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: iodine attending: chief complaint: n/v/d major surgical or invasive procedure: none history of present illness: this is a 53 year old female with past medical history of stage iv breast cancer diagnosed in 12 days s/p cycle 2 of chemotherapy (adriamycin/cytoxan) who presents with 4 days of nausea/vomiting/diarrhea and inability to tolerate po. the patient reports that 4 days prior to admission, she began to lose her appetite. she subsequently began vomiting multiple times daily ("innumerable times") and developed loose, watery stools as well. she was unable to take anything by mouth, including fluids. she continued to stay at home thinking her symptoms would improve. today, as she continued to feel unwell, she called her oncologist who recommended she come into the emergency room for evaluation. the patient denies any problems with prior chemotherapy, and tolerated her first cycle well. she does report that she has had several xrt treatments to her back and her leg recently, and she believes that the combination of this with her chemotherapy may have led to her symptoms. on review of systems, she reports subjective fevers at home, chills, and nausea, vomiting and diarrhea as above. she denies headaches, vision changes, chest pain, shortness of breath, abdominal pain even with her above symptoms, weakness, paresthesias, dysuria, or other symptoms. she denies any hematochezia, melena or hematemesis. she does complain of a sore throat from her vomiting. in the ed, the patient was febrile to 101.8 and initially tachycardic to the 160s. initial lactate was 7.2. she received approximately 6l of ivf and her heart rate came down to high 90s. additionally, lactate down to 1.0. she and her family refused a central line in the ed as well. stool was guaiac positive. she received vancomycin, cefepime, and flagyl and was transfused 2 units prbcs for a hct of 23.5 prior to being transfered to the icu. since arriving, the patient is tearful but states she feels much improved. she denies any pain, and has not be nauseated or vomiting throughout the day. no recent diarrhea. she has a sore throat from wretching but no other complaints. past medical history: 1. stage iv breast cancer (er+ pr+ her2/neu- ductal invasive carcinoma) c/b chord compression s/p xrt and spinal fusion t9-l4 on , pe/dvt now on lovenox, posterior laminectomy and fusion t1-t9 in ; course includes arimidex, lupron, xeloda, now adriamycin/cytoxan 2. tubal ligation and uterine fibroid removal 3. severed right 5th digit 4. tonsilectomy 5. htn social history: the pt denies past or present tobacco. denies etoh, ivdu, other rec drugs. she is a housewife. lives with husband and 2 children (in college). family history: denies family history of breast ca or other malignancy physical exam: on presentation: vitals: t: 98.8 bp: 127/78 hr: 106 rr: 23 o2sat: 97% on ra gen: well-appearing, tearful, nad heent: eomi, perrl, sclera anicteric, no epistaxis or rhinorrhea, dry mm, erythema of posterior oropharynx without tonsilar exudate, +alopecia neck: no jvd, carotid pulses brisk, no bruits, no cervical lymphadenopathy, trachea midline cor: tachycardia, regular rhythm, no m/g/r, normal s1 s2, radial pulses +2 pulm: lungs ctab, bibasilar rales, no wheezes or rhonchi abd: soft, nt, nd, +bs, + ecchymoses of lower abdomen, no masses ext: no c/c/e, no palpable cords neuro: alert, oriented to person, place, and time. cn ii ?????? xii grossly intact. moves all 4 extremities. skin: no jaundice, cyanosis, or gross dermatitis. pertinent results: imaging: ct a/p 1. significantly limited study given lack of contrast administration. no definite findings of acute intra-abdominal pathology such as colitis, diverticulitis, or obstruction. 2. diffuse permeative osseous metastases with little change over the interval. intrathecal detail is limited, especially in the region of hardware and if tumoral extension is suspected in the spinal canal, mri spine is warrented. 3. decreased size of right inguinal adenopathy although not well evaluated given lack of iv contrast. 4. soft tissue nodules within the subcutaneous tissues of the anterior pelvis. please correlate with injection history. 5. axial hiatal hernia. brief hospital course: this is a 53 year old female with a history of stage iv breast cancer with 4 days of nausea, vomiting, diarrhea and neutropenic fever. she was treated with broad spectrum antibiotics. additionally, she had a fib with rvr which responded well to iv lopressor. # neutropenic fever/sepsis: met sirs criteria on admission. was likely source is gi given loss of appetite, nausea, vomiting, diarrhea, and inability to tolerate po. patient was profoundly dehydrated with tachycardia, elevated lactate, all improved with aggressive hydration. started on vanc/cefepime/flagyl for broad coverage including gi source/anaerobes, which can narrow based on cultures and clinical source blood cultures sent which are ngtd, ua negative/ucx pending. cxr without evidence of infiltrate and ct abd/pelvis pending, with prelim read negative for infection. patient was started on a 7 day course of neupogen per heme/onc rec, to complete on . however, her wbc was 5.1 on day 3 so neupogen was stopped. patient spiked to 100.4 on morning of and was cultured. no additional antibiotics were started. patient remained afebrile and was transferred to the floor on . flagyl was stopped. the