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: aspirin attending: chief complaint: anemia and black stools major surgical or invasive procedure: egd cardiac catheterization history of present illness: 64-year-old woman with polycythemia , myelofibrosis, myeloid metaplasia started on revlimid last friday. pt. reports feeling fatigued for the past 2 weeks. she had routine labs drawn 2 weeks ago. her hct at the time was 24 per pt. report. she was transfused 2 units prbcs last friday. labs drawn this past sunday again showed an hct of 28.4. pt. was sent to , here her hct was 25 and she admitted to melanotic stools. pt. is being admitted for further workup of gi bleeding. . on review of systems, the patient denies any chest pain, shortness of breath, night sweats, fevers, chills, weight loss, headaches, dizziness, blurred vision, sore throat, nausea, vomiting, abdominal pain, any new rashes, denies dysuria, hematuria, increased urgency, diarrhea, constipation, epistaxis. pt. admits to melanotic stools of soft consistency. all other systems reviewed in detail and negative except for what has been mentioned above. past medical history: aortic stenosis s/p bovine valve repair in hypertension polycythemia myelodysplastic syndrome pneumonia s/p bunion removal s/p t&a s/p laser eye surgery social history: widow, live alone. denies tobacco or etoh use. family history: non-contributory physical exam: vs: t: 96.9 hr: 86 bp: 131/86 rr: 20 gen: nad heent:eomi, perrl cv: rrr iii/vi early systolic murmur with radiation to clavicles lungs: cta bilat. abdomen: bs normoactive, nt/nd, palpable spleen 10cm beyond ribs ext: 2+ tibial pitting edema neuro: a + o x 3, cn ii-xii grossly intact, motor both upper and lower extremities. pertinent results: admission labs: 142 101 51 -------------< 128 4.7 30 1.0 estgfr: 56/68 (click for details) ca: 8.4 mg: 2.3 p: 4.7 d alt: 21 ap: 82 tbili: 4.6 alb: 4.2 ast: 17 ldh: 321 . mcv: 114 7.9 14.5 >----< 283 23.8 n:98 band:0 l:1 m:1 e:0 bas:0 gran-ct: . blood bank labs: direct coombs positive indirect coombs positive anti i positive igg weak anti-c3 3+ cold agglutin negative eluate negative . trends: hct: 23.8 - 21 - 18.7 - 18.9 wbc: 14.5 - 12.9 - 16.5 - 25.2 plt: - 111 fibrinogen: 298 - 334 retic count: 5.7 - 2.4 - 3.9 tbili: 4.6 - 5.8 - 8.5 - 5.0 iron 231, tibc 239, b12 1661, folate elevated, hapto <20, ferritin 1890 . 10:35am po2-47* pco2-37 ph-7.32* 11:17am po2-60* pco2-41 ph-7.30* . images: admission ekg: irregular supraventricular rhythm, borderline for multifocal atrial tachycardia, and then probable sinus tachycardia . 12/1/0: abdominal ultrasound: 1. enlarged liver with patent but pulsatile portal vein. this reflects increased resistance within the portal vein, likely from diffuse liver disease, though the hepatic echotexture is normal. gallbladder wall edema also likely reflects sequelae of liver dysfunction. no ascites. 2. markedly enlarged spleen as was seen on outside hospital ct of . patent splenic vein with normal flow direction. . : echo: the left atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. regional left ventricular wall motion is normal. left ventricular systolic function is hyperdynamic (ef>75%). right ventricular chamber size and free wall motion are normal. a bioprosthetic aortic valve prosthesis is present. the leaflets appear thin/mobile, but the transaortic gradient is higher than expected for this type of prosthesis (?related to the dynamic left ventricle). no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is severe pulmonary artery systolic hypertension. there is no pericardial effusion. impression: increased gradient across the aortic bioprosthesis (?related to dynamic left ventricle). severe pulmonary artery systolic hypertension. preserved global and regional biventricular systolic function. . : lenis: 1. proximal left greater saphenous vein thrombus without extension to the common femoral vein. this finding can be present post saphenous vein graft sequalae (cardiac bypass surgery). 