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: cephalosporins / kefzol attending: chief complaint: hypotension major surgical or invasive procedure: intubation cpr defibrillation history of present illness: ms. is a 54 year old g2p2 lady, with a past medical history of symptomatic uterine fibroids and multinodular goiter (euthyroid), who was admitted for an elective tah, complicated by hypotension, ventricular tachycardia and cardiac arrest. patient presented on . following induction of anesthesia and intubation, kefzol was administered. while antibiotics were being given, patient developed hypotension to 40/20s, and was given 1 mg epinephrine iv, out of concern for anaphylaxis, which resulted in narrow-complex tachycardia. ekg at the time showed st segment elevation in the inferior leads. bedside tee performed showing hyperdynamic ventricle with poor filling. at 15:10, the patient's rhythm degenerated to vt/vf. after a first dc shock of 200j, there was initial return of sinus bradycardia, which degenerated into vt again. patient received another dose of epinephrine 1 mg iv and lidocaine 100 mg, followed by amiodarone 300 mg. second dc shock of 300j failed to convert patient out of vt/vf. the patient then was noted to be pulseless and received cpr for 3-5 minutes with resultant rosc. ekg following the arrest showed sinus tachycardia, with less then 1mm st elevations in inferior leads and persistent st depressions in anterior precordial leads. repeat bedside tee with ?inferior wall hypokinesis. at that time, the patient was noted to have a potassium of 2.4 as well. during this episode, the patient developed a diffuse pink, blanching rash. for her rash, patient was given diphenhydramine 25 mg and famotidine 30 mg. due to these complications, tah was cancelled. in the or, patient at 17 cc of urine output, and was given 2200 cc iv fluids. . full ros was not obtained on admission to icu as pt was intubated and sedated. . past medical history: 1.) symptomatic uterine fibroids: had caused pain in the past, and patient was recommended to have tah due to size of fibroids 2.) endometrial polyp 3.) multinodular thyroid: found on physical exam in , asymptomatic, tsh and t4 normal 4.) g2p2 5.) hyperlipidemia social history: lives at home in with two daughters. in a factory on assembly line. no known chemical exposures. no history of tobacco, alcohol or drug use. family history: mother, still living, with dm and htn. no family history of cardiovascular disease or anaphylaxis. no family history of sudden cardiac death. physical exam: on admission to icu vs t35.3 hr 59 bp 109/92 rr 14 o2 sat 100 on the vent vent settings: tv 500, rr 14 peep 5, fio2 50% gen: intubated, responds to voice, follows commands heent: perrl, eomi, anicteric cv: rrr, s1/s2, no m/r/g pulm: good air entry b/l abd:soft, nt, nd, normal bs ext: no edema, clubbing, cyanosis skin: rash resolved neuro: awakens to voice and follows commands access: femoral a-line, peripheral iv's pertinent results: 05:10pm blood wbc-16.7*# rbc-5.18 hgb-16.6*# hct-47.8# mcv-92# mch-32.1*# mchc-34.7# rdw-12.9 plt ct-231 04:18am blood wbc-15.3* rbc-4.54 hgb-14.0 hct-40.8 mcv-90 mch-30.9 mchc-34.4 rdw-13.2 plt ct-226 06:25am blood wbc-7.6# rbc-3.72* hgb-11.3* hct-33.7* mcv-91 mch-30.5 mchc-33.7 rdw-13.0 plt ct-180 12:55pm blood wbc-6.8 rbc-3.69* hgb-11.6* hct-34.0* mcv-92 mch-31.3 mchc-34.0 rdw-13.0 plt ct-182 05:10pm blood pt-14.9* ptt-33.0 inr(pt)-1.3* 05:10pm blood glucose-155* urean-15 creat-0.6 na-138 k-3.3 cl-106 hco3-17* angap-18 04:18am blood glucose-144* urean-12 creat-0.7 na-138 k-4.9 cl-107 hco3-20* angap-16 06:25am blood glucose-85 urean-8 creat-0.6 na-141 k-4.1 cl-108 hco3-30 angap-7* 05:10pm blood alt-48* ast-56* ld(ldh)-186 ck(cpk)-84 alkphos-39 totbili-0.6 04:18am blood alt-35 ast-29 ld(ldh)-151 alkphos-39 totbili-0.8 05:10pm blood ck-mb-3 ctropnt-0.05* 04:18am blood ck-mb-5 ctropnt-0.02* 11:41am blood ck-mb-4 ctropnt-<0.01 05:10pm blood calcium-7.9* phos-3.3 mg-1.6 04:18am blood calcium-8.4 phos-3.2 mg-2.0 06:25am blood calcium-8.0* phos-2.1* mg-2.1 05:10pm blood tryptase-pnd 11:42am urine color-yellow appear-clear sp -1.023 11:42am urine blood-lg nitrite-neg protein-30 glucose-neg ketone-80 bilirub-neg urobiln-neg ph-5.5 leuks-neg 11:42am urine rbc-77* wbc-14* bacteri-none yeast-none epi-0 11:42am urine casthy-10* . microbiology catheter tip culture (): pending, ngtd urine culture (): pending, ngtd blood culture (): pending, ngtd mrsa