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 attending: chief complaint: short of breath for 1 week major surgical or invasive procedure: s/p attempted rij, r subclavian, left subclavian central line. placement of swan ganz catheter history of present illness: ms. is a 72 year old female with h/o severe ventricular dysfunction (ef 10%) secondary to polysubstance abuse and hiv (dx on haart, last cd4 359), 2+ mr, on methadone maintenance who presents with 3 weeks of dyspnea on exertion, worsening over the past week. the patient notes that over the past week activities such as brushing her teeth have become difficult for her. she has a non-productive cough which has also been present for three weeks. at baseline she is unable to lie flat, however she says that this has worsened recently - her breathing is much worse at night and worse with lying down. she endorses orthopnea, pnd and ankle edema over past 2 days. she notes occasional sharp right sided chest pain which she believes is due to "gas". the pain occurs at any time of day, no associated symptoms. she denies any medication non-compliance or dietary indiscretions. she notes weight loss of 20lbs since and increased fatigue over the same time span. the patient was admitted here in for chf exacerbation. per the d/c summary from that admission she was treated with a single dose of iv lasix and sent home on po dose. her bnp at that time was 12,000. also of note, on last d/c summary from , pt reported 30lb weight loss. patient has not been placed on a beta blocker due to concern of cocaine use. on review of symptoms, she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. other review of symptoms negative aside from above. cardiac review of systems is notable for absence of palpitations, syncope or presyncope. in the ed, the patient was afebrile with sbp as low as 80s. an attempt at placing an ij and subclavian was attempted but difficult due to reportedly abnormal anatomy. sbp improved to 90s and no line was placed. hr 70s, o2sat 100% on ra, afebrile. lasix was recommended for chf but not given due to low bp. cxr showed mild chf. the patient was given levaquin for ? pna on cxr and nebulizers. she was initially admitted to the cardiology floor, however, given her echo with severe + mr, cardiomyopathy and congestive heart failure, she was transferred to the ccu for swan ganz catheter and tailored therapy. past medical history: 1. hiv- diagnosed in , has taken haart therapy intermittently. stopped taking her pills three months ago because stated she had foamy vomit every time she took them. cd4 274, vl<50 in 2. chf- ef 10-15% . reports no exacerbations of sob since admission in . however one clinic note states had admission to in 05. 3. hcv- vl >700k in , not a good candidate for interferon therapy or liver biopsy per gi note in 04. 4. mild copd- pfts showed a normal study 5. ivdu--last abuse heroin several days ago, skin popping 6. arthritis 7. chronic pancreatitis social history: has 20 grandchildren, tobacco: cig/day, 40 py heavy etoh in past. states that last used heroin in the past few days (skin popping) and also used cocaine in the last month. family history: nc physical exam: vs: t96.5, bp120/70, hr60, rr20, o2 99% on 3l gen: cachectic female in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple, thin. right neck with small stable hematoma from ij attempt in ed. cv: pmi located in 7th intercostal space, midclavicular line. distant heart sounds, regular rhythm, normal s1, s2. holosystolic murmur at apex. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. crackles at right base, left base clear. abd: soft, nt, nd, no hsm or tenderness. no abdominial bruits. ext: trace edema at ankles bilaterally. no femoral bruits. skin: multiple well healed lesions from h/o drug abuse back: mildly tender to palpation in left cv angle, no r cva tenderness pulses: right: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp left: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp pertinent results: 10:20am blood wbc-5.8 hgb-11.9* hct-36.0 plt ct-185 03:00am blood pt-12.7 ptt-30.4 inr(pt)-1.1 03:00am blood glucose-101 urean-47* creat-1.5* na-137 k-4.2 cl-105 hco3-24 angap-12 03:00am blood ck(cpk)-33 ctropnt-0.25* 08:24am blood ck(cpk)-25* ctropnt-0.19* 10:20am blood ck(cpk)-30 ctropnt-0.20* probnp-* 03:43pm blood tsh-2.1 03:43pm blood alt-11 ast-25 alkphos-58 totbili-0.5 . echocardiogram: the estimated right atrial pressure is 16-20 mmhg. normal lv wall thickness with severe global lv hypokinesis. no masses or thrombi are seen in the left ventricle. rv cavity is moderately dilated with severe global right ventricular free wall hypokinesis. "low-output" aortic stenosis is suggested (calculated 1.0cm2). moderate (2+) mitral regurgitation and moderate tricuspid regurgitation is seen. moderate pulmonary artery systolic hypertension (pasp = 46). . cxr: 1) mild chf 2) progression in size of cardiac silhouette. cxr: new moderate-sized apical pneumothorax on the right. cxr: resolution of the small right apical pneumothorax. cxr: 1. continued improvement in interstitial pulmonary edema. . brief hospital course: the patient is a 72 year-old female with severe ventricular dysfunction (ef 10%) secondary to polysubstance abuse and hiv (last cd4 359) who