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: percodan / percocet / cerebyx / phenytoin attending: chief complaint: right facial droop, left face and arm numbness major surgical or invasive procedure: -status post tracheostomy -status post peg -status post dental extraction of 3 teeth history of present illness: patient is a 56 year old right handed female with pastmedical history of breast cancer 10-15 years ago, pleural effusion, dvt and pe who presented to on for evaluation of left face and arm numbness and right facial droop. patient was in her usual state of health until about one week ago when she reports having "the flu". she then had several days of nausea and vomiting and malaise. two days prior to admission her daughter her right eye was "droopy". on evening prior to admission, her whole right face was drooped. then, on morning of admission, she awoke at 6am with left arm and face numbness. this was associated with a vertiginous sensation as well. daughter noted that her speech was slurred. no nausea or vomiting, headaches, blurry vision, double vision, lightheadedness, paresthesias, weakness or incoordination. she went to for evaluation. head ct there with pontine hemorrhage. transferred to for further evaluation. on initial arrival, heart rate 70-80s and sinus, bp 138/90, oxygen 93/ra and 98%/2l. while in ed, she received 2 units of ffp. however, she reported that her symptoms worsened. she felt that her speech was more slurred, she was having difficulty managing her saliva and secretions, and had vertical diplopia. repeat head ct showed interval worsening in the size of her bleed, from 8-12 mm. while in ed, she went into atrial fibrillation with rapid ventricular response; diltiazem 20mg iv resulted in rate control. after arrival to the neurology floor, she continued having difficulty managing her secretions. on several occasions, her oxygen saturation drooped into the 80s. she was transferred to the icu for closer monitoring. she received factor viia. she was electively intubated in early am on . past medical history: 1. breast cancer status post right mastectomy and chemotherapy 15 years ago 2. pleural effusion 3. dvt and pe 7 years ago social history: married, with 3 children. lives with husband,daughter, son and grandchildren. she is a homemaker. no tobacco,valcohol, drug use. family history: mother with stroke in her 70s. sister with history of breast cancer, died from brain mets. physical exam: tm: 99.0 tc: 98.4 bp: 97/69 (97-150/66-87) hr: 78 (76-140s) vent ac 600x12 () with fio2 0.40 gen: wd/wn, sitting up in bed comfortably, nad. heent: nc/at. anicteric. mmm. neck: supple. no masses or lad. no jvd. no thyromegaly. no carotid bruits. lungs: decreased breath sounds over right hemithorax. coarse breath sounds on left. no r/r/w. cardiac: rrr. s1/s2. no m/r/g. abd: soft, nt, nd, +nabs. no rebound or guarding. no hsm. extrem: warm and well-perfused. no c/c/e. neuro: mental status: sleepy but arousable. cooperative with exam. able to follow simple midline and appendicular commands. able to make needs known by writing on pad of paper. cranial nerves: i: not tested ii: pupils equally round and reactive to light, 2.5 to 2 mm bilaterally. visual fields are full to confrontation. iii, iv, vi: on neutral gaze, eyes are deviated to the left with right beating nystagmus. on right lateral gaze, eyes do not cross midline. upgaze impaired with vertical nystagmus, some rotatory component. v, vii: unable to fully assess with ett but appears to have right umn palsy. decreased sensation left hemiface. viii: unable to fully assess. ix, x: unable to assess with ett. : shoulder shrug strong. xii: tongue to right around ett. motor: normal bulk and tone. no abnormal movements or tremors. strength full. sensation: decreased to light touch over left hemibody. reflexes: b t br pa ac right 1 1 1 0 0 left 1 1 1 0 0 grasp reflex absent. right toe upgoing. left toe equivocal. coordination: slowed but accurate on left fnf. dysmetric right fnf. gait: unable to assess. pertinent results: 12:20pm wbc-8.1 rbc-4.15* hgb-12.1 hct-35.0* mcv-84 mch-29.1 mchc-34.5 rdw-14.1 12:20pm neuts-74.4* lymphs-21.2 monos-3.5 eos-0.5 basos-0.5 12:20pm plt count-258 12:20pm pt-18.9* ptt-29.3 inr(pt)-2.2 12:20pm glucose-107* urea n-15 creat-0.6 sodium-141 potassium-3.9 chloride-101 total co2-32* anion gap-12 12:20pm calcium-9.1 phosphate-3.5 magnesium-1.9 ----- ct head w/o contrast : a rounded hyperdensity is again noted in the right pontomedullary junction. this is slightly larger than on the prior study, now measuring 12 x 11 mm in size. in addition, this extends slightly more superiorly into the pons and slightly more inferiorly into the medulla. no new areas of hemorrhage are identified. streak artifact is again identified within this area which limits evaluation of surrounding edema. there is no mass effect or