screening (): pending . pcxr (): impression: ap chest reviewed in the absence of prior chest radiographs: lungs are low in volume but clear. no pneumothorax or pleural effusion. normal cardiomediastinal silhouette. tip of the endotracheal tube is no less than 22 mm above the carina, with the head in neutral or extension. withdrawal 15 mm is recommended. . pcxr (): findings: in comparison with the study of , the endotracheal tube has been removed. no evidence of acute pneumonia or vascular congestion. . echo (): the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. . ekg (#1): sinus tach with inferior and lateral st elevations ekg (#2): sinus tach with new q-waves in inferior leads brief hospital course: briefly, the pt is a 54 yo f who presented initially on day of admission for an elective hysterectomy for symptomatic uterine fibroids. prior to surgery, following intubation and administration of iv cefazolin, the patient developed hypotension to the 40's/20's. then given iv epinephrine with subsequent development of narrow-complex tachycardia, which degenerated into vt/vf, with unsuccessful debibrillation, subsequent pea arrest, received cpr for approximately 4 minutes and return of spontaneous circulation. tah was cancelled and pt was then transferred from the or to the icu, kept intubated. of note, during this incident, pt had 2 bedside echocardiograms done showing some inferior wall hypokinesis, and ekg's showed initially some st elevations that resolved but with some new inferior q waves. during the episode, the pt was noted to have a diffuse body rash, which responded to benadryl and famotidine. pt was successfully extubated the following day on and transferred to the medical floor in stable condition. . acute medical issues: . # anaphylactic shock: given the patient's acute hypotension and rash following administration of iv cefazolin, the pt is presumed to have a severe allergy to cephlasporins. following the acute episode in the or, the patiet remained hemodynamically stable without any pressors or aggressive ivf. she remained hemodynamically stable on the floor after transfer to the medical floor. the patient and her daughter were informed that she has a severe allergic, potentially fatal, reaction to cephlasporins. she has been instructed to abstain from cephlasporins and penicillins, and to avoid antibiotics in general if possible for now, until she follows-up in clinic after discharge. she may need further allergen testing once the acute phase of her anaphylaxis has resolved. she also received a prescription for epipen's, and was instructed on how to administer and also given an informational handout. with regards to concern for the epinephrine potentially triggering her arrhythmia and cardiac arrest, this was discussed with cardiology, and felt that the low dose of epinephrine would make this very unlikely and was not contraindicated. the epinephrine administered during the hypotensive shock had been given iv and at a much higher dose. furthermore, if she did have symptoms consistent with anaphylactic shock, epipen would be the appropriate immediate treatment. a tryptase level is currently still pending. . # vt arrest: the patient developed vt/vf following her anaphylactic shock and administration of iv epinephrine, and was noted to have some wall motion abnormality on bedside echo, ekg changes, and elevated troponin. as such, cardiology consult was asked to see the patient. her follow-up echocardiogram showed resolution of the wall motion abnormality, her ekg returned to baseline, and her troponin quickly downtrended to within normal range. as such, cardiology felt it was very unlikely for the patient to have underlying coronary artery or structural heart disease. they also did not think that her ekg was concerning for risk factors of sudden cardiac death. overall, they felt that vasospasm due to epinephrine most likely caused transient ischemia. however, they did recommend that she be on an aspirin for the next 2 weeks and to have a follow-up exercise-stress echocardiogram in 2 weeks with appropriate cardiology follow-up. she may also need to have her lipids rechecked in the outpatient setting given a reported prior history of dyslipidemia. . # uterine fibroids: unfortunately, given the pt's pre-operative course, the pt's tah was cancelled. given that it was an elective surgery, the pt and her gynecologist, dr. , have opted to postpone the surgery indefinitely until she has further cardiac and allergy follow-up. . transitional issues: 1. she will need to continue on aspirin for 2 weeks and have a outpt exercise-stress echocardiogram, which has already been scheduled, and follow-up with cardiology after the stress testing. 