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: heparin agents attending: chief complaint: pulmonary embolism major surgical or invasive procedure: ivc filter, history of present illness: 48f with hx. of invasive melanoma (7mm breslow depth) diagnosed on biopsy of left buttock lesion on . subsequently she had wide excision with rotation flap on . on she had left inguinal lymphadenectomy by dr.. while inpatient she was on prophylactic heparin, venodyne boots, and ambulated, and she was discharged on . at home she noticed shortness of breath with climbing stairs, and this morning she had worsening shortness of breath. she was seen at an osh for this and a ct scan showed bilateral pe's. she was given a bolus of 5000u heparin and started on heparin drip at 1400u/hr. upon presentation to our service, she no longer has shortness of breath and is saturating in high 90s on room air. her only complaint is pleuritic sub-xiphoid pain with deep inspiration. she denies any pain in her calfs, feet, denies any skin changes in her lower extremities. denies chest pain, nausea, vomiting, diziness, headache, cough, or hemoptysis. past medical history: diabetes mellitus depression cholecystectomy abdominoplasty left gluteal melanoma excision w/ flap rotation social history: no tobacco, occassional alcohol brief hospital course: ms. was admitted to the floor and started on a heparin drip. as stated in the hpi, she was mostly asymptomatic at the time of admission, breathing without difficulty and her oxygen saturations in the mid-to-high 90s on room air. she also had a lower extremity duplex to rule out dvt which returned negative. her heparin drip was titrated and bridging to coumadin was started on hd 2. the heparin drip was therapeutic with a ptt in the 60s by the end of hd 2 into hd 3. ms. developed sharp pleuritic pain on deep inspiration starting on hd 4 which worsened over the course of the evening and into hd 5 with the addition of concomitant dyspnea. she continued to have normal oxygen saturations but her worsening clinical status prompted a cta which showed the subsegmental pes had now become a right lobar pe. she was promptly transferred to the surgical intensive care unit where an echocardiogram was performed to rule out right heart strain and was negative and a head ct was performed to rule out metastatic disease in the head/embolic processes; it was negative. her respiratory status worsened and she required oxygen support of l nasal cannula to maintain saturations in the mid 90s. vascular surgery and a hem/onc consults were obtained due to continued worsening of her pe while on anticoagulation, she was taken to the or by the vascular surgery team and had an ivc filter placed. post-operatively, she returned to the icu on a heparin drip before being switched over to argatroban in the possibility that she was hit positive (her platelet count was 327 on admission, slowly trending downwards to 158 on hd 6 prior to being switched to argatroban). the hit panel returned positive as well as a serotonin release assay. the argatroban gtt continued to be titrated post-operatively. she spiked a fever on hd 7/pod 1 and was pan-cultured and had another low grade temperature the following day. all cultures returned negative. cxr showed gradual improvement in terms of aeration and her symptoms improved where she was ambulating, tolerating regular diet, no longer dyspneic and she no longer required oxygen, once again with oxygen saturations in the high 90s on room air. she was transferred back to the floor on hd 8 where the argatroban drip was continued. starting on hd 9 a bridge to coumadin was resumed. she was therapeutic on hd 16 with an inr of 4.1 on the argatroban drip. the argatroban drip was discontinuation with discussion with the hem/onc service on hd 17, day of discharge, when patient's inr was 4.7. in total, the patient received the following dosing of coumadin (with associated inrs in brackets) while on argatroban: 7 . 5 ( 2.4)-->5(2.9)-->5(2.9)-->7.5(3.4)-->10(3.9)-->10(4.2)-->10(4.7). of note, from a cardiovascular perspective, the patient was tachycardic on admission. this was initially attributed to the pulmonary embolisms and was not treated. she continued to be tachycardic at the tail end of her hospitalization, after her pulmonary symptoms had resolved and she was therapeutic on her anticoagulation regimen. she was started on low dose (12.5 mg ) metoprolol on hd 15. on day of discharge, she was no longer tachycardic with hr in the 90s and bp in her baseline systolic 100s-110s. she was monitored on telemetry throughout. of note, the patient noted persistent heavy menstrual bleeding on which she reported had started the