presented with chf exacerbation. . # pump: the patient had an ef of 10% on her last echo prior to admission (07/). troponin was elevated on admission, but thought likely to be secondary to demand after three sets were stable. physical exam on admission was only slightly consistent with chf - crackles at right lung base, minimal le edema. cxr was concerning for pericardial effusion given that cardiac silhouette was enlarged from prior, and showed mild chf, though not worsened compared to a previous cxr. given her low ef, it was likely acute on chronic heart failure with poor forward flow secondary to dilated cardiomyopathy of hiv. the precipitating event was unclear. echocardiogram showed no pericardial effusion although severely depressed ef with mr. bnp was . the patient was diuresed with lasix. a swan ganz catheter was placed on in l brachial artery to monitor hemodynamics and for tailored therapy. digoxin and acei were continued. captopril was titrated up as blood pressure tolerated for afterload reduction. dobutamine was started to maximize heart function/inotropic effect and titrated off on . eventually, patient was weaned off oxygen and breathing comfortably on room air. . # rhythm: pt was admitted in sinus rhythm and was noted to have some ectopy on telemetry. on occasional ventricular bigeminy was noted, and by this pattern became more frequent. given her improved cardiac index we attempted to wean the dobutamine. on , patient developed runs of vtach and was started on amiodarone 400mg po bid. tsh, lft's, ekg were within normal limits. digoxin dose was decreased to 0.0625mg po daily due to amiodarone metabolism. by discharge, the episodes of vtach had resolved. . # hiv: last cd4 359 in 04/. her outpatient regimen of haart and bactrim was continued. . # polysubstance abuse: last use mos prior to admission. the patient was continued on her outpatient methadone regimen. . #)anticoagulation- patient was started on a heparin drip and then bridged to coumadin due to the poor lv function and risk of clot formation. currently on coumadin 5mg po daily with theraputic goal of inr . . # fen: po intake was poor initially. nutrition was consulted and recommended additional supplements. low sodium diet. . #) difficulty swallowing- on , patient complained of difficulty swallowing solids, painful swallowing, and regurgitation of solid food. she was started on a ppi and outpatient gi follow-up with possible egd was recommended. . medications on admission: lasix 80mg po bid lisinopril 20mg daily digoxin 0.125 mg daily methadone 90mg daily (confirmed with methadone clinic) nevirapine 400mg daily bactrim ds 1 tab daily truvada 1tab daily albuterol inhlaer discharge medications: 1. outpatient lab work please draw potassium, creatinine, pt/ptt/inr on monday, , . fax results to dr. at (. 2. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). disp:*30 tablet,rapid dissolve, dr(s)* refills:*1* 3. warfarin 1 mg tablet : five (5) tablet po at bedtime. disp:*150 tablet(s)* refills:*2* 4. amiodarone 200 mg tablet : two (2) tablet po see instructions: take 2 tablets twice daily for 9 days then take 2 tablets once daily thereafter . disp:*39 tablet(s)* refills:*1* 5. furosemide 20 mg tablet : one (1) tablet po twice a day: take 1 (one) 20 mg tablet with 1 (one) 80 mg tablet twice a day (for a total of 100mg twice a day). disp:*60 tablet(s)* refills:*2* 6. methadone 10 mg tablet : nine (9) tablet po daily (daily). tablet(s) 7. nevirapine 200 mg tablet : two (2) tablet po daily (daily). 8. trimethoprim-sulfamethoxazole 160-800 mg tablet : one (1) tablet po daily (daily). 9. emtricitabine-tenofovir 200-300 mg tablet : one (1) tablet po daily (daily). 10. digoxin 125 mcg tablet : 0.5 tablet po daily (daily). 11. lisinopril 20 mg tablet : one (1) tablet po daily (daily). discharge disposition: home with service facility: vna discharge diagnosis: congestive heart failure with ejection fraction of less than 10% human immunodeficiency virus dysphagia discharge condition: the patient is in stable condition. afebrile, comfortable on room air. discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: 1500 ml you were admitted with an exacerbation of congestive heart failure. please call dr. office or 911 if you experience increasing shortness of breath, chest pain, leg swelling, increasing weight. followup instructions: please follow up with your primary care physician, . , () on at 2:30 pm. please follow up with dr. , your cardiologist, on monday, at 3:30 pm. please call ( if there is a problem with this appointment. you should have your labwork drawn this coming monday, . this will include your kidney function as well as your coumadin level. these results should be faxed to dr. office. provider: , : date/time: 11:00 procedure: pulmonary artery wedge monitoring diagnoses: pneumonia, organism unspecified mitral valve disorders congestive heart failure, unspecified chronic hepatitis c without mention of hepatic coma chronic airway obstruction, not elsewhere classified human immunodeficiency virus [hiv] disease chronic kidney disease, unspecified opioid type dependence, continuous paroxysmal ventricular tachycardia diseases of tricuspid valve secondary cardiomyopathy, unspecified 

Answer: The patient is high likely exposed to