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 / shellfish / fish product derivatives attending: chief complaint: low back pain major surgical or invasive procedure: anterior c4-7 spinal fusion/ posterior laminectomy and fusion c4-7 history of present illness: 53f with severe ra, recently diagnosed cervical spine stenosis at bumc after presenting with rue numbness and tingling presents today with increased low back pain and bilateral le weakness. saw dr. of orthopedic surgery yesterday, and was ordered for outpatient spine mr, but her low back pain was worse leading to a fall x2 yesterday weakness. no fever, chills, sob, cp, +vomiting x1 yesterday, no loss of bowel or bladder control. past medical history: rheumatoid arthritis asthma pyelonephritis horseshoe kidney rll nodule cervical spinal stenosis with cord edema dx 2 weeks ago by mr social history: denies etoh, tobacco, illicits family history: nc physical exam: t 98.1 hr 88 bp 139/78 rr 20 o2sat gen: pleasant, lying in bed, +cervical collar heent: anicteric, mmm, op clear cv: regular, no mrg lungs: ctab on anterior exam abd: soft ntnd +bs rectal: normal tone, no stool ext: strength severely limited in all extremities pain -- rue worse than lue. sensation intact to light touch throughout. neuro: aox3, strength limited as above, +clonus pertinent results: chemistries 10:50am glucose-204* urea n-19 creat-0.9 sodium-141 potassium-4.1 chloride-102 total co2-26 anion gap-17 cbc 10:50am wbc-9.5 rbc-4.24 hgb-11.5* hct-36.3 mcv-86 mch-27.2 mchc-31.7 rdw-17.6* 10:50am neuts-84.7* bands-0 lymphs-9.2* monos-4.0 eos-1.6 basos-0.5 10:50am hypochrom-normal anisocyt-normal poikilocy-1+ macrocyt-normal microcyt-normal polychrom-normal ovalocyt-1+ 10:50am plt count-309 coags 10:50am pt-13.5 ptt-23.9 inr(pt)-1.1 c-spine mr impression: 1) multilevel cervical spondylosis. central canal stenosis at c3-c4 through c6-c7 associated with central cord edema. grade 1 anterolisthesis of c3 on c4. 2) unusual configuration of the dens worrisome for a fracture deformity although there is no marrow edema to suggest acute injury. thickened soft tissue in at the atlantoaxial joint suggests pannus. correlation with ct is recommended. ct c-spine impression: changes in the odontoid process from rheumatoid arthritis. no evidence of atlantoaxial subluxation. no acute fracture visible by ct. there may be ligamentous laxity and instability from degenerative change, and this cannot be assessed with the static imagese acquired. l-spine mr impression: bilateral l5 spondylolysis with grade 1/grade 2 anterolisthesis of l5 on s1. resultant narrowing of the bilateral neural foramen at that level. probable prominent synovial tissue versus fibrosis projecting toward the right neural foramen; a nonemergent contrast-enhanced lumbar spine mri may be useful for further characterization. cervical decompression procedure performed: 1. total laminectomy of c4, c5, c6 and c7. 2. fusion c4 - c7. 3. autograft. brief hospital course: cervical spinal stenosis the patient presented with cervical spinal stenosis with associated cord edema between c3 and c7. additionally, a c-spine mr of a dens fracture but a ct c-spine did not corroborate this finding. the patient was seen by dr. of ortho spine in the emergency department, and a cervical decompression was planned; meanwhile the patient was admitted for pain control. the patient was started on oxycontin and this was titrated up to 20mg . she was given initially morphine and then oxycodone for breakthrough pain. she was started on a beta-blocker preop. she underwent an uncomplicated cervical decompression on . post operatively she was briefly on a morphine pca. she worked with the physical therapists. she was transferred to the ortho-spine service, and was taken back to the or on ... for an anterior stabilization. low back pain the patient also has l5-s1 disc bulge and neural foraminal stenosis per l-spine mr, likely contributing to her low back pain. her pain was managed as above. physical therapy was consulted. left calf pain the day after surgery the patient complained of pain in her left calf, and on exam, the calf was more firm than the other side. she undewent a left-sided leni which did not show a dvt. her pain resolved, and she was able to ambulate with pt. rheumatoid arthritis the patient was continued on her outpatient medications; her naproxen was held prior to surgery. in addition to her daily 10mg of prednisone, she was given stress dose steroids the day of her surgery. asthma the patient was contined on her outpatient inhalers. ulcerative keratitis the patient said that she no longer used the prednisolone eye drops. diabetes the patient was continued on avandia (held while she was npo), and additionally a long acting insulin and a hiss were added. medications on admission: albuterol q6h prn flovent 2 puffs klonapin 1mg qhs darvacet 1 tab q4-6 hrs prn tylenol 3 naproxyn 500 fosamax 70 weekly prilosec 20 daily prednisone 10 daily plaquenil 400 daily arava 20 daily avandia 4mg daily prednisolone drops for eyes discharge medications: diazepam 5 mg po q6-8h:prn spasm prochlorperazine 10 mg po/iv q6h:prn @ 1355 view lisinopril 5 mg po daily hold for sbp <130 lactulose 30 ml po q8h:prn titrate to 1 bm daily @ 1355 view insulin sc (per insulin flowsheet) sliding scale & fixed dose bisacodyl 10 mg po/pr daily:prn senna 1 tab po bid metoprolol 25 mg po bid hold for hr <60 and sbp <100 sarna lotion 1 appl tp tid: zolpidem tartrate 5 mg po hs:prn oxycodone (sustained release) 20 mg po q12 acetaminophen 650 mg po q6h docusate sodium 100 mg po bid albuterol puff ih q6h:prn fluticasone propionate 110mcg 2 puff ih clonazepam 1 mg po qhs hydroxychloroquine sulfate 400 mg po daily arava *nf* 20 mg oral daily alendronate sodium 70 mg po qfri pantoprazole 40 mg po q24h prednisone 10 mg po daily discharge disposition: home with service facility: homecare discharge diagnosis: cervical spinal stenosis with cord compression s/p surgical decompression low back pain rheumatoid arthritis asthma discharge condition: stable discharge instructions: please take your medications as prescribed. followup instructions: please see dr. in follow up as needed. keep the following appointments: provider: , m.d. where: center phone: date/time: 9:00 provider: , md where: lm phone: date/time: 2:30 provider: scan where: radiology phone: date/time: 11:30 procedure: other cervical fusion of the anterior column, anterior technique excision of intervertebral disc excision of bone for graft, other bones other cervical fusion of the posterior column, posterior technique fusion or refusion of 4-8 vertebrae fusion or refusion of 4-8 vertebrae diagnoses: anemia, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled asthma, unspecified type, unspecified osteoporosis, unspecified rheumatoid arthritis kyphosis (acquired) (postural) cervical spondylosis with myelopathy 

Answer: The patient is high likely exposed to