hydrocephalus. -white matter differentiation remains preserved. the osseous structures are normal. ----- mri head w/o contrast and mra head : multiplanar t1 and t2w images of the brain was obtained. mra of the circle of was performed. correlation is made to the ct examination dated . as seen on the ct examination, there is a small 1 cm lesion of increased t2 signal along the right pontomedullary junction which demonstrates magnetic susceptibility on gradient echo images suggestive of a small cavernoma or a calcified lesion due to the increased density seen on the ct exam and magnetic susceptibility. flair images demonstrate a similar but smaller lesion near the left middle cerebellar peduncle. additional evaluation of the brain with gadolinium enhanced mri in both axial and coronal planes would be recommended. the ventricular system is symmetrical without hydrocephalus. the 4th ventricle is in the midline. there is normal signal flow void within the intracranial portions of the carotid and basilar arteries. mra of the circle of demonstrates patent distal vertebrobasilar circulation. no aneurysms are seen along the posterior circulation. the visualized anterior, middle, and posterior cerebral arteries are patent. the exam is insensitive to detect tiny aneurysms less than 3 mm in diameter. ----- ct chest, abdomen, pelvis : ct of the chest with iv contrast: there are multiple enlarged lymph nodes in the left supraclavicular and prevascular regions, the largest is in the left supravicular region measuring approximately 12 x 19 mm. the patient is intubated. the trachea and left main stem bronchi and its tributaries are widely patent. there is obstruction within the central right airways with complete opacification of the more distal airways and the entire right lung. there is a mixed low and high attenuation density of the collapsed right lung. there is a small loculated effusion at the posterior inferior right thoracic cavity with a thickened wall. the distal right main pulmonary artery is obstructed. posterior atelectatic changes are noted within the left lung. at the superior aspect of the superior segment of the left lower lobe there is a pleural based nodular density measuring approximately 6 x 10 mm. the patient is status post right mastectomy and surgical clips are noted in the right axilla consistent with lymph node dissection. a porta cath is noted in the superior left chest wall. ct of the abdomen with iv contrast: the liver, pancreas, spleen, adrenal glands, kidneys, ureters, and small/large bowel loops are unremarkable. there is layering high attenuation material within the gallbladder suggestive of layering sludge. there is gallbladder wall thickening or gallstones. there is no lymphadenopathy or free fluid. ct of the pelvis with iv contrast: the uterus, adnexa, sigmoid colon, rectum, distal ureters, and urinary bladder are unremarkable. surgical clips are noted adjacent to the uterine fundus. there is no lymphadenopathy or free fluid. there are no suspicious lytic or sclerotic osseous lesions. ----- mri head with and without contrast : since the previous mri study there is now evidence of subacute hemorrhage with increased t1 and decreased t2 signal identified in the right side of the pontomedullary junction. the previously seen surrounding edema has also increased which involves now the medulla and the posterior portion of the pons. no distinct enhancement is seen in this region. a second area of increased t2 signal with subtle enhancement is identified in the left middle cerebral peduncle which is unchanged from the previous study. no midline shift or hydrocephalus is seen. there are no other distinct areas of abnormal enhancement noted. impression: interval new hemorrhage with subacute characteristics in the right pontomedullary junction with increased edema. no distinct enhancement is seen in this region given the presence of blood products. however in the presence of a second small enhancing lesion in the left middle cerebral peduncle, and given the patient's clinical history, these findings are suggestive of metastatic lesions. no hydrocephalus is seen. brief hospital course: patient is a 56 year old female with past medical history of breast cancer 15 years ago, dvt/pe admitted on after 2 day history of right facial droop, left hemibody numbness. exam with left gaze preference, impaired right lateral gaze with nystagmus, impaired upgaze with vertical and rotatory nystagmus, right central 7th palsy, altered palatal and gag function, diminished sensation over left hemibody and right dysmetria. in terms of localization, her findings point to lesion in right lower pons/upper medulla. indeed, she has hemorrhage at right pontomedullary junction, 12x11mm. in light of location and history of breast ca, hemorrhagic transformation of underlying mass was a concern. she was admitted to