born in hospital, delivered by cesarean section need for prophylactic vaccination and inoculation against viral hepatitis observation for suspected infectious condition respiratory distress syndrome in newborn neonatal jaundice associated with preterm delivery patent ductus arteriosus anemia of prematurity other specified conditions originating in the perinatal period retrolental fibroplasia neonatal hypoglycemia extreme immaturity, 500-749 grams 25-26 completed weeks of gestation ostium secundum type atrial septal defect umbilical hernia without mention of obstruction or gangrene other and unspecified atelectasis other apnea of newborn other specified anomalies of kidney interstitial emphysema and related conditions congenital reduction deformities of brain congenital hypothyroidism euthyroid sick syndrome 

Answer: The patient is high likely exposed to