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: gemzar / morphine / hydromorphone attending: chief complaint: fever/malaise major surgical or invasive procedure: -had paracentesis which removed 2l fluid in , final cx pending history of present illness: this is a 53 year-old female with a history of stage iii peritoneal serous ca who presents to the ed 5 days s/p third cycle of alimta, with mild fever and malaise. a ct torso was performed which showed a worsening pleural effusion, new pericardial effusion, and no abdominal process seen. she initially had stable vitals, was at her baseline sbp's in the 90's with a small o2 requirement and was to be sent to the floor, but became hypotensive to the 70's this morning with hr's to 120's. she was asymptomatic and was responsive to 1l fluid, with bp's coming back up to 90/60. the concern was for tamponade from the enlarging pericardial effusion and they did a bedside echo which they thought might have shown ? chamber collapse. pulsus wnl. cardiology was called, and their stat echo showed small to moderate effusion with no evidence of tamponade per cards fellow. she was given cefepime and vanco for her fevers. she remains 97% 2l nc upon transfer to . . upon arrival, the patient seems comfortable and says she feels tired. initial bp was 90/58, but she dropped subsequently to 83/50. she is satting 99%2l. . ros: the patient denies any weight change, nausea, vomiting, abdominal pain, diarrhea, constipation, melena, hematochezia, chest pain, orthopnea, pnd, lower extremity edema, cough, urinary frequency, urgency, dysuria, lightheadedness, gait unsteadiness, focal weakness, vision changes, headache, rash or skin changes. past medical history: stage iii primary peritoneal carcinoma, status post suboptimal debulking surgery. six cycles of carboplatin and taxol with recurrence. poor tolerance on gemcitabine. completed 6 cycles of low-dose weekly taxol with gradual response to therapy complicated by severe colitis and c. difficile infection. she was started on taxol in and radiation on the right ilium/hip sacral area in 01/. restarted doxil in , 6 cycles. social history: denies alcohol or tobacco. very supportive sisters family history: mother with lung ca. cvd and dm2. physical exam: physical exam: vitals: t: 97.5 bp: 95/71 hr: 94 rr: 16 o2sat: 98% 2l nc gen: chronically ill-appearing, no acute distress heent: eomi, perrl, sclerae anicteric, mmm, op clear neck: no jvd, carotid pulses brisk, no bruits, no cervical lymphadenopathy, trachea midline cor: rrr, +rub no m/g, normal s1 s2, radial pulses +2 pulm: decreased breath sounds half way up on left, basilar crackles on the right. abd: soft, nt, mild distention, +bs, no hsm, +fluid wave and shifting dullness. ext: no c/c/e, no palpable cords neuro: alert, oriented to person, place, and time. cn ii ?????? xii grossly intact. moves all 4 extremities. strength 5/5 in upper and lower extremities. patellar dtr +1. plantar reflex downgoing. no gait disturbance. no cerebellar dysfunction. skin: no jaundice, cyanosis, or gross dermatitis. no ecchymoses. pertinent results: 02:36pm ascites tot prot-3.9 albumin-2.5 02:36pm ascites wbc-133* rbc-203* polys-0 lymphs-33* monos-48* mesotheli-19* 12:27pm hct-29.9* 07:11am glucose-93 urea n-7 creat-0.6 sodium-140 potassium-3.7 chloride-108 total co2-25 anion gap-11 07:11am glucose-93 urea n-7 creat-0.6 sodium-140 potassium-3.7 chloride-108 total co2-25 anion gap-11 07:11am alt(sgpt)-36 ast(sgot)-29 ld(ldh)-254* alk phos-93 tot bili-0.3 07:11am albumin-2.8* calcium-7.6* phosphate-3.9 magnesium-1.6 07:11am ca125-35 07:11am pt-14.3* ptt-26.2 inr(pt)-1.2* 09:10pm lactate-0.8 09:00pm urine hours-random 09:00pm urine -neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.0 leuk-tr 08:25pm neuts-64 bands-0 lymphs-13* monos-23* eos-0 basos-0 atyps-0 metas-0 myelos-0 08:25pm wbc-9.4 rbc-3.77* hgb-10.8* hct-31.0* mcv-82 mch-28.7 mchc-34.9 rdw-17.3* . echocardiogram: conclusions the left atrium is mildly dilated. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets appear structurally normal with good leaflet excursion. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. the estimated pulmonary artery systolic pressure is high normal. there is a small circumferential pericardial effusion without evidence for hemodynamic compromise. . impression: small circumferential pericardial effusion without evidence for hemodynamic compromise. preserved global biventricular systolic function. . . ct c/a/p impression: 1. new moderate pericardial effusions. 2. worsening left pleural effusion. 3. no pulmonary embolism. 4. new right upper lobe 9-mm spiculated mass concerning for metastasis. 5. stable liver and peritoneal lesions. 6. multiple new bony hyperdense foci concerning for spinal and sternal metastasis. 7. large volume abdominal and pelvic ascites, which somewhat limits assessment. no evidence of an acute bowel process. 