patient remained afebrile and she started taking pos. vanco was d/c'd and she was discharged on 10 day course of cefpodoxime. . # tachycardia/atrial fibrillation with rvr: patient became tachy to 190's morning of , 12-lead ekg showed it was atrial fibrillation. patient has no prior history of this. arrythmia broken with iv lopressor she was transitioned to metoprolol 25mg with good effect. patient was anticoagulated with lovenox (see below) which she was on for her portal vein thrombosis. she continued to have episodes of svt from 100-120, which was treated with iv fluids. on the floor, the patient had sinus tachycaria into the 140s. she was asymptomatic. no underlying cause was found, likely chemo, cancer, recovering from acute illness, anxiety. her bb was uptitrated to metoprolol 50 tid. she was seen by physical therapy and was tachycardic to the 130s while walking but not dizzy or sob, so she was d/c'd home with close follow up. metoprolol can be downtitrated as an outpatient. . # nausea/vomiting/diarrhea: resolved with fluids and anti-emetics. was likely gastroenteritis, though given neutropenia, was initially more concerning for occult cause. diet was advanced to clears which patient tolerated and nausea was treated with anti-emetics. c. diff was negative x2. stool cultures were negative and patient was given low dose of immodium. . # anemia: admission hct 22 on admission. in the micu, received 2 units prbc without appropriate bump. recevied an addition 2 units with bump to 29. remained stable 28-32 for the length of stay. . # metastatic stage iv breast ca: admitted 14 days post cycle two of adriamycin/cytoxan - last dose . continuing to get xrt to back and leg, last . per omr appears next xrt is due in . dr. is primary oncologist and is aware of admission. she has a follow up appointment with dr. three days after discharge. . # anxiety: patient was quite tearful and anxious intermittenly. notes that she uses ativan at home for this prn. we continued ativan prn. social work was consulted for patient coping. . # portal vein thrombosis: was on lovenox on admission which was held for 36 hours as patient was anemic and thrombocytopenic. restarted on lovenox 120mg sq qd as anemia responded well to tranfusion and was stable. . # hypertension: patient came in hypotensive, so we held her atenolol and lisinopril. she was normotensive on discharge so her medications were not restarted (on metoprolol 50 tid). she was advised to call her primary care doctor to have her blood pressure medications titrated as needed. . medications on admission: lisinopril 10 mg daily atenolol 50 mg daily lovenox 120 mg daily ativan 1 mg qhs, prn q6h multivitamin calcium carbonate discharge medications: 1. multivitamin tablet sig: one (1) tablet po daily (daily). 2. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). 3. enoxaparin 120 mg/0.8 ml syringe sig: one (1) injection subcutaneous q24h (every 24 hours). 4. cefpodoxime 100 mg tablet sig: two (2) tablet po q12h (every 12 hours) for 9 doses: last dose will be pm on . disp:*18 tablet(s)* refills:*0* 5. lorazepam 1 mg tablet sig: one (1) tablet po at bedtime. 6. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* discharge disposition: home with service facility: discharge diagnosis: primary diagnosis: sepsis neutropenic fever metastatic breast cancer hypokalemia discharge condition: stable discharge instructions: you came to the hospital with neutropenic fever, diarrhea and hypotension. we believe this was from an infections, but we were not able to find the bacteria that caused it. we treated you with iv fluids and iv antibiotics in the icu. you were stable and transferred to the regular floor and switched to po antibiotics. we also noticed that your potassium was low and replaced it. . we made the following changes to your medications: added cefpodoxime (this is your antibiotic) stopped atenolol started metoprolol 50mg tid stopped lisinopril . please follow up with your doctors as below. . if you have worsening diarrhea, abdominal pain, fevers, chills, nausea, weakness, confusion, or any other symptom that is concerning to you, please call your doctor or come to the emergency room. followup instructions: provider: , md phone: date/time: 12:30. please have your blood pressure and heart rate checked at this time and consider decreasing your metoprolol dose if needed. . provider: , rn phone: date/time: 2:00 . please call your primary care doctor to make an appointment. you should have your blood pressure and potassium checked and discuss restarting your lisinopril. procedure: transfusion of packed cells diagnoses: acidosis anemia of other chronic disease other and unspecified noninfectious gastroenteritis and colitis malignant neoplasm of liver, secondary unspecified essential hypertension unspecified septicemia atrial fibrillation personal history of malignant neoplasm of breast sepsis hypopotassemia anxiety state, unspecified antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use personal history of venous thrombosis and embolism nonspecific abnormal findings in stool contents dehydration tachycardia, unspecified secondary malignant neoplasm of bone and bone marrow personal history of irradiation, presenting hazards to health neutropenia, unspecified arthrodesis status acute pharyngitis portal vein thrombosis fever presenting with conditions classified elsewhere 

Answer: The patient is high likely exposed to