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: codeine attending: chief complaint: respiratory failure major surgical or invasive procedure: mechanical ventillation lumbar puncture history of present illness: limited history as patient intubated and sedated. history obtained from medical records and ed course. 43 yo f presented to with complaint of cp and agitation. woke up shaking, complaining of pressure on her chest. concerned for anxiety attack at home and took her to osh. apparently patient usually takes cymbalata. ran out of cymbalta 48 hours prior to presentation. found to be restless, short of breath, with chest pain, delerious with hallucinations. she also developed strange movements, concern for dystonic reaction. she was given ativan 1mg, toradol 30mg, cymbalta 60mg, ativan 1mg, valium 10mg, thorazine, benadryl, and haldol at osh. then propofol and versed gtt and was intubated. she was transferred for concern for ?medication reaction vs. overdose. head ct from osh was negative. . history of multiple suicide attempts -most recently 2 years ago overdosed on sleeping pills. has had inpatient psych admissions. severe depression. intermittent extreme agitation. this situation has occurred before, in the setting of drug use. daughter is concerned that she may be taking opiates. she has been physically restrained before. . in the ed, initial vs were: t 98.4 p 71 bp 132/87 r 18 o2 sat 100% -intubated, unknown fio2. a+ox 0. pupils 2-3mm. intubated and sedated. gaze downward bilaterally. no clonus or hyperreflexia. guaiac negative. no petichiae. neck supple. lp was performed. given ceftriaxone 2g iv x1, acyclovir 700mg iv x1, vancomycin 1g iv x1. consulted toxicology, but they were not reached. . on the floor, . review of sytems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. denied arthralgias or myalgias. past medical history: h/o multiple suicide attempts -most recently 2 years ago od'd on sleeping pills. has had inpatient psych admissions. severe depression. intermittent extreme agitation. this situation has occurred before, in the setting of drug use. daughter is concerned that she may be taking opiates. she has been physically restrained before. cholecystectomy ulcerative colitis s/p ileostomy takedown anal stenosis s/p dilatation social history: works as a teacher at southeastern. no alcohol use. occasional tobacco. family history: non-contributory physical exam: vitals: t: 96.6 bp:113/75 p: 70 r: 15 o2: 100% on fio2 50%. vt 450ml. peep 5. general: intubated and sedated heent: sclera anicteric, downward gaze bilaterally, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly. ext: warm, well perfused, 1+ pulses, no clubbing, cyanosis or edema pertinent results: 11:16am ck(cpk)-302* 11:16am ck-mb-6 ctropnt-<0.01 04:56am urine color-yellow appear-clear sp -1.050* 04:56am urine blood-neg nitrite-neg protein-neg glucose-100 ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 03:19am urine hours-random 03:19am urine bnzodzpn-pos barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 02:41am glucose-190* urea n-6 creat-0.6 sodium-141 potassium-3.5 chloride-112* total co2-19* anion gap-14 02:41am alt(sgpt)-11 ast(sgot)-18 ld(ldh)-211 alk phos-73 amylase-49 tot bili-0.3 02:41am lipase-16 02:41am albumin-3.4 calcium-7.7* phosphate-1.8* magnesium-2.0 02:41am vit b12-942* folate-greater th 02:41am tsh-0.68 02:41am wbc-17.9* rbc-3.90* hgb-10.9* hct-33.2* mcv-85 mch-27.8 mchc-32.7 rdw-14.7 02:41am plt count-447* 11:45pm estgfr-using this 02:41am pt-14.2* ptt-29.2 inr(pt)-1.2* 11:55pm lactate-1.0 11:45pm glucose-111* urea n-6 creat-0.6 sodium-144 potassium-3.1* chloride-115* total co2-20* anion gap-12 11:45pm estgfr-using this 11:45pm ck(cpk)-312* 11:45pm ck-mb-8 ctropnt-<0.01 11:45pm vit b12-893 folate-greater th 11:45pm tsh-0.72 11:45pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 11:45pm wbc-14.7* rbc-3.91* hgb-10.7* hct-31.6* mcv-81* mch-27.4 mchc-33.9 rdw-14.3 11:45pm neuts-76.7* lymphs-19.6 monos-2.9 eos-0.4 basos-0.3 11:45pm plt count-471* 11:35pm cerebrospinal fluid (csf) protein-32 glucose-77 11:35pm cerebrospinal fluid (csf) wbc-1 rbc-3* polys-5 lymphs-85 