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: tramadol attending: chief complaint: hypoxic respiratory distress major surgical or invasive procedure: none history of present illness: ms. is a 30 year old g2p1 woman at 22 wks +2 d gestation who was transferred from with dyspnea and concern for chf. her symptoms began 2-3 days ago suddenly, and she has had progressive doe. she would now get out of breath by any movement. she reports orthopnea last night, had to sleep in a chair, because she felt sob lying flat. at , she was found to have o2 sat of 73% on ra and was placed on a non-rebreather. chest x-ray there showed pulmonary edema raising concern for acute chf. she was given 20 mg of iv furosemide, 70 mg of lovenox, and 5 mg of iv ntg. troponin there was negative. she was transferred to for further management. in the ed, initial vs were: t 97, hr 86, bp 107/67, rr 24, o2 sat 95% on nrb. she was placed on bipap and continued on nitro gtt for preload reduction. she was briefly taken off of bipap and was noted to have o2 sat 88% on 6l. she had repeat cxr showing reportedly "fluid". ekg showed sr, no st changes, + twi in iii and v1-v3. cardiology consult was called and performed bedside echocardiogram, which revealed preserved ef and normal systolic function. cta was ordered to rule out pe. she was noted to breathe comfortably on bipap but was mildly somnolent during her ed stay. she did not receive antibiotics as she did not demonstrate evidence of infection (no fever, chills, sputum, leukocytosis). the obgyn team was consulted and recommended admission to icu with verification of due date and prenatal records. bedside ultrasound of the uterus showed good fetal movement. gas prior to transfer was 7.43/33/138/23. on the floor, she reports breathing is slightly better. + cough but no sputum production. no pleuritic chest pain but has sharp pain in her throat when she takes in deep breath. also feel that her hearing is muffled and feels that she hears echos. has mild nausea, no vomiting. no recent travel or sick contact, although 's sister has mrsa. has not been hiking or been in standing water. review of sytems: (+) per hpi (-) denies fever, chills, night sweats, lumps or bumps. denies headache, sinus tenderness, rhinorrhea or congestion. denied chest pain or tightness, palpitations. denied vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. denied arthralgias or myalgias. past medical history: - hbv - hcv - kidney stones - depression - cholecystectomy - seizure while on ultram, last one was 2 years ago, no neurological work up (per patient) - h/o iv drug use on methadone social history: - unemployed - currently living with parents, planning to move in with - has an 11 yo son - denies alcohol - smokes 1ppd - reports history of heroin use but has not used anything since this year per patient family history: - copd - father - unprovoked pe - no family history of bleeding disease physical exam: physical exam on arrival vitals: t:96.5 bp:99/74 p:79 r: 22 o2: 93% 40% non-rebreather general: alert, oriented, uncomfortable heent: sclera anicteric, mucous membrane dry, oropharynx clear neck: supple, jvp not elevated, no lad lungs: diminished bibasilar lung sound, diffused crackles throughout, r> l, no wheeze or rhonchi cv: regular rate and rhythm, normal s1 + s2, no murmur, no rub, no gallops abdomen: soft, non-tender, gravid, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: 11:45am blood wbc-8.1 rbc-3.14* hgb-10.5* hct-29.0* mcv-92 mch-33.4* mchc-36.2* rdw-14.2 plt ct-101* 06:20am blood wbc-3.4* rbc-2.96* hgb-9.5* hct-26.9* mcv-91 mch-32.0 mchc-35.2* rdw-13.4 plt ct-122* 11:45am blood neuts-88.6* lymphs-8.7* monos-1.7* eos-1.0 baso-0 05:30am blood neuts-69.2 lymphs-25.8 monos-3.4 eos-1.6 baso-0 05:30am blood pt-14.2* ptt-26.1 inr(pt)-1.2* 12:54pm blood fibrino-834* 03:29am blood esr-80* 07:45am blood fetlhgb-0 04:55am blood fetlhgb-0 03:29am blood aca igg-pnd aca igm-pnd 06:20am blood glucose-78 urean-22* creat-0.7 na-138 k-3.8 cl-107 hco3-26 angap-9 11:45am blood glucose-96 urean-9 creat-0.6 na-138 k-4.3 cl-106 hco3-20* angap-16 06:20am blood alt-24 ast-28 alkphos-110* totbili-0.2 11:45am blood alt-42* ast-102* ld(ldh)-513* ck(cpk)-29 alkphos-134* totbili-0.4 05:30am blood alt-24 ast-35 ld(ldh)-271* alkphos-111* totbili-0.2 11:45am blood ck-mb-3 ctropnt-<0.01 probnp-336* 03:29am blood ck-mb-2 ctropnt-<0.01 06:20am blood calcium-8.3* phos-3.0 mg-1.7 11:45am blood albumin-3.2* calcium-8.9 phos-3.4 mg-1.6 04:55am blood cryoglb-pnd 03:29am blood hapto-117 11:45am blood hcg- 03:29am blood anca-negative b 03:29am blood -negative 03:29am blood crp-193.0* 03:29am blood hiv ab-negative 03:29am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 03:07pm blood type-art po2-138* pco2-33* ph-7.43 caltco2-23 base xs-0 intubat-not intuba comment-non-invasi 03:07pm blood lactate-0.8 urine legionella negative 7:03 pm rapid respiratory viral screen & culture source: nasopharyngeal aspirate. **final report ** respiratory viral culture (final ): no respiratory viruses isolated. culture screened for adenovirus, influenza a & b, parainfluenza type 1,2 & 3, and respiratory syncytial virus.. detection of viruses other than those listed above will only be performed on specific request. please call virology at within 1 week if additional testing is needed. respiratory viral antigen screen (final ): greater than 400 polymorphonuclear leukocytes;. specimen inadequate for detecting respiratory viral