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: compazine / droperidol / sulfonamides / gadolinium-containing agents / demerol / morphine / haldol attending: chief complaint: sob and abdominal pain major surgical or invasive procedure: egd history of present illness: patient is a 60 yo female with pmhx significant for mast cell degranulation syndrome with multiple admissions with flares who presents with dyspnea. pt reports that she began having her usual flare symptoms of sob, cp, nausea, and diarrhea this afternoon that started off mild. she then began driving to as that is where she receives most of her care. her symptoms worsened during the drive and she attempted to use her epi pen, but it was empty. she continued to drive and arrived at the ed. she reports uri symptoms of cough, sore throat, congestion, body aches, and subjective fevers for 3 days before onset of symptoms. she had taken one day of azithromycin for this from her pcp. denied other possible flares such as exercise, etoh, asa, nsaids, opiates, insects. of note, she has had three admissions in the last month for similar episodes, the latest being to . . in the ed, initial vs were: hr 129, bp 119/109, r 18 o2 sat 100% on nrb. she was given benadryl 50 mg iv x 1, solumedrol 125 mg iv x 1, dilaudid 1 mg, 2 grams ativan, albuterol nebs. . on admission to the , initial vs were: 97.9 98 144/89 30 98% on 4l she reported severe substernal chest pain and tightness that radiated to her back but not her arms or jaw. she also reported sob, epigastric pain, and nausea. her ekg was unchanged from priors except for some diminished r wave progression. first set of ces was negative. she was given another 2mg dilaudid, 25mg benadryl, 1mg ativan, and 8mg zofran. she was resting comfortably after this medication was given. past medical history: - mast cell degranulation syndrome (mcds): followed by who is an allergist at , #. also followed here by dr. in gi. has been intubated twice. - depression/anxiety/bipolar d/o, hx of si - mi in after receiving cardiac arrest dose epi instead of anaphylactic dose epi - htn - erosive osteoarthritis - gerd, gastritis and esophagitis on recent egd - paradoxical vocal cord dysfunction viewed on fiberoptic laryngoscopy - anemia, iron studies c/w aocd - hemorrhoids - pt reports egd demonstrated vegetable bezoar (?). - status post hysterectomy and oophorectomy - h/o mrsa infection (porthacath associated) - portacath placed - d/c'd mrsa infection - portacath placed social history: pt is divorced. lives alone. she works as an er tech in . no tobacco or etoh or illicit drugs. son is hcp family history: mother died of mi @ 76, sister w/ breast cancer and bilateral mastectomy. physical exam: afebrile, vss, on room air gen- nad heent- ncat, mmd, perrl, eomi grossly neck- no lad, no tmg, no jvd cor- regular, no murmur pulm- diminished sounds, sparse wheezes abd- benign extrem- no c/c/e skin- aox4, cn2-12 intact grossly, no focal abnormalities pertinent results: cxr: left lower lobe opacity may represent pneumonia. new right lower lobe atelectasis. no pleural effusion or pneumothorax. the left lower lobe findings could also represent pulmonary infarct, although less likely. 04:07am blood wbc-7.3 rbc-3.71* hgb-10.8* hct-32.3* mcv-87 mch-29.2 mchc-33.6 rdw-14.7 plt ct-240 08:30pm blood wbc-8.6 rbc-4.52 hgb-13.3 hct-40.0 mcv-89 mch-29.5 mchc-33.3 rdw-16.7* plt ct-332# 08:30pm blood neuts-73* bands-1 lymphs-11* monos-8 eos-2 baso-0 atyps-0 metas-2* myelos-2* promyel-1* 01:00pm blood pt-11.4 ptt-22.1 inr(pt)-1.0 04:07am blood glucose-131* urean-15 creat-0.7 na-142 k-3.1* cl-107 hco3-26 angap-12 08:30pm blood glucose-90 urean-21* creat-1.0 na-141 k-4.8 cl-101 hco3-30 angap-15 11:58am blood ck(cpk)-28 05:25am blood alt-37 ast-19 ld(ldh)-358* ck(cpk)-33 alkphos-84 amylase-36 totbili-0.1 11:58am blood ck-mb-2 ctropnt-<0.01 05:25am blood ck-mb-2 ctropnt-<0.01 08:30pm blood ctropnt-<0.01 05:25am blood albumin-3.6 calcium-8.2* phos-3.7 mg-2.5 07:45pm blood type-art fio2-50 po2-160* pco2-36 ph-7.45 caltco2-26 base xs-2 intubat-not intuba 01:33am blood type-art po2-70* pco2-34* ph-7.48* caltco2-26 base xs-2 brief hospital course: patient is a 60 yo female with pmhx mast cell degranulation syndrome who presents with recurrent flare. . 