monos-10 11:29pm type-art peep-5 po2-427* pco2-32* ph-7.46* total co2-23 base xs-0 -assist/con intubated-intubated . head ct-impression: no evidence of acute hemorrhage. . ct abd/pelvis:preliminary report !! wet read !! no intra-abdominal abscess. free fluid around the gallbladder, in the right flank and in the pelvis. no evidence of acute cholecystitis, although hida scan would be more specific if clinical suspicion becomes high. . discharge labs 05:30am blood wbc-11.6* rbc-4.10* hgb-11.5* hct-34.0* mcv-83 mch-28.2 mchc-33.9 rdw-14.7 plt ct-515* 05:30am blood plt ct-515* 05:30am blood glucose-98 urean-6 creat-0.7 na-140 k-3.7 cl-107 hco3-24 angap-13 brief hospital course: assessment and plan: this is a 43 yo f with a history of a suicide attempt who presented to osh with chest pain, sob, and with altered mental status. . # altered mental status: the pt presented intubated from an osh. initial differentiel included withdrawal from cymbalta vs reemergence of underlying psychosis. it was thought that a toxidrom from cymbalta was less likely. given concern for infectious etiologies including hsv encephalitis, meningitis the pt underwent an lp which was found to be negataive, as the pt was briefly placed on empiric abx and acyclovir. head ct negative for acute intracranial process. electrolytes did not support metabolic abnormality. the pt was subsequently extubated and was calm and aox3, only complaining of chronic back pain. following consultations with both psych and toxicology, the patients most likely etiology for change in ms from cymbalta, followed by complications to polypharmcy at the osh in the setting of a potential panic attack. infectious etiologies for change in ms less likely consider exam, cultures and imaging non-focal. pt did have leukocytosis and fever in the last 24hrs of her icu course, but these resolved prior to arrival to the floor. the pt was restarted on cymbalta 30mg daily and instructed to increase to her home dose of 60mg the following day once at home. the pt was given a 1 week supply of percocet to bridge her to her next pain clinic appointment. medications on admission: (of note per patient, could not confirm with pcp or doc) cymbalta 60mg po qd "oxycodone 20mg tid:prn" tylenol discharge medications: 1. cymbalta 60 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 2. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 3. oxycodone-acetaminophen 10-325 mg tablet sig: two (2) tablet po twice a day for 5 days: please do not drive or operate heavy machinery while taking this medication. disp:*20 tablet(s)* refills:*0* 4. trazodone 50 mg tablet sig: 0.5 tablet po at bedtime. disp:*7 tablet(s)* refills:*0* 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). discharge disposition: home discharge diagnosis: primary diagnosis - acute respirtory failure discharge condition: good. patient ambulating. at her physical and mental baseline. pain controlled. discharge instructions: you were admitted from an outside hospital intubated following a change in your mental status. this was likely secondary to a combination of medications. you were seen by both our toxicology and psychiatry departments that made no further recommendations to your medication regimen. . please continue to take all of your medications as listed below. we have made no changes to your regimen. . please keep all of your appointments and follow-up with your pcp within the next 1-2 weeks. . please return to hospital if you experience chest pain, shortness of breath, fainting, loss of consciousness, fevers or chills. followup instructions: please follow-up with your pcp and management physicians within 1-2 weeks of discharge. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours spinal tap incision of lung diagnoses: anemia, unspecified major depressive affective disorder, single episode, unspecified other diseases of lung, not elsewhere classified altered mental status ulcerative colitis, unspecified chest pain, unspecified restless legs syndrome (rls) panic disorder without agoraphobia shortness of breath unspecified personality disorder 

Answer: The patient is high likely exposed to