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: aspirin / penicillins / sulfa (sulfonamide antibiotics) attending: chief complaint: dyspnea major surgical or invasive procedure: none history of present illness: 71 yo f with pmh of cad, chf, dm, htn, cva who developed acute onset sob the night prior to admission. she additionally had an approximate 5 minute period of chest pain with burning sensation. during the course of the night she noted difficulty lying flat. sob seemed somewhat positional. the day of presentation, she went to her pcp who then sent her to . there she was found to have elevated troponin 0.12, 0.13. cxr was not exemplary but cta with massive pulmonary embolism. given lovenox 80 mg sc at at . has history of r hemorrhagic cva in with resultant left hemiparesis. hemodynamically stable and transferred to . . at , initial vs 97.7, 128/93, 85, 14 and 97 on unknown oxygen. pulmonary exam noted to be clear to auscultation bilaterally. ekg with sr, multiple pvcs and diffuse new twi v2-v6 compared to . labs revealed hypernatremia, low bicarbonate to 20 and ua with pyuria and bacteria. she was not given additional medication but ir was contact for potential thrombectomy. past medical history: chronic obstructive pulmonary disease. systolic chf, ef 10-15% (patient unsure) s/p hemorrhagic cva (left sided hemiparesis) due to right middle cerebral artery infarction who underwent a craniotomy hyperlipidemia htn diabetes mellitus constipation utis h/o tracheostomy social history: lives with husband with daughter upstairs. previously smoked (20 years x 1.5 ppweek) family history: no family history of thrombus or bleeding disorders. father with history of mis. physical exam: vs 98, 79, 125/90, 14, 99/2l nc gen: nad heent: ncat, perrl, mmm pulm: ctab without w/r/r cv: rrr without m/g/r abd: soft, nt, active bowel sounds le: without e/o edema, symmetric pertinent results: 09:25pm hct-41.5 09:25pm pt-14.8* ptt-150.0* inr(pt)-1.3* 01:17pm ck(cpk)-114 01:17pm ck-mb-6 ctropnt-0.07* 01:17pm pt-15.5* ptt-150* inr(pt)-1.4* 05:39am urine blood-sm nitrite-neg protein-30 glucose-neg ketone-10 bilirubin-neg urobilngn-neg ph-5.5 leuk-sm 12:01am glucose-163* urea n-15 creat-0.8 sodium-146* potassium-3.4 chloride-113* total co2-20* anion gap-16 12:01am ck(cpk)-88 12:01am ctropnt-0.11* 12:01am ck-mb-notdone 12:01am wbc-11.4* rbc-4.91# hgb-15.0# hct-44.1# mcv-90 mch-30.5 mchc-33.9 rdw-14.7 12:01am plt count-182 12:01am pt-13.2 ptt-36.4* inr(pt)-1.1 ekg : normal sinus rhythm with occasional ventricular premature beats. low voltage in the standard leads and in the precordial leads. very poor r wave progression. rsr' pattern in lead v1. qrs duration of 90 milliseconds. non-specific st-t wave changes throughout the tracing. compared to the previous tracing of the patient has gone from atrial fibrillation at a rate of 117 to normal sinus rhythm at 86 beats per minute with occasional atrial premature beats. the t wave inversions in the lateral leads are new. the poor r wave progression out through v6 is new. this may be related to altered lead placement. consider anterior wall myocardial infarction of undetermined age. echo : due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). the right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. there is abnormal systolic septal motion/position consistent with right ventricular pressure overload. no aortic regurgitation is seen. mild (1+) mitral regurgitation is seen. there is a very small pericardial effusion. impression: dilated and hypokinetic right ventricle with evidence of pressure overload. small left ventricle with normal global systolic function. at least mild mitral regurgitation. suboptimal study. compared with the report of the prior study (images unavailable for review) of , lv function appears to have improved. at the same time, there is new rv dilation/dysfunction. cxr : impression: 1. no evidence of pneumonia or congestive heart failure. 2. diminished vascularity in lung, likely due to known large pulmonary embolism. bilateral le u/s : impression: partially occlusive dvt of the left common femoral vein extending through the entire left superficial femoral vein where it is nearly completely occlusive and into the left popliteal vein where again it is partially occlusive. left calf veins cannot be seen. right lower extremity venous structures do not demonstrate any thrombus. brief hospital course: # pulmonary embolus: pt was admitted to micu and started on heparin gtt. lle u/s positive for dvt as above. an echo showed moderate rv dilation as above. an ivc filter was placed. she continued to have borderline blood pressures which were fluid responsive, likely in part do to her right heart failure, after transition to regular medicine unit, pt remained normotensive. otherwise, she remained hd stable and did not require significant o2 supplementation. pt was transitioned to lovenox and then to coumadin. inr was 5 on the day of discharge. pt had previously recieved 5mg coumadin x2 days and was held on the day of discharge. coumadin was held on the day of discharge. rehab facility will continue to adjust coumadin dose as needed. pt has no family history or prolonged recumbency, though clot is in hemiparetic leg. ca screening appears to be mostly uptodate with colonoscopy in , mammogram in though she has not had a pap recently. -pt scheduled for lower extremity ultrasound on for consideration of ivc filter removal. -interventional radiology (dr and ) to review leni and will call pt to arrange for removal of ivc filter at that time. . # uti: pt was noted to have a +ua and initially started on cipro. however, pt's urine grew esbl e coli s to nitrofurantoin