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: penicillins / clindamycin attending: chief complaint: sob major surgical or invasive procedure: . history of present illness: 88f h/o metastatic breast cancer c/b malignant pleural and pericardial effusion s/p window, currently on chemotherapy, initially presented on with sob increased above chronic baseline. right pleurex catheter w/ increased drainage of ~300cc/day. +cough with minimal sputum. . in the ed, t 98.5, bp 91/31, hr 94, rr 20-24, 94% on 4l nc (91% on 1l nc). cxr revealed reaccumulation of right pleural effusion with possible superimposed pna. given ctx, azithro, and flagyl initially, then changed to levofloxacin and flagyl on admission to omed. ip consulted, drained 150cc and thought effusions unlikely etiology of increased dyspnea. echo with normal cardiac function, trivial pericardial effusion. cta chest negative for pe. lenis negative for dvt. portacath placed on for long-term access. derm consulted for new rash at right pleurex site concerning for cutaneous metastases of her breast cancer (carcinoma erysiploides), a biopsy was performed. . on the floor this morning, became more dyspnic, hypoxic to 90% on 100% shovel mask, and tachypnic to 30s. newly tachycardic to 150s (ecg with ?afib). sbp mid-80s. pulsus 10. abg 7.39/27/76. cxr with modest decrease in the size of the right pleural effusion, but otherwise unchanged. coarse breath sounds on exam bilaterally (?upper airway). no response to nebs, morphine, racemic epi, or deep suction (although suboptimal). transferred to . past medical history: ponch # metastatic breast ca (dx ) - s/p mastectomy - s/p malignant pleural effusion () - s/p pleurodesis, r pleurex catheter placement () - s/p fulvestran x4 cycles - s/p malignant pericardial effusion (), d/c'd fulvestran - pericardial window placed - s/p anastrozole, d/c'd progression - s/p capecitabine, d/c'd inability to swallow pills - current therapy: navelbine x1 cycle () . pmh # hypothyroidism # hyperlipidemia # esophageal stenosis s/p dilation (, ) # r eye blindness herpes keratitis # s/p umbilical hernia repair () social history: other: # personal: lives alone # tobacco: prior, quit > 50 yr ago # alcohol: social # recreational drugs: not elicited family history: non-contributory. physical exam: general appearance: no acute distress, thin, anxious eyes / conjunctiva: perrl, right eye opacification head, ears, nose, throat: normocephalic cardiovascular: (s1: normal), (s2: normal) peripheral vascular: (right radial pulse: not assessed), (left radial pulse: not assessed), (right dp pulse: not assessed), (left dp pulse: not assessed) respiratory / chest: (expansion: symmetric), (percussion: dullness : right lower ), (breath sounds: bronchial: bilateral, rhonchorous: ) abdominal: soft, non-tender, bowel sounds present, no(t) distended extremities: right: 1+, left: 1+, no(t) cyanosis musculoskeletal: unable to stand skin: warm neurologic: attentive, follows simple commands, responds to: not assessed, movement: not assessed, tone: not assessed pertinent results: 04:30pm blood wbc-3.9* rbc-4.93 hgb-14.8 hct-43.6 mcv-88 mch-30.1 mchc-34.0 rdw-14.4 plt ct-457* 01:00am blood wbc-3.9* rbc-4.28 hgb-13.1 hct-38.3 mcv-89 mch-30.6 mchc-34.3 rdw-14.5 plt ct-355 06:42am blood wbc-4.9 rbc-4.46 hgb-13.7 hct-39.7 mcv-89 mch-30.7 mchc-34.5 rdw-14.8 plt ct-371 04:00am blood wbc-6.4 rbc-3.50* hgb-10.8* hct-32.9* mcv-94 mch-30.8 mchc-32.8 rdw-15.1 plt ct-276 04:00am blood plt ct-276 04:00am blood pt-18.5* ptt-41.3* inr(pt)-1.7* 02:47am blood pt-18.6* ptt-43.0* inr(pt)-1.7* 07:40pm blood pt-16.2* ptt-33.0 inr(pt)-1.4* 04:30pm blood glucose-99 urean-24* creat-1.2* na-137 k-6.8* cl-105 hco3-23 angap-16 07:20am blood glucose-99 urean-26* creat-1.2* na-141 k-5.0 cl-109* hco3-23 angap-14 05:37am blood glucose-128* urean-26* creat-1.2* na-141 k-4.5 cl-109* hco3-23 angap-14 07:40pm blood glucose-133* urean-28* creat-1.4* na-139 k-4.2 cl-111* hco3-16* angap-16 04:00am blood glucose-214* urean-26* creat-1.3* na-137 k-4.3 cl-108 hco3-13* angap-20 04:30pm blood ck-mb-3 probnp-1143* 04:00am blood ck-mb-9 ctropnt-0.15* 04:30pm blood ctropnt-0.01 06:42am blood ck-mb-4 ctropnt-<0.01 07:40pm blood ck-mb-5 ctropnt-0.04* 07:20am blood calcium-8.6 phos-4.0 mg-2.3 01:00am blood calcium-8.1* phos-3.3 mg-2.1 05:37am blood calcium-8.1* phos-3.5 mg-2.0 06:42am blood calcium-8.1* phos-3.1 mg-2.1 07:40pm blood calcium-7.7* phos-3.4 mg-2.0 04:00am blood phos-2.9 mg-1.5* 04:00am blood tsh-7.5* 05:02pm blood type-art fio2-100 po2-76* pco2-27* ph-7.39 caltco2-17* base xs--6 aado2-620 req o2-100 intubat-not intuba 02:45am blood type- po2-30* pco2-31* ph-7.26* caltco2-15* base xs--12 intubat-not intuba 05:25pm blood lactate-1.9 06:34pm blood k-4.4 ------------------ ct chest: impression: 1. overall progression of metastatic disease involving the pleura and lung interstitium (lymphangitic carcinomatosis) right greater than left. 2. similar-appearing chest wall metastases. 