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: sulfonamides / iodine; iodine containing / tetracyclines / macrodantin / flexeril / keflex attending: chief complaint: fatigue and bradycardia major surgical or invasive procedure: pacemaker placement history of present illness: the patient is a 65 year old woman with multiple medical problems most notably chf (ef 40-45%), dm2, seizure disorder, multiple admissions for bradycardia presenting with bradycardia. she was just discharged from on at which time she presented with bradycardia and weakness. at that time the bradycardia was junctional escape and self resolved during the hospital stay. per discharge notes, the bradycardia was attributed to zoloft which was held on admission and removed from her medication list. the patient states that she has not taken any of the zoloft or her prior metoprolol which had been discontinued in after being admitted with bradycardia. when returning home from breakfast she noted progressive weakness. she also had sudde onset of shortness of breath and right sided chest pain. the pain happened both at rest and with exertion. the pain was worse with deep breathing. the pain radiated to her neck and both shoulders. the pain was a tightness. she noted that she was so weak that she could only take a nap. when her boyfriend found her she was too weak to transfer to her wheelchair, so ems was called. she states that she takes all of her medications daily with the help of a nurse who lays them out for her in medication boxes. she denies getting confused and taking extra doses of medication. she states that she took her blood sugar this morning but does not remember the value. . initial vital signs in the ed were f 36 117/61 12 99%ra. an ekg showed junctional bradycardia @30-40 with no ischemic changes seen. a head ct was unremarkable. . on review of symptoms, she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, black stools or red stools. she denies recent fevers, chills or rigors. she has no dysuria or abdominal pain. she denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of paroxysmal nocturnal dyspnea, syncope or presyncope. past medical history: # skin cancer s/p resection to right temple () # bradycardia # chf (: ef 40-50%) # htn # asthma # dm2 with peripheral neuropathy # grand mal seizures mva # depression # b total knee replacement () # l4-l5 lumbar laminectomy, l4-l5 diskectomy, and foraminotomy (l5-s1) lumbar spinal stenosis # hip pinning # l2 compression fracture fall from height () # lbka train accident () # barrett's esophagus # diverticulosis, diverticulitis # lower gi bleed () # appendectomy (remote) # laparascopic cholecystectomy (remote) # peptic ulcer disease # kidney trauma mva requiring surgeries, unclear procedures # bladder reconstruction (remote) # total abdominal hysterectomy, unilateral oophorectomy (remote) . cardiac risk factors: +diabetes, dyslipidemia, +hypertension social history: lives alone in apartment. receives vna services and home visits from . per previous d/c summary--she has never been employed and has received welfare. the patient denies etoh or smoking history but per past d/c summary has a history of ppd x 20y, quit and alcohol abuse x 20y, quit , recreational drugs (multisubstance and ivdu in ). patient had 5 children all died by age 13. family history: n/c physical exam: vs: t 98.4 , bp 121/49, hr 33, rr 21, o2 97-100% on ra gen: obese middle aged female in nad, resp or otherwise. oriented x3. mood, affect appropriate. pleasant. heent: well healing surgical scar on right forehead. sclera anicteric. left anisocoria, bilateral reactive pupils, left cataract, eomi. lid droop on right. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. edentulous neck: supple with jvp flat cv: pmi located in 5th intercostal space, midclavicular line. bradycardic, normal s1, s2. no s4, no s3. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. no crackles, wheeze, rhonchi. abd: well healed surgical scars. obese, soft, ntnd, no hsm or tenderness. no abdominal bruits. ext: no c/c/e. no femoral bruits. s/p left bka w/o stump erythema skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp left: carotid 2+ without bruit; femoral 2+ without bruit neuro: ms - alert and oriented x3, coherent response to interview cn: ii-xii intact except for anisocoria motor: normal tone and bulk. bicep/tricep/hip flex bilat : light touch intact to face/hands/right foot w/o extinction coord: ftn intact and rapid brief hospital course: 65 year old woman with mmp and prior hx of bradycardia previously attributed to medications who presented with symptomatic junctional bradycardia (hr 35 bpm) on no av nodal agents. . # rhythm: pt was admitted with a junctional bradycardia that spontaneously converted to sinus bradycardia. after multiple admissions for symptomatic bradycardia attributed