infection by dfa testing. interpret all negative results from this specimen with caution. negative results should not be used to discontinue precautions. refer to respiratory viral culture results. reported to and read back by , () on at 11:54am. cmv serology igg and igm negative time taken not noted log-in date/time: 11:11 am hbv viral load (final ): greater than 110 million iu/ml. performed using the cobas ampliprep / cobas taqman hbv test. linear range of quantification: 40 iu/ml - 110million iu/ml. limit of detection: 10 iu/ml. time taken not noted log-in date/time: 11:11 am hcv viral load (final ): 4,790 iu/ml. performed using the cobas ampliprep / cobas taqman hcv test. linear range of quantification: 43 iu/ml - 69 million iu/ml. limit of detection: 18 iu/ml. rare instances of underquantification of hcv genotype 4 samples by cobas ampliprep/cobas taqman hcv test method used in our laboratory may occur, generally in the range of 10 to 100 fold underquantitation. if your patient has hcv genotype 4 virus and if clinically appropriate, please contact the molecular diagnostics laboratory () so that results can be confirmed by an alternate methodology. blood culture - no growth to date at the time of discharge 10:00 am post- viral culture site: lung post fetal lung , baby. post- viral culture (preliminary): no virus isolated. cytomegalovirus early antigen test (shell vial method) (preliminary): brief hospital course: 30 f g2p1 who presents hypoxic respiratory distress. hypoxic respiratory distress. hypoxic to 73% on ra upon presentation, she was intially treated with broad spectrum antibiotics. in addition the patient was 22 weeks pregnant and 1 day after admission she suffered a spontaneous abortion of the fetus. her symptoms began to improve around this time but it is unclear if the abortion led to a quicker improvement. she was noted to have thrombocytopenia, anemia (not hemolytic) and lft elevations. her lfts normalized by discharge. thought this was not hellp and hematology though that the patient did not have any hemolysis. the patient underwent a cta with a poorly timed contrast bolus without clear evidence of pe. her cxr had diffuse infiltrates as did her cta which was consistent with widespread lung injury / ards. the patients echo was normal. cmv serologies and blood cultures were negative, urine legionella negative. she was diuresed as she improved and this sped up her recovery. the post on her fetus revealed likely placental abruption causing cessation of blood supply causing a myocardial infarction. the patient was informed of these results by the pathologist. she was supported by social work. the patient's pancytopenia stabilized and she was discharged home when she was able to be weaned off oxygen and was 97% on room air upon discharge. there was not a clear unifying diagnosis for the patient's presentation. it is possible she had an atpyical bacterial versus viral pneumonia which led to ards and she was discharged to complete a 7 day course of levofloxacin. in addition given the history of drug use it is possible substance abuse such as heroin could have led to ards however she denies recent use of heroin. the pathology of the fetus did not reveal any bacterial or viral infection. in regards to the pancytopenia it is possible this was related to hcv infection versus acute illness and the patient should have a cbc repeated next week in f/u with her pcp. she is still pancytopenic she should follow up with hematology. anaplasma serologies were sent and pending at the time of discharge. medications on admission: - fluoxetine 20 mg po daily - trazodone 100 mg po qhs - methadone 10 mg x 11 tablets po daily - prenatal vitamin po daily discharge medications: 1. fluoxetine 20 mg capsule sig: one (1) capsule po daily (daily). 2. methadone 10 mg tablet sig: eleven (11) tablet po daily (daily). 3. trazodone 100 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. 4. levofloxacin 750 mg tablet sig: one (1) tablet po daily (daily) for 3 days: start on . disp:*3 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis: ards, acute respiratory failure discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital with acute respiratory failure, possibly due to a viral or bacterial infection, however no exact cause could be found. you improved and should take 3 additional days of antibiotics. please make your appointment with you pcp next week. followup instructions: name: dr (works with dr location: family care of address: , , phone: appt: at 10:45am procedure: injection of rh immune globulin other manually assisted delivery central venous catheter placement with guidance diagnoses: pneumonia, organism unspecified thrombocytopenia, unspecified anemia, unspecified pure hypercholesterolemia unspecified viral hepatitis c without hepatic coma opioid type dependence, continuous acute respiratory failure early onset of delivery, delivered, with or without mention of antepartum condition other current conditions classifiable elsewhere of mother, delivered, with or without mention of antepartum condition anemia of mother, delivered, with or without mention of antepartum condition other viral diseases in the mother, delivered, with or without mention of antepartum condition coagulation defects complicating pregnancy, childbirth, or the puerperium, delivered, with or without mention of antepartum condition outcome of delivery, single stillborn 

Answer: The patient is high likely exposed to