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: patient recorded as having no known allergies to drugs attending: chief complaint: fever major surgical or invasive procedure: none history of present illness: 22 year-old gravida 2 para 0 at 21 weeks 2 days ga presented to the ed with fever and flank pain. she reported bilateral flank pain, mild nausea and denied any vaginal bleeding, contractions, or leakage of fluid. she was feeling active fetal movement. . upon arrival to the ed she was found to have fever 101.1, tachycardia to 120 and hypotension with blood pressure 80/50s. examination revealed cva tenderness. labs revealed a white blood count of 18 and urinalysis had >50 wbc. the clinical picture was consistent with pyelonephritis. ceftriaxone was administered. given the persistent hypotension despite 4 liters of iv fluid, the decision was made to admit her to the . . of note she has hyperthyroidism and had not be taking her ptu for the last 2 weeks. past medical history: prenatal course: 1. dating: estimated due date 2. labs: a+/ri/hepb s antigen -/rprnr/hiv negative 3. ultrasound: normal full fetal survey 4. issues: hyperthyroidism . past obstetric history: spontaneous abortion x 1 . past gynecologic history: - abnormal pap->colpo with normal biopsy -h/o gc/chlamydia->negative . medical history: hyperthyroidism () . surgical history: right eye surgery social history: patient denies any tobacco, alcohol or recreational drug use. prior to pregnancy, + alcohol family history: maternal great uncle had disease, mother has thyroid dysfunction. no other family history of other autoimmune diseases. physical exam: on presentation: v/s tm: 100.7, tc: 98.8, bp 90/44 - 109/33, hr 81-122, rr 22-42, o2 92-96% 2l gen: young woman in nad heent: slight bilateral proptosis with very slight soft tissue swelling in area of epicanthal fold over left eye. op clear without erythema or exudate. neck: thyroid gland small, firm, slightly irregular on left, without tenderness to palpation. pulm: good respiratory effort with no audible wheezes, rhonchi, or rales cv: tachycardic, nl s1/s2 abd: gravid, soft, non-tender, +bs back: no significant cva tenderness skin: no acanthosis nigricans, no rashes, left forearm tattoo ext: warm and well perfused without lower extremity edema pertinent results: wbc-18.0*# rbc-3.42* hgb-10.9* hct-30.1* mcv-88 plt ct-268 neuts-93.3* lymphs-4.5* monos-1.6* eos-0.5 baso-0.1 wbc-14.4* rbc-2.92* hgb-9.2* hct-25.9* mcv-89 plt ct-209 wbc-11.7* rbc-2.57* hgb-8.2* hct-22.7* mcv-88 plt ct-187 neuts-85.9* lymphs-10.1* monos-3.8 eos-0.1 baso-0.1 hct-28.9*# wbc-10.3 rbc-2.88* hgb-9.3* hct-25.4* mcv-88 plt ct-206 wbc-6.2 rbc-3.08* hgb-9.6* hct-27.3* mcv-89 plt ct-207 . pt-13.3 ptt-30.2 inr(pt)-1.1 pt-14.0* ptt-36.0* inr(pt)-1.2* . glucose-123* urean-7 creat-1.1 na-136 k-3.1* cl-102 hco3-21* glucose-96 urean-7 creat-0.7 na-139 k-3.5 cl-112* hco3-15* glucose-97 urean-6 creat-0.7 na-130* k-3.8 cl-100 hco3-17* glucose-89 urean-6 creat-0.8 na-140 k-3.4 cl-110* hco3-19* glucose-76 urean-5* creat-0.8 na-136 k-4.1 cl-108 hco3-19* . alt-14 ast-21 alkphos-57 totbili-0.6 alt-13 ast-25 ld(ldh)-200 alkphos-47 totbili-0.4 . albumin-3.0* calcium-6.7* phos-1.6* mg-1.4* calcium-6.4* phos-2.1* mg-2.2 iron-10* mg-1.7 albumin-2.9* calcium-8.3* mg-1.9 . caltibc-179* ferritn-129 trf-138* . 11:49am blood tsh-0.19* 11:49am blood t3-146 free t4-0.86* 09:17pm blood t4-9.4 calctbg-1.28 tuptake-0.78 t4index-7.3 04:54am blood pth-16 07:45am blood tsh-1.0 07:45am blood t3-129 free t4-0.96 . type- temp-39.1 ph-7.34* comment-green top type- ph-7.43 . urine blood-neg nitrite-pos protein-30 glucose-100 ketone-tr bilirub-neg urobiln-1 ph-5.0 leuks-mod urine rbc-0-2 wbc->50 bacteri-many yeast-none epi- urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg . urine culture (final ): escherichia coli. >100,000 organisms/ml.. sensitivities: mic expressed in mcg/ml ampicillin------------ <=2 s ampicillin/sulbactam-- <=2 s cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 2 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s meropenem-------------<=0.25 s nitrofurantoin-------- <=16 s piperacillin---------- <=4 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s . urine culture (final ): <10,000 organisms/ml. . blood cultures 1/19, : no growth . echocardiogram : impression: normal lv cavity size with normal global and regional biventricular systolic function. no diastolic dysfunction or significant valvular disease seen. small pericardial effusion located posterior to inferolateral wall without evidence of tamponade. . chest x-ray : final report indication: 22-year-old female who is pregnant with pyelonephritis and shortness of breath after fluid. pa and lateral chest radiographs: there is bilateral predominantly lower lobe air space opacity with air bronchograms. there is prominent azygos vein. the heart size is normal. there are no pleural effusions on this frontal radiograph. findings are consistent with pulmonary edema. . bilateral lower extremity venous doppler : clinical history: acute onset of shortness of breath, 21 weeks pregnant. evaluate for deep vein thrombosis. normal flow and compressibility was present in the common femoral, superficial