1)dyspnea: mi ruled out and cxr showed possible pneumonia. presentation likely multifactorial as this was typical of the patient's acute flares of mast cell degranulation syndrome exacerbations. patient's ekg is not consistent with acs and one set of enzymes is normal. she does have some atalectasis vs. consolidation on cxr and reports subjective fevers, cough of green sputum recently which could be contributing. in addition, likely combination of pain and anxiety. she has a respiratory alkalosis which is consistent with this. treated mast cell degranulation with steroids, diphenhydramine, h2blockers, gastrocrom. 2) chest pain- mi ruled out with 3 sets neg cardiac enzymes 3) htn- well-controlled; continued diltiazem. 4) oa- tylenol and plaquenil. 5) pt reports history of melena last week which has resolved. hematocrip abover her baseline and stable. egd done per dr. given recent symptoms, no evidence of active bleeding, one polyp biopsied. ms. was provided dr. telephone number to follow up biopsy report. 6) psychiatric: bipolar/anxiety/depression- continue duloxetine medications on admission: 1. doxepin 50 mg qhs 2. zolpidem 10 mg qhs prn 3. cromolyn 100 mg/5 ml solution sig: one (1) po four times a day. 4. diltiazem hcl 180 mg qd 5. hydroxyzine hcl 25 mg qid 6. ranitidine hcl 150 mg 7. duloxetine 60 mg capsule, delayed release(e.c.) qd 8. hydroxychloroquine 200 mg 9. amphetamine-dextroamphetamine 20 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po once a day. 10. fexofenadine 180 mg qd 11. omeprazole 20 mg 12. zofran 8 mg tid prn 13. butalbital-acetaminophen-caff 50-325-40 mg tablet q8 prn headache 14. cholecalciferol (vitamin d3) 800 unit daily 15. asmanex twisthaler 220 mcg (120 doses) aerosol powdr activated sig: two (2) inhalation (2 times a day). pt doesnt remember taking this. 16. prednisone taper finished yesterday 17. vivelle-dot 0.05 mg/24 hr patch semiweekly sig: one (1) patch transdermal 2x/week. discharge medications: 1. doxepin 25 mg capsule sig: two (2) capsule po hs (at bedtime). 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 3. hydroxyzine hcl 25 mg tablet sig: one (1) tablet po qid prn () as needed for pruritis. 4. duloxetine 30 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 5. hydroxychloroquine 200 mg tablet sig: one (1) tablet po bid (2 times a day). 6. fexofenadine 60 mg tablet sig: three (3) tablet po bid (2 times a day). 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 9. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 10. albuterol sulfate 0.083 % (0.83 mg/ml) solution sig: one (1) treatment inhalation q4h (every 4 hours) as needed. 11. cromolyn 100 mg/5 ml solution sig: one hundred (100) mg po qid (4 times a day). 12. diltiazem hcl 180 mg capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). 13. estradiol 0.05 mg/24 hr patch semiweekly sig: one (1) patch semiweekly transdermal 2x/week (2 times a week). discharge disposition: home discharge diagnosis: mast cell degranulation syndrome discharge condition: stable discharge instructions: you were hospitalized with mast cell degranulation/activation syndrome. call dr. regarding your egd biopsy results next week. please call your pcp or dr. , or go to er depending on severity of new abdominal pain, sob, chest tightness, or other concerning symptoms. followup instructions: please follow up with your allergist within the next 2 weeks.provider: , md phone: date/time: 1:30 provider: , md phone: date/time: 2:00 procedure: esophagogastroduodenoscopy [egd] with closed biopsy endoscopic excision or destruction of lesion of duodenum diagnoses: anemia of other chronic disease dysthymic disorder other specified cardiac dysrhythmias blood in stool other chest pain benign essential hypertension shortness of breath benign neoplasm of duodenum, jejunum, and ileum other specified disorders involving the immune mechanism 

Answer: The patient is high likely exposed to