2. no additional evidence of superficial or deep venous thrombosis. . : cxr: prominence of the central pulmonary vasculature with upper zone redistribution and infrahilar hazy opacity _____ moderate interstitial pulmonary edema. presumed bilateral pleural effusions, if present, are small. no pneumothorax. patient is status post median sternotomy and cabg. . micro: guaiac negative x3 c diff neg x3 urine cx: klebsiella pansensitive blood cx: ngtd as of brief hospital course: pt is a 64 yo female with polycythemia , myelodysplastic syndrome, and myeloid metaplasia who was admitted to on with two weeks of fatigue, melena, and decreased hct. she had egd which only showed friable mucosa but no evidence of bleeding site. hct drop was thought to be cold agglutin hemolytic anemia from mycoplasma infection and pt was always guaiac negative per review of notes. prednisone 60 mg po qday was started on . pt received 12 units of prbc from - . on pt desatted to 83% on ra and was tachypnic. cxr showed pulmonary edema. of note, hct was 18 at that time but had just received 1 unit of prbc. she was intubated and transferred to the where she was thought to have flash pulmonary edema. she was transfused 2 units of prbc and diuresed with lasix > 1 l. ekg was reportedly unremarkable. she was able to extubated on . she was diuresed 2 l the next day and returned to bmt service on . . complicating this was arf to peak of 2.2. she was given allopurinol, bicitra, sodium bicarb, d51/2 for lysis with elevated uric acid to 14. on rituxin was added for the hemolytic anemia. this am, pt felt sob, was satting 90% on ra (after receiving rituxin in 600 cc fluid). she denied cp but was noted to have altered mental status and was only oriented x 1. cxr showed b/l pulmonary edema. abg was 7.43/48/58. pt was transferred to the for bipap and intubated for hypoxic respiratory failure. in the , noted to have an ekg showing ste in v4-v6, iii. she given asa 300 mg pr, clopidogrel 600 mg po x 1, and started on heparin gtt. cardiac catheterization showed a 70% left circumflex lesion, not thought to be the culprit and not intervened upon. it also showed lvep of 40 mm hg, mod mr, minimal wall motion abnormality of inferior wall, and ef 50%. she was then transferred to the ccu and then micu teams. bp decreased to 80s systolic with ventricular ectopy and run of svts. she was started on neosynephrine. a-line was attempted multiple times and fem a line was placed. . ms was found to be anuric with a lactacte of 15. she was also found to have focal neurologic signs with deviation of the right eye and lack of corneal reflex. she went for head ct which was unrevealing. the family was contact because of her extremely poor prognosis; the decision was made to not escalate care. she died shortly after from cardiac arrest. medications on admission: anagrelide 2 mg hydroxyurea 1000mg p.o. folic acid 1 mg p.o. b.i.d., prednisone 5mg qday omeprazole 20 mg p.o. daily, fludrocortisone 0.1 mg p.o. daily, neurontin 300 mg p.o. b.i.d., toprol-xl 150mg qday lasix 80mg po qd allopurinol 400 po qhs revlimid 25mg. discharge disposition: home discharge diagnosis: primary: - hemolytic anemia - aortic stenosis s/p bovine repair - polycythemia - myelodysplastic syndrome - urinary tract infection - lactic acidosis discharge condition: deceased discharge instructions: none followup instructions: none procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures other endoscopy of small intestine insertion of endotracheal tube transfusion of packed cells diagnoses: coronary atherosclerosis of native coronary artery urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified unspecified septicemia severe sepsis myelodysplastic syndrome, unspecified acute respiratory failure septic shock diarrhea heart valve replaced by transplant acute myocardial infarction of unspecified site, initial episode of care autoimmune hemolytic anemias polycythemia vera 

Answer: The patient is high likely exposed to