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: pelvic mass, abdominal pain major surgical or invasive procedure: 3 unit blood transfusion exam under anesthesia exploratory laparotomy cyst drainage peritoneal washings bilateral salpingo-oophorectomy history of present illness: 84yo g3p3 transferred from with a new diagnosis of a pelvic mass. the pt reports being in usual state of health until , when she woke with severe lower abdominal pain and experienced prolonged nausea and emesis. she presented to on and was admitted. during her hospital course she was treated for a presumed uti and was kept npo. a ct scan of her abdomen revealed a large (>20cm) pelvic mass arising from the l ovary. she was transferred for further evaluation and management. she reports an unquantified weight gain over the past year associated with increased abdominal girth. no changes in appetite, bowel or bladder habits. past medical history: obhx: svd x3 gynhx: menopause ~30y ago, no postmenopausal bleeding; underwent vaginal hysterectomy with ?unilateral salpingo-oophorectomy for prolapse at age 50; no abnl paps or stis medhx: cad s/p cabg x5; dyslipidemia; gerd; osteoarthritis surghx: cabg; vaginal hysterectomy social history: married; lives with husband for whom pt is primary caregiver; denies t/e/d family history: no hx gyn, breast, colon malignancy physical exam: at admission: vs 101.3 122/52 100 20 90% on ra -> 97% on 4l via nc gen mild distress, uncomfortable-appearing chest bibasilar crackles, decreased breath sounds overall heart rrr abd firm, markedly distended, dull to percussion throughout, +bs, diffusely tender without guarding or rebound extr nt, no erythema, 1+ le edema pelvic not performed due to pt immobility pertinent results: 06:35pm urine blood-lg nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-1 ph-5.0 leuk-neg 07:50am blood wbc-8.1 rbc-3.67* hgb-9.1* hct-27.0* mcv-74* mch-24.7* mchc-33.6 rdw-19.2* plt ct-458* 03:19pm blood wbc-10.7 rbc-3.73* hgb-9.1* hct-27.7* mcv-74* mch-24.4* mchc-32.8 rdw-18.7* plt ct-457* 04:00am blood wbc-11.2* rbc-3.27* hgb-7.8* hct-23.6* mcv-72* mch-23.8* mchc-32.9 rdw-18.2* plt ct-445* 03:53am blood wbc-17.0* rbc-3.56* hgb-8.5* hct-25.5* mcv-72* mch-23.9* mchc-33.4 rdw-18.1* plt ct-436 08:48pm blood wbc-20.4* rbc-3.62* hgb-8.6* hct-25.8* mcv-71* mch-23.6* mchc-33.1 rdw-18.0* plt ct-422 07:30am blood wbc-25.7* rbc-3.90* hgb-8.9* hct-27.6* mcv-71* mch-22.8* mchc-32.2 rdw-16.1* plt ct-517* 06:00am blood wbc-27.4* rbc-3.59* hgb-8.2* hct-25.7* mcv-72* mch-22.9* mchc-32.0 rdw-16.0* plt ct-408 03:41pm blood wbc-23.85* rbc-4.02* hgb-9.1* hct-28.0* mcv-70* mch-22.7* mchc-32.7 rdw-15.8* plt ct-389 08:48pm blood neuts-91.5* bands-0 lymphs-4.8* monos-3.5 eos-0.1 baso-0 07:50am blood plt ct-458* 07:20am blood glucose-106* urean-9 creat-0.5 na-137 k-3.5 cl-105 hco3-25 angap-11 07:50am blood glucose-115* urean-15 creat-0.5 na-134 k-3.6 cl-101 hco3-24 angap-13 04:00am blood glucose-73 urean-17 creat-0.6 na-138 k-3.5 cl-107 hco3-22 angap-13 03:53am blood glucose-106* urean-12 creat-0.5 na-134 k-3.7 cl-104 hco3-21* angap-13 08:48pm blood glucose-115* urean-13 creat-0.5 na-132* k-4.0 cl-104 hco3-19* angap-13 03:41pm blood glucose-70 urean-18 creat-0.8 na-133 k-3.9 cl-98 hco3-22 angap-17 07:20am blood calcium-8.1* phos-3.1 mg-2.2 03:41pm blood caltibc-329 vitb12-240 folate-10.5 ferritn-94 trf-253 03:41pm blood cea-2.3 ca125-62* 12:09 pm sputum source: endotracheal. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 1+ (<1 per 1000x field): gram positive cocci. in pairs and singly. respiratory culture (final ): sparse growth oropharyngeal flora. staph aureus coag +. sparse growth. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | ciprofloxacin--------- =>8 r erythromycin---------- =>8 r gentamicin------------ <=0.5 s levofloxacin---------- =>8 r oxacillin------------- =>4 r penicillin------------ =>0.5 r rifampin-------------- <=0.5 s tetracycline---------- <=1 s vancomycin------------ <=1 s 6:35 pm urine source: catheter. **final report ** urine culture (final ): no growth. **final report ** aerobic bottle (final ): no growth. anaerobic bottle (final ): no growth. 6:00 pm blood culture **final report ** aerobic bottle (final ): no growth. anaerobic bottle (final ): no growth. cxr: two views of the chest: small bilateral pleural effusions obscure the costophrenic angles, left greater than right. a left basilar vague opacity is present likely seconday to the underlying effusion and/or atelectasis. the lungs are otherwise clear. there is left ventricular enlargement. the bony thorax is normal. bilat lower ext veins 10:18 am impression: no evidence of dvt. echocardiogram the left atrium is mildly dilated. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. left ventricular systolic function is hyperdynamic (ef 70-80%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic arch is mildly dilated. there are focal calcifications in the aortic arch. the aortic valve leaflets (3) are mildly thickened and display slightly reduced systolic excursion. there is no valvular aortic stenosis. the increased transaortic velocity is likely related to high stroke volume. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild to moderate (+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the supporting structures of the tricuspid valve are thickened/fibrotic. moderate to severe tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. ct abdomen/pelvis and cta chest impression: 1. no pulmonary embolism. 1. large, 20-cm complex, cystic pelvic mass with features highly worrisome for neoplasm. differential diagnosis would include such entities as ovarian cystadenocarcinoma. no uterus or ovaries are specifically identified. clinical correlation with surgical history is recommended. other etiologies such as a benign, post-surgical peritoneal inclusion cyst are also possible, but considered less likely. a least one, enlarged, mildly enhancing lymph node is noted. no evidence of peritoneal carcinomatosis. 3. there is extensive sigmoid diverticulosis. mild thickening of a small segment of the sigmoid colon just inferior and posterior to the large cystic mass could represent a focal area of diverticulitis. this area is incompletely characterized secondary to lack of intraluminal oral contrast. clinical correlation is recommended. there is no evidence of bowel obstruction. 4. bibasilar atelectasis, right greater than left. no focal areas of consolidation is identified. a 6-mm, rounded focus in the right upper lobe of the lung could represent a focal area of atelectasis or represent a focal nodule. attention to this area should be paid on subsequent examinations. 5. mild anterior wedging of the l1 vertebral body could represent a compression fracture of indeterminate chronicity. clinical correlation is recommended. 6. cholelithiasis without evidence of cholecystitis. 7. bilateral renal low attenuation lesions, most too small to characterize but most likely simple cysts. brief hospital course: the patient was admitted with four day history of abdominal pain, shortness of breath, nausea/vomiting and a new diagnosis of a pelvic mass arising from the left ovary. the patient was transferred from an outside hospital. pelvic mass: the patient was evaluated with ct scan which demonstrated large pelvic complex cystic mass 20 cm. no peritoneal carcinomatosis was seen. a medicine consult was obtained for preoperative clearance. an echocardiogram was obtained to evaluate the patient's heart function and ejection fraction. cea, ca -9 and ca-125 were obtained. the patient was taken to the operating room on . please see operative note for details. her intraoperative course was complicated by emesis following intubation of 600cc of fluid. following initial extubation, the patient was reintubated due to concern for aspiration pneumonia and an elevated respiratory rate. a cxr was obtained in the postoperative area which could not rule out aspiration pneumonia. the patient was transported to the icu intubated. she was transferred to the floor on postoperative day 2. id: the patient presented with elevated wbc of 23.8 which increased to 27 on hospital day 2. the patient was initially started on levofloxacin for empiric treatment of a uti diagnosed at outside hospital. urine culture at returned negative. blood cultures were obtained and negative/no growth to date at time of discharge. the patient was febrile upon presentation and respiked on hospital day 2 preoperatively. a ct scan obtained showed diverticulosis but could not rule out a small foci of diverticulitis. flagyl was added to the antibiotic regimen on hospital day 2. following surgery on hospital day 2, during which a necrotic torsed 20 cm ovarian cyst was found along with diffuse peritonitis, antibiotics were discontinued. she was restarted on levofloxacin/flagyl when the patient spiked a temperature on post-operative day 0 to 101. the patient's wbc improved and normal on postoperative day . she remained afebrile since 0400. sputum cultures returned positive for sparse growth of mrsa on . the patient remained afebrile and had no symptoms or signs of pneumonia. a repeat cxr showed no evidence of pneumonia and significant for small bilateral pleural effusions vs atelectasis. per discussion with infectious disease team, no further treatment was indicated as the patient was improving without treatment for mrsa and the patient was clinically well. the mrsa was thought to be from colonization and not evidence of an acute infection. the patient received 7 days of levofloxacin and flagyl. blood cultures returned negative on and some remained pending at discharge. pulmonary: the patient presented with oxygen desaturation to 90% room air; the patient symptomatically was short of breath. oxygen was titrated. a cta angiogram demonstrated no evidence of pulmonary embolism on admission. the patient was transported intubated to the icu given some concern for aspiration pneumonia and an increased respiratory rate following surgery. she was extubated on postoperative day 1. her oxygen requirement resolved on post-operative day 3. serial cxr were followed. on , the cxr showed no evidence of infiltrate. small bilateral pleural effusions versus atelectasis were seen. gi: the patient had significant ileus caused by the diffuse peritonitis from the torsed, necrotic