the neurology/neurosurgical icu. neuro checks were performed every hour. initially, she was started on mannitol and decadron. these were both weaned . goal systolic blood pressure was <130. all antiplatelets and anticoagulant agents were held. repeat mri with gadolinium to assess for underlying mass demonstrated enhancement of hemorrhagic mass and second enhancing lesion in cerebellum. oncology was consulted. patient actively refusing chemotherapy and/or radiotherapy but is actively discussing other treatment options with oncology. on hospital day #1, she was intubated for inability to protect airway and difficulty handling secretions. chest xray showed opacification of right hemithorax and mediastinal shift. she underwent flexible and rigid bronch with tissue biopsies samples taken. chest ct demonstrated multiple enlarged lymph nodes, collapsed right lung and left sided pleural based density concerning for malignancy. pathology from her right mainstem tumor mass was consistent with metastatic adenocarcinoma of breast origin. we were unable to wean patient from ventilator, likely related to collapsed right lung and poor lung volumes. tracheostomy was performed . patient continues to rely on mechanical ventilation. while on telemetry monitoring, patient was noted to have intermittent rapid atrial fibrillation alternating with sinus bradycardia. she was seen by cardiolgoy. esmolol or diltiazem was recommended as needed for rate control. tsh was within normal limits. peg tube was placed . due to location of her hemorrhagic tumor, patient is likely to have difficulties with swallowing and speech function as she has decreased palatal, tongue, and gag functions. in terms of infectitious disease issues, patient spiked a temperature on . sputum culture showed s. aurea. urine culture had gram positive bacteria. she was started on vancomycin empirically while identification and sensitivities were pending on cultures. the day prior to discharge she was started on a right eye patch to be used intermittently to alleviate her diplopia. she also has a right conjunctivitis that is being treated with drops. we discussed the patient's disposition with oncology, who stated that they had had a lengthy conversation with the patient and her daughter on , at which time the patient had adamantly refused any chemotherapy or further therapeutic interventions. arimidex or tamoxifen are not therapeutic candidates because they have already been used in her treatment regimen in the past. oncology requested that she make a follow up appointment with dr. if she is interested in further therapy. medications on admission: 1. coumadin 10 mg po qhs 2. arimidex 1 mg po qd 3. lasix 40 mg po qd 4. potassium kcl discharge medications: 1. vancomycin 1000 mg iv q12 2. reglan 10 mg po qid 3. senna 1 tab po bid prn constipation 4. prochlorperazine 10 mg iv q6 hours prn nausea 5. magnesium sulfate 2 gm iv qday prn mg<2 6. potassium chloride 40 meq iv qday prn k<3.5 7. tocopheryl 400 ml pg qday 8. esmolol 25 mcg/kg/min titrate to hr<110 9. dulcolax 100 mg po bid 10. insulin sliding scale discharge disposition: extended care facility: - discharge diagnosis: metastatic breast cancer, with hemorrhage in right pontomedullary junction, likely secondary to metastasis. discharge condition: stable discharge instructions: neuro: neuro checks, supportive care onc: pt should follow up with oncology (dr. office) as an outpatient if she wishes to pursue therapy optho: pt needs eye patch on r eye intermittently to alleviate diplopia, also eye drops for conjunctivitis cv: continue esmolol for rate control. pt has hx of intermittent rapid atrial fibrillation, but has been stable from that perspective for many days resp: follow o2 sats, continue ventilation through trach id: continue vancomycin x14 day course (last day will be ), recommend reculturing if she spikes heme: follow hematocrit, transfuse for hematocrit <30, last transfusion was gi: continue peg tube feeds, follow electrolytes prophylaxis: pneumoboots, insulin sliding scale, proton pump inhibitor followup instructions: follow up with oncology: call dr. office at to schedule appointment md, procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus extraction of other tooth transfusion of packed cells transfusion of other serum teleradiotherapy using photons diagnoses: anemia, unspecified urinary tract infection, site not specified unspecified protein-calorie malnutrition personal history of malignant neoplasm of breast intracerebral hemorrhage pulmonary collapse acute respiratory failure secondary malignant neoplasm of brain and spinal cord methicillin susceptible pneumonia due to staphylococcus aureus personal history of venous thrombosis and embolism secondary malignant neoplasm of lung sinoatrial node dysfunction conjunctivitis, unspecified 

Answer: The patient is high likely exposed to