2. she will follow-up with clinic for possible further allergen testing. she also has a pending tryptase level that may aid in the confirmation of her diagnosis of anaphylaxis reaction to cephlasporins. 3. she will follow-up with her pcp, she has pending culture data, including a mrsa screen, blood culture, urine culture, and catheter-tip culture. 4. she will follow-up with her gynecologist to determine when to pursue her hysterectomy that was originally scheduled for this admission. . pending studies: 1. tryptase level 2. urine culture, blood culture, catheter tip culture () 3. mrsa screen () . medications on admission: vitamin d discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily) for 2 weeks: please continue for 2 weeks till . disp:*14 tablet(s)* refills:*0* 2. epipen 0.3 mg/0.3 ml pen injector sig: one (1) injection intramuscular once as needed for anaphylaxis - shortness of breath, tongue swelling, rash, low blood pressure: please keep 1 injection on you at all times or in your purse, keep 1 in your car or your house. please call your doctor or 911 after using. disp:*2 injectors* refills:*1* discharge disposition: home discharge diagnosis: anaphylactic allergic reaction medication ventricular tachycardia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you presented to the hospital for an elective gyn surgery for fibroids, however, prior to your sugery, your developed an anaphylactic allergic reaction with low blood pressure to an antibiotic (cefazolin) and also developed a cardiac arrest, requiring cpr and electric shocks. you were kept intubated and monitored in the icu. you did well in the hospital, but your surgery has been deferred indefinitely at this time. there were some mild abnormalities seen on ultrasound of the heart, so the cardiologists recommend that you take aspirin for the next 2 weeks. you will then have follow-up testing of your heart and will follow-up with cardiology outpatient. you will also have a referral to clinic. you will also follow-up with your gynecologist and pcp. note the following medication changes: 1. aspirin was started. 2. epipen is being prescribed . please follow-up with all the appointments listed below. . the epipen is to be used if you develop any reaction similar to what you experienced here in the hospital, with low blood pressure, difficulty breathing, shortness of breath, rash. please carry one in your purse or on you at all times, and keep one in your car if you drive or at home if you don't. we also recommend that you also avoid any antibiotics until you are seen in follow-up by the allergy specialists, especially the class of antibiotics known as penicillins and cephlasporins. . followup instructions: name: , : internal medicine address: , , phone: appointment: wednesday at 1:30pm . department: cardiac services when: thursday at 1 pm with: , md building: campus: east best parking: garage . department: allergy and clinic address: one place, , phone: **we are working on a follow up appointment with the allergy and clinic within 2-4 weeks. you will be called at home with the appointment. if you have not heard from the office within 2 days or have any questions, please call the number above.** . you will need to have a stress echo test performed prior to your appointment with dr. in cardiology. the test has been scheduled for (wed) at 9am at building . please call if you have questions, need to reschedule, or need directions. you should receive additional instructions in the mail 1 week prior to your study. . please keep your previously scheduled follow-up appointment with dr. for next tuesday (). procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube other electric countershock of heart cardiopulmonary resuscitation, not otherwise specified diagnoses: other iatrogenic hypotension paroxysmal ventricular tachycardia acute respiratory failure cardiac arrest ventricular fibrillation surgical or other procedure not carried out because of contraindication nontoxic multinodular goiter cephalosporin group causing adverse effects in therapeutic use leiomyoma of uterus, unspecified other anaphylactic reaction polyp of corpus uteri 

Answer: The patient is high likely exposed to