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: abdominal pain and hypoxia major surgical or invasive procedure: none history of present illness: chief complaint: abdominal pain reason for micu transfer: hypoxia requiring bipap history of present illness: f with h/o metastatic renal ca, chf, pacemaker, presented to ed yesterday () c/o of epigastric abdominal pain and weakness, was admitted to medicine for hypoxia, and was transferred to micu this morning for inability to maintain o2 sat on nrb. . she initially presented with abdominal pain, which is chronic in nature and has gone on intermittently for several years. she states that it is associated with certain foods such as "cucumbers and tomatoes." her alum-mag hydroxide-simethicone typically helps somewhat. the pain does not radiate anywhere and is associated with some nausea. patient lives alone but has been feeling weak for the past 3 days. has no appetite and has not been eating much. denies fevers/chills, cough, chest pain, sob, pain anywhere else, dysuria, vomiting. went to osh and had abdominal ct 3 days ago showing worsening right renal mass and invasion to right renal vein and ivc. not currently undergoing treatment for ca. . patient initially came here with complaints of abdominal pain again, but was noted to be hypoxic in the ed. she denies orthopnea, pnd, but does complain of difficulty climbing a flight of stairs. the family is unable to detail if these symptoms have changed recently, but they said she has been hypoxic before when she was seen at 3 days ago. she was given "some liquid" which resulted in her being able to come off o2. other than that, her only prior o2 requirement was when she required pacer placement in at the time of her rcc diagnosis. . in the ed, initial vitals: 97.6 104 149/75 18 86%. labs notable for na 125, k 5.4, bnp , wbc 12.9, diff n:93.9 l:5.1 m:0.7 e:0.1 bas:0.1. the pt underwent a cxr pa and lat which showed a l sided consolidation concerning for pna vs atelectasis, she received nothing in the ed. vitals prior to transfer to floor: 98.2, 149/78, 25, 94, 99%4l. . initially on the floor, patient's vitals were 98.5, 146/83, 99, 20, 94%, 3l. were treating and working up hypoxia as pe vs. mi vs. malignancy vs. chf. also treating hyponatremia. became hypoxic on floor early this morning to o2 sat 61, put on nrb, came up to mid 80s. abg showed 7.28/64/63/31. given nebs, started on vanc and cefepime. patient is dnr/dni, but was transferred to the floor for bipap. on arrival to the micu, patient was satting poorly on nrb. she seemed confused and disoriented and was switched to non-invasive pressure support. review of systems: (+) per hpi (-) not able to complete full ros due to ams. past medical history: hypertension, congestive heart failure, presumably diastolic pacer dependent heart block diverticulosis. colectomy in at left hip pinning in the 40s. social history: ms. lives alone in in an apartment on the 5th floor. her brother and sister-in-law live nearby. she has never been married. she has no children. no tobacco use. occassional etoh use. family history: father had kidney cancer in his 60s mother had melanoma physical exam: admit exam: general ?????? increased work of breathing heent - nc/at, perrl, eomi, sclerae anicteric, mmm, op clear neck - supple, distended neck veins, no carotid bruits lungs - lungs with crackles, poor airation heart - rrr, 3/6 systolic murmer, nl s1-s2 abdomen - nabs, soft/nt/nd, no masses or hsm, no rebound/guarding extremities - wwp, no edema, 2+ peripheral pulses (radials, dps) skin - no rashes or lesions lymph - no cervical lad neuro ?????? disoriented, pulling at lines/mask pertinent results: 08:47am blood wbc-12.9* rbc-4.10* hgb-12.0 hct-36.3 mcv-89 mch-29.2 mchc-33.0 rdw-13.9 plt ct-256 01:54am blood wbc-13.7* rbc-3.96* hgb-12.4 hct-35.0* mcv-88 mch-31.3 mchc-35.4* rdw-14.0 plt ct-250 05:22am blood wbc-18.6* rbc-4.48 hgb-13.3 hct-40.3 mcv-90 mch-29.7 mchc-33.1 rdw-13.9 plt ct-305 02:43am blood wbc-19.9* rbc-4.05* hgb-12.0 hct-36.7 mcv-91 mch-29.7 mchc-32.8 rdw-14.1 plt ct-264 04:46am blood wbc-15.4* rbc-4.17* hgb-12.2 hct-38.8 mcv-93 mch-29.3 mchc-31.5 rdw-13.9 plt ct-276 08:47am blood glucose-218* urean-25* creat-1.1 na-125* k-5.4* cl-89* hco3-24 angap-17 09:15pm blood na-128* k-5.6* cl-89* 01:54am blood glucose-168* urean-23* creat-0.9 na-125* k-5.7* cl-88* hco3-28 angap-15 05:22am blood glucose-222* urean-24* creat-1.0 na-126* k-5.2* cl-87* hco3-25 angap-19 02:43am blood glucose-142* urean-33* creat-1.3* na-129* k-5.1 cl-89* hco3-31 angap-14 04:46am blood glucose-110* urean-47* creat-1.7* na-134 k-5.5* cl-95* hco3-29 angap-16 08:47am blood probnp-* 08:47am blood ctropnt-0.07* 09:15pm blood ck-mb-6 ctropnt-0.08* 01:54am blood ck-mb-6 ctropnt-0.09* 05:24pm blood type-art po2-54* pco2-46* ph-7.43 caltco2-32* base xs-4 intubat-not intuba 04:09am blood type-art po2-63* pco2-64* ph-7.28* caltco2-31* base xs-0 comment-non-rebrea 05:36am blood type- po2-65* pco2-102* ph-7.13* caltco2-36* base xs-0 05:38am blood type-art temp-36.7 fio2-100 po2-76* pco2-98* ph-7.14* caltco2-35* base xs-0 aado2-545 req o2-90 intubat-not intuba 07:30am blood type-art po2-65* pco2-78* ph-7.22* caltco2-34* base xs-0 intubat-not intuba comment-non-rebrea 06:38pm blood type- temp-36.4 po2-182* pco2-68* ph-7.27* caltco2-33* base xs-2 intubat-not intuba 02:58am blood type- temp-36.5 po2-47* pco2-79* ph-7.24* caltco2-36* base xs-2 intubat-not intuba brief hospital course: ms. is a yo female with a hx of chf, rcc, and htn presenting with abdominal pain, now resolved, but noted to be hypoxic on admission to 86%. given vacomycin and cefepime. hypoxemia progressed despite abx and patient developed . worsening hypoxemia and in the setting of metastatic rcc and dnr/dni prompted decision to transition to cmo. ms. passed while in the micu on . medications on admission: - amlodipine 5 mg po/ng daily - aluminum-magnesium hydrox.-simethicone 30 ml po/ng qid:prn dyspepsia - cefepime 2 g iv q24h - furosemide 40 mg iv x 3 - heparin 5000 unit sc tid - metoprolol succinate xl 25 mg po daily - omeprazole 40 mg po daily - vancomycin 1000 mg iv q48h discharge disposition: expired discharge diagnosis: expired discharge condition: expired procedure: non-invasive mechanical ventilation diagnoses: acidosis abdominal pain, unspecified site mitral valve disorders congestive heart failure, unspecified acute kidney failure, unspecified hyposmolality and/or hyponatremia secondary malignant neoplasm of other specified sites malignant neoplasm of kidney, except pelvis acute respiratory failure cardiac pacemaker in situ do not resuscitate status delirium due to conditions classified elsewhere diverticulosis of colon (without mention of hemorrhage) chronic diastolic heart failure bacterial pneumonia, unspecified 

Answer: The patient is high likely exposed to