3. new left renal pelvis prominence, concerning for possible hydronephrosis. consider ultrasound for confirmation/characterization, if warranted clinically. 4. stable right 5th rib lesion, which could represent osseous metastasis. 5. prior granulomatous disease. 5. the study and the report were reviewed by the staff radiologist. reason for examination: metastatic breast cancer and recurrent pleural effusion, assessment of change in pleural effusion. portable ap chest radiograph compared to , obtained at 02:15 a.m. bilateral pleural effusions, right significantly more the left, are again demonstrated with increased right lower lobe opacity consistent with consolidation, consistent with aspiration versus developing pneumonia. there is no significant change in bibasilar atelectasis. the left upper lung is unremarkable. the right chest tube is in unchanged position as well as the right subclavian line with its tip at the cavoatrial junction. dr. approved: tue 9:46 am brief hospital course: 88f h/o metastatic breast cancer (malignant pleural effusion, pericardial effusion) on chemotherapy with acute on chronic dyspnea, tachypnea, tachycardia, hypotension. # dyspnea, tachypnea: acute worsening may be due to mucous plugging in patient with little pulmonary reserve (effusions, lobar collapse, extensive mets with lymphangitic spread), compounded by tachycardia leading to chf decreased diastolic filling and acute pulmonary edema. pneumonia (post-obstructive, aspiration pneumonitis) also possible especially given immunosuppression from malignancy, although less likely. recent negative lenis and cta chest make pe lower on differential. dyspnea and hypoxia likely due to enlarging malignant pleural effusion on cxr given high-flow o2, nebs prn treated atrial fibrillation per below continued levo/flagyl, added vanco for possible post-obstructive pna blood, urine, sputum, pleurex catheter cultured pleurex catheter for drainage of effusions. # atrial fibrillation: new onset in setting of acute illness, may have been related to hypoxia and possible underlying pneumonia. normal atria by recent echo. amiodarone loaded given hypotension, temporarily converted. # hypotension: likely volume depletion in the setting of poor filling and co due to tachycardia. less likely sepsis, cardiogenic, or adrenal etiology. no evidence bleeding or tamponade (normal pulsus, jvp, and no effusion on recent echo). volume resuscitated with ivf bolus prn antibiotics per above cycled cardiac enzymes, increase in troponin likely rate related. no evidence for acs. # esophageal stenosis: last dilation failed, with limited po intake dysphagia. -npo in setting of ams # metastatic breast ca: last navelbine . - : received navelbine as inpatient starting . # hypothyroidism: outpatient levothyroxine. in setting of worsening respiratory failure and poor overall prognosis decision was made to make patient dnr/dni and ultimately comfort measures only in family meeting. pt passed away from respiratory failure. her family was present and patient was comfortable. please see official paper work for details on official time of death. medications on admission: meds at home: # levothyroxine 50mcg po daily # b12 # mvi daily . meds on transfer: ipratropium bromide neb 1 neb ih q6h levothyroxine sodium 50 mcg po daily levofloxacin 750 mg iv q48h acetaminophen 325-650 mg po q6h:prn metronidazole (flagyl) 500 mg iv q8h d1 = albuterol 0.083% neb soln 1 neb ih q6h:prn morphine sulfate 2 mg iv once cyanocobalamin 500 mcg po daily multiple vitamins liq. 5 ml po daily diltiazem 10 mg iv once ondansetron 4-8 mg iv q8h:prn guaifenesin ml po q6h:prn prochlorperazine 10 mg po/iv q6h:prn nausea heparin 5000 unit sc tid racepinephrine 0.5 ml ih q4h:prn senna 1 tab po bid:prn discharge medications: expired discharge disposition: expired discharge diagnosis: breast cancer respiratory failure discharge condition: expired discharge instructions: expired followup instructions: expired md, procedure: venous catheterization, not elsewhere classified closed biopsy of skin and subcutaneous tissue injection or infusion of cancer chemotherapeutic substance dilation of esophagus diagnoses: acute kidney failure, unspecified unspecified septicemia unspecified acquired hypothyroidism atrial fibrillation secondary malignant neoplasm of pleura personal history of malignant neoplasm of breast accidental puncture or laceration during a procedure, not elsewhere classified other and unspecified hyperlipidemia acute respiratory failure other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation secondary malignant neoplasm of skin systemic inflammatory response syndrome due to noninfectious process with acute organ dysfunction stricture and stenosis of esophagus 

Answer: The patient is high likely exposed to