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: multinodular goiter major surgical or invasive procedure: total thyroidectomy history of present illness: the patient is a 43 year old woman who has had a history of hypothyroidism,here for total thyroidectomy for mng.she had an increasing thyroid swelling since a couple of years,and showed up at dr clinic. the goiter went basically from her chin down to her sternum. she was diagnosed with mng and was planned for a total thyroidectomy. past medical history: hypothyroidism social history: she works as a hotel manager. prior smoker and quit in . drinks alcohol rarely per hospital records. denies illicit drug use. family history: no history of thyroid disease, diabetes, heart disease, or copd. father's side of family has had uterine cancer and other cancers of unknown etilogy. physical exam: general: alert and oriented x3, obese female with large neck swelling, no distress, appears comfortable. eyes: anicteric sclerae. extraocular movements normal. ent: normal external appearance. oropharynx is without lesions. neck: incision with steri strips clean dry intact,no erythema, positive edema. cardiovascular: regular, borderline tachycardic, sm at lusb. respiratory: normal to inspection, percussion, and auscultation. gi: normal bowel sounds. abdomen not distended or tender. no hepatomegaly. neurologic: normal deep tendon reflexes. no tremor. no spasms. vulvar exam: erythematous vulva with redness extending out to inner thigh. underlying skin - moist with concern for wheeping from the wound. no vaginal discharge noted. extremities:+ pitting edema present bilaterally, warm, no clubbing. pertinent results: 08:50pm blood wbc-12.7* rbc-2.75* hgb-8.8* hct-26.6* mcv-97 mch-31.9 mchc-33.0 rdw-13.5 plt ct-213 08:50pm blood pt-13.7* ptt-30.2 inr(pt)-1.2* 08:50pm blood plt ct-213 08:50pm blood glucose-154* urean-10 creat-0.6 na-140 k-4.0 cl-108 hco3-22 angap-14 08:50pm blood calcium-8.2* phos-4.6* mg-1.6 09:49pm blood lactate-0.9 09:49pm blood type-art temp-35.9 rates-14/ tidal v-500 peep-5 fio2-40 po2-149* pco2-44 ph-7.38 caltco2-27 base xs-0 -assist/con intubat-intubated 03:52am blood wbc-11.6* rbc-2.46* hgb-7.9* hct-25.4* mcv-103* mch-32.0 mchc-31.0 rdw-14.1 plt ct-193 05:54am blood wbc-13.4* rbc-2.88* hgb-9.1* hct-27.4* mcv-95# mch-31.6 mchc-33.2 rdw-14.2 plt ct-228 03:52am blood plt ct-193 05:54am blood pt-13.0 inr(pt)-1.1 05:54am blood plt ct-228 03:52am blood glucose-686* urean-8 creat-0.4 na-110* k-3.4 cl-88* hco3-17* angap-8 05:54am blood glucose-139* urean-11 creat-0.5 na-139 k-4.0 cl-107 hco3-21* angap-15 01:50pm blood ck(cpk)-375* 08:16pm blood ck(cpk)-448* 04:03am blood ck(cpk)-482* 01:50pm blood ck-mb-9 ctropnt-<0.01 08:16pm blood ck-mb-9 ctropnt-<0.01 04:03am blood ck-mb-9 ctropnt-<0.01 05:54am blood calcium-7.4* phos-5.1* mg-2.3 08:16pm blood calcium-7.7* 03:52am blood pth-12* 05:54am blood pth-14* 05:53am blood type-art po2-113* pco2-45 ph-7.38 caltco2-28 base xs-1 04:28am blood freeca-1.11* 05:53am blood freeca-1.06* 04:03am blood wbc-10.3 rbc-2.37* hgb-7.5* hct-22.7* mcv-96 mch-31.6 mchc-33.1 rdw-14.2 plt ct-122* 03:41pm blood hct-24.0* 04:03am blood glucose-93 urean-8 creat-0.5 na-137 k-3.8 cl-104 hco3-20* angap-17 03:41pm blood calcium-8.0* brief hospital course: 43 year old female with diagnosis of a massive goiter is status post total thyroidectomy on . intraoperatively patient was intubated and transferred to the intensive care unit for observation as there were concerns that the patient may not be able to maintain her airway due to preoperatively concerns that the thyroid was compressing the airway. over the night of her operation she became hypotensive with systolic blood pressure to the 80s and she was started on dopamine drip this was ultimately thought to be related to hypocalcemia. she was infused with 250 ml of albumin to which her systolic blood pressure responded and she was successfully weaned off dopamine drip and was extubated on and on room air. on she was transferred out of the intensive care unit to the surgical inpatient unit.of note, she was noted to have extensive vulvar irritation and erythema while in the intensive care unit and gynecology were consulted and provided recommendations. on she her oxygen saturation was in the mid 90s on room air during the morning,and then triggered at noon time for o2 sat of 85% room air. patient had no dyspnea and was asymptomatic. she was placed on 1 to 4 liters via nasal cannula to maintain her o2 sats. however patient continued to have an o2 sat 90% on 3 liters nasal cannula. therefore a chest xray was done which was negative for pneumonia and chest scan was done and was negative for pulmonary embolism. she was diuresed with lasix intravenously. she continued to have low grade temperature 99 up to 100.2, an electrocardiogram and continued to be tachycardic, although denied dyspnea or chest pain. on she continued to have decrease oxygen saturation, mid 90's on 40-50% shovel mask. she received lasix 20 mg intravenous and diuresed well. overnight she was ordered for blood transfusion