ovary. the patient was made npo upon admission. iv fluids were maintained until the patient's diet was advanced. her electrolytes were checked daily and repleted appropriately until tolerating diet. the patient passed flatus on . her diet was advanced slowly. she had bowel movement on . she was tolerating regular diet x 3 days at time of discharge. arthritis: the patient received 1 dose of 100 mg of hydrocortisone stress dose steroids prior to incision as recommended by the medicine consult. she was maintained on her normal dose of steroids for rheumatoid arthritis following surgery. cardiovascular: a medicine consult was obtained upon admission to help manage the patient and provide guidance for clearance for surgery. an ekg showed no changes from baseline. an echocardiogram was performed (see reports). the patient was maintained on a beta blocker. anemia: the patient's initial hematocrit was 28.0. guiac exam negative. ct scan showed no evidence of intraabdominal bleeding. the patient's hct was followed daily until surgery. she received 1 unit blood transfusion intraoperatively. postoperatively her hct was 25. on postoperative day 1, her hct dropped to 23.6. the decision was made to transfuse the patient 2 additional units of blood. her hct responded appropriately to 27.7 and stable at discharge 27.9. iron studies and folic acid/b12 were normal. anemia contributed to anemia of chronic disease. prophylaxis: the patient was started on heparin sc 5000 mg tid and pneumoboots/teds which were continued until discharge. she received pepcid iv and incentive spirometer for use. lenis were performed on for bilateral symmetrical leg pain which were negative. rehab: the patient received physical therapy treatment/evaluation daily. the patient's family desired rehabilitation facility given the lack of help at home for the patient. she was discharged on pod 7 to a rehabilitation facility. medications on admission: atenolol 50mg qd prednisone 4mg qd darvocet-n 1 tab tid prn salsalate 500mg qd protonix 40mg qd lipitor 20mg qd hydroxychloroquine 200mg qd meds on transfer: morphine 4mg sc q4h zofran 4mg iv q6h protonix 40mg iv qd discharge medications: 1. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed. disp:*50 tablet(s)* refills:*0* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. acetaminophen 500 mg capsule sig: capsules po q6h (every 6 hours) as needed. disp:*60 capsule(s)* refills:*0* 4. prednisone 1 mg tablet sig: four (4) tablet po daily (daily). disp:*40 tablet(s)* refills:*2* 5. atenolol 50 mg tablet sig: one (1) tablet po daily (daily). disp:*50 tablet(s)* refills:*2* 6. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). disp:*40 tablet(s)* refills:*2* 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 8. salsalate 500 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 9. hydroxychloroquine 200 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 10. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* discharge disposition: extended care facility: bay - discharge diagnosis: primary diagnosis: 20 cm ovarian cyst with torsion and necrosis final pathology pending secondary diagnosis: dyslipidemia arthritis cad s/p cabg x 5 gerd chronic leg edema s/p cabg vein harvesting discharge condition: tolerating regular diet, afebrile, vital signs stable. voiding and moving bowels. discharge instructions: call dr. or dr. if fever > 100.4, severe abdominal pain not relieved by medicine, nausea/vomiting or inability to eat regular diet, chest pain, shortness of breath or other concerns, redness around incision or other worrisome signs. for pain: you may take tylenol or percocet. do not take these medicines together. tylenol: 1-2 tablets every 6 hours percocet: 1 tablet every 6 hours you may take colace as a stool softener and senna as bowel motility . you should walk every day with assistance and your walker. you may go up the stairs. no heavy lifting for 6 weeks. you may restart all your home medications: prenisone 4 mg daily atenolol 50 mg daily protonix 40 mg daily lipitor 20 mg daily hydroxychlroquine (plaquenil) 200 mg daily salsalate 500 mg daily do not take darvocet and percocet together! they are both narcotic pain medicines. followup instructions: provider: , md phone: date/time: 2:30 clinical center you should follow up with dr. after discharge from the rehab facility to check on your blood count. md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube enteral infusion of concentrated nutritional substances other removal of both ovaries and tubes at same operative episode transfusion of packed cells diagnoses: anemia, unspecified esophageal reflux pure hypercholesterolemia unspecified pleural effusion congestive heart failure, unspecified unspecified essential hypertension coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status pulmonary collapse paralytic ileus rheumatoid arthritis hypoxemia acute on chronic combined systolic and diastolic heart failure other and unspecified ovarian cyst tachypnea torsion of ovary, ovarian pedicle, or fallopian tube salpingitis and oophoritis not specified as acute, subacute, or chronic 

Answer: The patient is high likely exposed to