femoral, and popliteal veins in both the right and left side. no evidence of thrombus in either calf was seen. impression: no evidence of deep vein thrombosis. . renal ultrasound : indication: 21 weeks pregnant with pyelonephritis. please assess for hydronephrosis or perinephric abscesses. findings: the right kidney measures 11.7 cm. the left kidney measures 10.6 cm. there is moderate bilateral hydronephrosis. no definite stones are identified in either kidney. renal parenchymal abnormalities are identified to suggest abscess. an intrauterine pregnancy is present with fetal heart rate of 167 beats per minute. impression: moderate bilateral hydronephrosis and small amount of right perinephric fluid with no son evidence for renal abscesses. as no renal stones are identified and the entire course of the ureters is not visualized, it is not possible to determine whether the hydronephrosis present relates to pregnancy or other causes. brief hospital course: micu course: # acute pyelonephritis: treated with ampicillin and gentamicin per ob recommendations. renal ultrasound did not show perinephric abscess. continued to have intermittent low grade fevers while in the icu . # hypotension: patient met the criteria for sepsis, howevere per prior omr notes, blood pressures had been running in 90's, so patient not hypotensive per her parameters. . # tachycardia: differential diagnosis includes hyperthyroidism though per endocrine consult, felt that based on her labs, she was likely hypothroid. however, may be a sign of early dilated cardiomyopathy. echocardiogram was normal. was minimally fluid responsive. ruled out deep vein thrombosis with lower extremity venous dopplers. . # oxygen desaturation: oxygen saturation in the mid 80s% on hospital day #2. patient was approximately 9 liters positive. chest x-ray was consistent with pulmonary edema . # pregnancy at 21 weeks: fetal heart rate was reassuring on admission. continued prenatal vitamins. had daily fetal heart rate spot checks that were reassuring. . # disease status post eye surgery: tsh is low at 0.19. free t4 is also low at 0.86. this may be a result of increased thyroid binding globulin induced by hyper-estrogen state. also, patient had not been taking ptu for 2 weeks. the importance of taking this medication for fetal well-being was explained to the patient and she understood this conversation. endocrinology consult placed for recommendations regarding thyroid hormone level normalization. . # hypokalemia: etiology unclear, was 3.1 on admission. resolved with repletion. only 1 episode of diarrhea ~2 weeks ago. kidney function normal. oral intake had been good until 3 days ago. . # anemia: likely dilutional and secondary to pregnancy, appears to also have iron deficiency component. recevied 1 unit packed red blood cells for hematocrit of 22. . # hypocarbia: likely a hyperchloremic metabolic alkalosis secondary to fluid resuscitation. also be a consequence of tachypnea. . . the patient was called out of the icu on hospital day #3. clinically she was stable with no oxygen requirement and stable blood pressure. she continued on iv ampicillin and gentamicin until she was afebrile for 48 hours on the evening of hospital day #5. her initial urine culture grew pan-sensitive e. coli and she was transitioned to oral nitrofuantoin. she remained afebrile and was discharged home on hospital day #6. she will remain on suppression for the remainder of her pregnancy. . while hopsitalized, she was followed by the endocrine service. her thyroid function tests were normal off medication and they believed her to be in remission and that she should remain off the propylthiouracil that she had been taking. she will follow up with endocrine as an outpatient. medications on admission: pnv propylthiouracil 100mg (has not taken for 2 weeks) discharge medications: 1. nitrofurantoin (macrocryst25%) 100 mg capsule sig: one (1) capsule po bid (2 times a day): for 10 days, then once daily for rest of pregnancy. disp:*50 capsule(s)* refills:*2* discharge disposition: home discharge diagnosis: pyelonephritis discharge condition: good discharge instructions: take antibiotics as prescribed - twice a day for 10 days, then once a day for rest of pregnancy. call with abdominal pain, pain or burning with urination, vaginal bleeding, or any other problems. followup instructions: dr. at on as scheduled. endocrine: , m.d. phone: date/time: 2:30 procedure: transfusion of packed cells diagnoses: acidosis hypocalcemia unspecified septicemia hyposmolality and/or hyponatremia sepsis hypopotassemia iron deficiency anemia, unspecified toxic diffuse goiter without mention of thyrotoxic crisis or storm hydronephrosis acute pyelonephritis without lesion of renal medullary necrosis anemia of mother, antepartum condition or complication other specified infectious and parasitic diseases of mother, antepartum condition or complication infections of genitourinary tract in pregnancy, antepartum condition or complication thyroid dysfunction of mother, antepartum condition or complication other current conditions classifiable elsewhere of mother, antepartum condition or complication 

Answer: The patient is high likely exposed to