for a hematocrit of 22 which was stopped due to a rise in temperature from 99.2 to 100.2. she was expectorating green and brown sputum and a sputum culture was obtained. she has some intermittent productive sputum but otherwise is dry and per the patient this is usually worse during the night. a sputum culture and repeat chest xray pa/lat was done to rule out pneumonia. the patient continued to have no dyspnea, no respiratory distress and the oxygen was subsequently weaned to 40% and her o2 sats 92% to 94%room air. she was started empirically on levofloxacillin but has no evidence of lower respiratory tract infection. the pulmonary team were consulted for etiology of hypoxia and recommendations. the patient will follow-up with pulmonology outpatient for a bubble study. the patient has no nausea or emesis and diet was advanced from clears to regular which was tolerated well. her pain was well controlled with oral analgesia. she is ambulating independently with a steady gait. the neck incision with steri strips is clean, dry and intact without erythema, there is edema in the neck. she will follow-up with dr. on for her postoperative visit. she will be discharged home on levothyroxine, calcium carbonate and calcitriol. she will follow up with primary care provider and gynecology in week. medications on admission: 1. levothyroxine 125 mcg tablet sig: one (1) tablet po daily (daily) discharge medications: 1. levothyroxine 125 mcg tablet sig: one (1) tablet po daily (daily). 2. calcium carbonate 200 mg (500 mg) tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). disp:*60 tablet, chewable(s)* refills:*2* 3. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 4. calcitriol 0.5 mcg capsule sig: one (1) capsule po daily (daily). disp:*20 capsule(s)* refills:*2* 5. aluminum-calcium packet sig: one (1) packet topical tid (3 times a day) as needed for vulvar pruritis. disp:*20 packet(s)* refills:*0* 6. silver sulfadiazine 1 % cream sig: one (1) appl topical tid (3 times a day) as needed for vulvar pruritis. disp:*2 tubes* refills:*0* discharge disposition: home discharge diagnosis: multinodular goiter discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the general surgery inpatient unit and underwent a total thyroidectomy.your tissue was sent to pathology and you should have your results in 1 week. please monitor your neck incision for any drainage, swelling or redness. please seek immediate attention if you develop shortness of breath or increase neck swelling. please notify dr. office if you have any questions or concerns. you have steri strips on your neck incision, please keep clean and dry. these steri-strips will fall off on their own, please do not remove them. you may shower but avoid swimming or bathing. please take tylenol for pain as directed. please do not drink alcohol or drive while taking this medication as it may cause drowsiness. do not take more than 4000 mg of acetaminophen (tylenol) in a 24 hour period. please monitor for signs and symptoms of hypothyroidism: watch for numbness or tingling around mouth or legs, confusion, muscle spasm,or changes in level of conciousness, these could be signs of low calcium which can happen after thyroid surgery. please monitor for signs and symptoms of hyperthyroidism: anxiety, irritability, trouble sleeping weakness (in particular of the upper arms and thighs, making it difficult to lift heavy items or climb stairs), tremors (of the hands, perspiring more than normal, difficulty tolerating hot weather rapid or irregular heartbeats, fatigue,weight loss in spite of a normal or increased appetite, frequent bowel movements. if you experience any of these signs or symptoms please contact dr. office . your follow-up appointment with dr. is scheduled for thursday at 11:00 a.m. you will be given a prescription for ciprofloxacin to treat your respiratory infection, please take 500mg twice a day for 2 weeks, please take all antibiotics as prescribed. please follow-up with the pulmonary clinic ( as an outpatient for a bubble study. please resume your home medication. please schedule an appointment with your primary care provider for monitoring of your thyroid level. you will be given a prescription for calcium carbonate(tums)and calcitriol please take as directed. followup instructions: your follow-up appointment with dr. is scheduled for thursday at 11:00 a.m.( ., division: general surgery please schedule an appointment with pulmonary clinc for bubble study please schedule follow-up appointment with primary care provider . in 2 weeks. please schedule follow-up appointment with gynecology in 1 week. procedure: closed biopsy of skin and subcutaneous tissue complete thyroidectomy percutaneous insertion of other extracranial artery stent(s) parathyroid tissue reimplantation diagnoses: other iatrogenic hypotension hypocalcemia unspecified acquired hypothyroidism hypoxemia obesity, unspecified nontoxic multinodular goiter postprocedural fever unspecified inflammatory disease of cervix, vagina, and vulva 

Answer: The patient is high likely exposed to