8. large volume of dense colonic and rectal stool. . . ct cervical spine impression: a tiny sclerotic focus in the medial aspect of the left first rib, but otherwise no evidence of osseous metastatic disease within the cervical spine. brief hospital course: assessment: 53 year-old female with a history of stage iii peritoneal serous ca who presents to the ed 5 days s/p third cycle of alimta, with mild fever and malaise and transient hypotension. . # fevers/hypotension: the patient was transferred to the unit and fluid resuscitated. there was initial concern re: sepsis physiology but the patient's bp stabilize with minimal ivf and the fevers resolved after 24 hours. a pericardial effusion was noted on ct scan. an echocardiogram showed that the effusion was too small to drain and there was no evidence of tamponade physiology. a paracentesis was done for therapeutic and diagnostic reasons. there was concern regarding spontaneous bacterial peritonitis, but the patient's peritoneal fluid analysis was negative for such a process. cultures remained negative. no clear source of fevers was found. . # hypoxia: patient denied sob but had low o2 sats (to 90%) and an increased pleural effusion on the left with a new small rul mass on ct chest. the hypoxia was felt to be more consistent with patient's effusion. the patient was weaned off oxygen and thoracocentesis was deferred. . # stage iii peritoneal serous ca: patient just completed her 3rd round of alimta. she had a mild transaminitis which was being attributed to the chemo. initially seemed to be having good response with reduction in ca-125 levels, but now has mets in the spine which are new and a possible new met in the rul of the lung. the patient's primary oncologist preferred to further evaluate these lesions as an outpatient. a ct of the cervical spine was done to evaluate neck pain for bony mets and the cervical spine was negative for mets. # recurrent dvt/pe: patient was to be on lifelong coumadin therapy, which was stopped by patient's pcp for unclear reasons. heme/onc consulted and suggests pt. restarts coumadin after discharge given her high risk. cta done was negative for new pe. the patient was encourgaged to contact her pcp and have coumadin restarted as she is at high risk for pe. patient had office visit scheduled with pcp for next day to discuss matter. medications on admission: medications: dexamethasone 2 mg tablet - 1 tablet(s) by mouth once a day take twice a day the day before, day of and day after chemo dolasetron - 50 mg tablet - 1 tablet(s) by mouth gabapentin - 300 mg capsule - 1 capsule(s) by mouth tid latanoprost 0.005 % drops - 1 drop at bedtime to both eyes lidocaine - 5 % (700 mg/patch) adhesive patch, medicated - 1 adhesive(s) daily (daily) do not leave on longer than 12 hours lorazepam - 1 mg tablet - 1 tablet(s) by mouth q4-6hrs prn olanzapine 2.5 mg tablet - 1 tablet(s) by mouth prn and hs oxycodone - 5 mg tablet - tablet(s) by mouth q4-6hrs as needed for breakthrough pain ranitidine hcl 150 mg tablet - 1 tablet(s) by mouth twice a day tramadol 50 mg tablet - 2 tablet by mouth four times a day warfarin ***not taking***- 6 mg tablet - 1 tablet(s) by mouth every other day alternates with 7.5mg qd discharge medications: 1. tramadol 50 mg tablet sig: two (2) tablet po four times a day as needed for pain. tablet(s) 2. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily) as needed for pain: do not leave on skin longer than 12 hrs. . adhesive patch, medicated(s) 3. gabapentin 300 mg capsule sig: one (1) capsule po q8h (every 8 hours). 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 5. olanzapine 2.5 mg tablet sig: three (3) tablet po daily (daily). 6. lorazepam 1 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed. 7. latanoprost 0.005 % drops sig: one (1) drop ophthalmic at bedtime as needed for pain. 8. dexamethasone 2 mg tablet sig: one (1) tablet po twice a day: as instructed for chemotherapy . 9. folic acid 800 mcg tablet sig: one (1) tablet po once a day. 10. zyprexa 7.5 mg tablet sig: one (1) tablet po at bedtime. discharge disposition: home discharge diagnosis: fever pleural effusion ascites peritoneal serous cancer discharge condition: good discharge instructions: you presented with fevers of unclear cause. you were also found to have worsening fluid collections around your lung and in your belly. you had fluid removed from your abdomen. all of your culture data was negative and your fever resolved prior to discharge. if you develop fevers, chills, cough, worsening shortness of breath, or chest pain, abdominal pain or pain with urination or other symptoms, please call your doctor immediately or go to the emergency room. there were no changes to your home medication regimen. please take all of your medications as you were prior to admission. we recommend that you discuss restarting coumadin for recurrent dvt/pe with your pcp. needs to be initiated in a setting in which the inr can be monitored. followup instructions: provider: , md phone: date/time: 2:00 provider: , md phone: date/time: 2:00 provider: , rn phone: date/time: 3:00 md, procedure: percutaneous abdominal drainage diagnoses: anemia of other chronic disease malignant neoplasm of liver, secondary unspecified pleural effusion unspecified schizophrenia, unspecified unspecified disease of pericardium hypotension, unspecified long-term (current) use of other medications personal history of venous thrombosis and embolism hypoxemia secondary malignant neoplasm of lung dehydration personal history of malignant melanoma of skin secondary malignant neoplasm of bone and bone marrow personal history of irradiation, presenting hazards to health personal history of malignant neoplasm of ovary acquired absence of organ, genital organs malignant neoplasm of specified parts of peritoneum malignant ascites 

Answer: The patient is high likely exposed to