to medications (zoloft, metoprolol), on this admission it was determined that pt likely had sick sinus syndrome due tointrinsic sa nodal failure. an ischemic trigger was ruled out by negative cardiac enzymes and a recent tsh was normal. the patient was monitored on telemetry and received a dual-chamber pacemaker on . the patient did not experience any episodes of bradycardia or arrhythmia following pacemaker placement. the patient was discharged with a short course of clindamycin following pacemaker placement. . # uti: pt developed urinary retention on day 1 of admission and the urine culture grew gram negative rods. the patient was treated with aztreonam empirically due to multiple drug allergies, and when sensitivities were available it was confirmed by telephone with the clinical lab that the pt's e. coli uti was sensitive to aztreonam. the patient completed a 3-day course of aztreonam. . # chf/pump: 2d-echocardiogram performed on calculated lvef 35%. the patient remained euvolemic during admission. . # cad: ekg from admission demonstrated no significant st changes compared with prior dated . cardiac enzymes were negative. the patient was continued on aspirin. . # hypertension: hctz and lisinopril were started and the patient's blood pressure tolerated the medications. . # dm2: the patient was continued on her home dose of insulin. . # seizure disorder: the patient was continued on her home tegretol for her history of seizure disorder. the patient did not experience any seizure activity during the hospitalization. . # fen: the patient followed a diabetic, heart-healthy diet. . # code: full medications on admission: 1. insulin nph 30 units in the morning and 12 units at night. 2. gabapentin 300 mg qam 3. trazodone 100 mg hs prn 4. hydrochlorothiazide 25 mg daily 5. mirtazapine 30 mg qhs 6. gabapentin 1200 mg qhs. 7. carbamazepine 200 mg hs 8. albuterol 90 mcg inh q6prn 9. lisinopril 20 mg daily 10. aspirin 81 mg daily discharge medications: 1. mirtazapine 15 mg tablet sig: two (2) tablet po hs (at bedtime). 2. gabapentin 300 mg capsule sig: one (1) capsule po q24h (every 24 hours). 3. carbamazepine 200 mg tablet sig: one (1) tablet po hs (at bedtime). 4. hydrochlorothiazide 12.5 mg capsule sig: two (2) capsule po daily (daily). 5. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 6. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed. 7. gabapentin 600 mg tablet sig: two (2) tablet po at bedtime. 8. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 9. trazodone 50 mg tablet sig: two (2) tablet po hs (at bedtime) as needed. 10. albuterol 90 mcg/actuation aerosol sig: one (1) puff inhalation every six (6) hours as needed for shortness of breath or wheezing. 11. insulin nph human recomb 100 unit/ml suspension sig: thirty (30) units subcutaneous once a day. 12. insulin nph human recomb 100 unit/ml suspension sig: twelve (12) units subcutaneous at bedtime. 13. acetaminophen 325 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain. 14. clindamycin hcl 150 mg capsule sig: three (3) capsule po three times a day for 2 days. disp:*18 capsule(s)* refills:*0* discharge disposition: home with service facility: , discharge diagnosis: primary: bradycardia s/p pacemaker urinary tract infection . secondary: seizure disorder hypertension discharge condition: stable. transfers from bed to wheelchair without assist. discharge instructions: you were admitted with generalized weakness and a slow heart rate. you were also found to have a urinary tract infection. you had a pacemaker placed on . you will need to follow up with device clinic as shown below. you also had a urinary tract infection that was treated with antibiotics. . we have started you on an antibiotic called clindamycin 450mg three times a day for the next 2 days to prevent infection around the new pacemaker. otherwise, we have not made any changes to your medications. . if you develop any chest pain, shortness of breath, weakness, loss of consciousness or any other general worsening of condition, please call your pcp or come directly to the ed. followup instructions: primary care doctor: dr. knows that you are home and will make sure your home visits resume. please call with questions. provider: clinic phone: date/time: 1:30 neurology: provider: , md phone: date/time: 6:00 procedure: initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle artificial pacemaker rate check diagnoses: urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension asthma, unspecified type, unspecified diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes long-term (current) use of insulin sinoatrial node dysfunction barrett's esophagus below knee amputation status diverticulosis of colon (without mention of hemorrhage) generalized convulsive epilepsy, without mention of intractable epilepsy 

Answer: The patient is high likely exposed to