but not cipro and so pt was switched to nitrofurantoin for total course of 7 days. . # history of hemorrhagic stroke: review of records indicates conversion from ischemic to hemorrhagic stroke. seemingly minimal risk for recurrent bleeding approximately 6 years post-event. pt had been on secondary stroke ppx with plavix but this was transitioned to coumadin. . # cad/?chf: pt reports history of ef 10-15%, however, tte was repeated and showed preserved lv function (no lv systolic or diastolic dysfunction). metoprolol was initially held for hypotension and then restarted prior to discharge in setting of frequent ectopy (including one 16 beat run of nsvt) and normal blood pressures. pt is not on aspirin allergy. crestor was continued. . # copd: continued tiotroprium . # htn: held bblocker initially in setting of potential hd instability, restarted prior to discharge. . # hyperlipidemia: continued home crestor . # low bicarbonate: felt to be compensatory elevated respiratory rate and low pco2 as pt's venous pco2 was only 36. . family contact: (daughter) medications on admission: metoprolol tartrate 25 mg tab oral 1 tablet(s) twice daily plavix 75 mg tab oral 1 tablet(s) once daily tiotropium bromide 18 mcg caps w/inhalation device(s) once daily crestor 20 mg tab oral 1 tablet(s) once daily glipizide 5 mg tab oral 1 tablet(s) once daily trazodone 50 mg tab oral 1 tablet(s) qhs topamax 200 mg tab oral qpm topamax 150 mg qam allergies: aspirin / penicillins / sulfa discharge medications: 1. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 2. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 3. rosuvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 4. glipizide 5 mg tablet sig: one (1) tablet po daily (daily). 5. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 6. topiramate 100 mg tablet sig: two (2) tablet po hs (at bedtime). 7. topiramate 100 mg tablet sig: 1.5 tablets po qam (once a day (in the morning)). 8. nitrofurantoin (macrocryst25%) 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 3 days: last day . 9. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 10. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 11. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 12. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain: limit tylenol to less that 4g per day. 13. nystatin 100,000 unit/g cream sig: one (1) appl topical (2 times a day) for 2 weeks: apply to rash underneath right knee and behind right ankle. 14. clotrimazole 1 % cream sig: one (1) appl topical (2 times a day) for 2 weeks: apply to rash in right axilla. 15. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily) as needed for pain: 12 hours on, 12 hours off. apply to sore shoulder as needed. 16. coumadin 2 mg tablet sig: as below tablet po once a day: hold all coumadin on (inr 5 today). recheck inr tomorrow (), if inr 3.5 or lower would give 2mg. np on call daily with inr to help with coumadin adjustment until she's on a stable dose of coumadin (just started coumadin 2d ago). discharge disposition: extended care facility: cape code nursing & rehabilitation center - discharge diagnosis: primary: pulmonary embolus, uti discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to the hospital for a large blood clot in the lungs. we started you on a blood thinner called lovenox (which is a shot), but are transitioning you to coumadin (which is a pill). you will need to get your coumadin levels checked very closely for the next few weeks to confirm that your your coumadin levels are not too high (which can cause bleeding) or low (which can lead to clotting). you are going to rehab but when you go home, please weigh yourself every morning, call your primary doctor if your weight goes up more than 3 lbs. we have made several changes to your medications. please ensure that your rehab gives you a copy of your medicine list when you go. in brief, we stopped your plavix, decreased your metoprolol tartrate (lopressor), started coumadin, started lidocaine patch followup instructions: please go to the following appointment which we have arranged for you: 1. you need to return to to see if you still have clot in your leg. it is very important that you go to this appointment. the radiologists will call you after they see the result of the leg ultrasound and arrange a time to take out the filter they placed in the veins near your heart. ultrasound appointment: hospital, monday at 12:30 pm in the clinical center on the in the radiology suite *** after your ultrasound the radiologists should call you to arrange your next appointment (to get the filter out). if they don't call within 1 week, please call them at . your appointment should be with dr . 2. we also arranged for you to see a dermatologist for the rash on your shoulder and knee. if these rashes have disappeared, you can cancel this appointment. department: dermatology and laser when: wednesday at 2:15 pm with: , md building: (, ma) campus: off campus best parking: free parking on site procedure: venous catheterization, not elsewhere classified interruption of the vena cava angiocardiography of venae cavae diagnoses: acidosis anemia of other chronic disease coronary atherosclerosis of native coronary artery urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension chronic airway obstruction, not elsewhere classified other and unspecified hyperlipidemia chronic systolic heart failure late effects of cerebrovascular disease, hemiplegia affecting unspecified side acute venous embolism and thrombosis of deep vessels of proximal lower extremity hyperosmolality and/or hypernatremia other pulmonary embolism and infarction 

Answer: The patient is high likely exposed to