day of her original surgery on . this persisted over the weekend and a ob/gyn consult was obtained. they recommended ruling out acute sources of bleeding with a pelvic, transvaginal ultrasound which should only fibroids in the uterus with the rest of the study normal. a tsh, hcg and prolactin level were checked and normal. after conversation with the ob/gyn service, she opted to not undergo further treatment or diagnostic workup at this time and has been scheduled to follow up with the ob/gyn service in . heme: her hematocrit was monitored throughout her hospitalization and was stable in the 30-35 range. the last five days of her hospitalization were as follows 35.5->31.0->31.0->28.7->28.0. she was asymptomatic and reported decreased menstrual bleeding at this time. her heart rate and blood pressure were unchanged from prior baselines (systolic bp as noted above in 100s-110s range, consistent with rest of hospitalization). she exhibited no signs of bleeding otherwise. she was instructed to follow-up her hct in addition to her inr with her pcp appointment on , . other aspects of her hospitalization were unremarkable. her pain was well controlled on oral pain medication, she tolerated a regular diet without difficulty, she voided normally and without need of a foley catheter and she ambulated frequently throughout her hospitalization with the exception of her short stay in the icu. medications on admission: metformin 500'', glyburide 5', buproprion 150' discharge medications: 1. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). 2. glyburide 5 mg tablet sig: one (1) tablet po bid (2 times a day). 3. bupropion hcl 150 mg tablet extended release sig: one (1) tablet extended release po qam (once a day (in the morning)) as needed for home med for depression. 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): while taking narcotic pain medication to avoid constipation. 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 6. lorazepam 1 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for anxiety. 7. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 8. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 9. warfarin 5 mg tablet sig: two (2) tablet po once (once) for 3 days: take 10 mg daily from . adjust dose as per your pcp . starting . disp:*60 tablet(s)* refills:*1* 10. blood draw sig: one (1) blood draw once: please check inr for coumadin monitoring and a hematocrit. disp:*1 1* refills:*0* discharge disposition: home with service facility: all care vna of greater discharge diagnosis: melanoma pulmonary embolism discharge condition: mental status: clear and coherent. level of consciousness: lethargic but arousable. activity status: ambulatory - independent. discharge instructions: dear ms. - as always it was a pleasure taking care of you in the hospital. you were admitted for clots that had travelled to your lungs, called pulmonary embolisms; you were treated with anticoagulation (blood thinners) and your condition greatly improved. you were transitioned to an oral anticoagulant called warfarin. warfarin's effect on the blood needs to be monitored closely and it has been arranged such that your primary care physician, . (), will be managing this aspect of your care. please call his office as soon as possible to confirm your appointment on , the first day in which you should have your blood level checked. you will be prescribed to take 10 mg of coumadin until you follow up with dr. when he may readjust. you were also started on a medication called metoprolol, a beta blocker, to decrease your heart rate. continue taking this until your follow-up appointment and/or as directed by dr. . finally, you were seen by the ob/gyn service while in the hospital for prolonged menstrual bleeding. you had an ultrasound which showed fibroids and other lab testing was normal. you are scheduled to follow up with them on at 10:00 am on the east campus' ob/ clinic. in the coming days as you continue to recover at home, please keep in mind the following: please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. while taking narcotic pain medication, please emember to take colace (to avoid constipation) and please do not drive or operate heavy machinery. please follow-up with your primary care physician (in addition to your surgeon) in the coming weeks to reconcile all of your medications and to touch base regarding other medical issues or concerns after the surgery. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *you may shower, and wash surgical incisions with a mild soap and warm water. gently pat the area dry. please call your doctor if you experience the following: *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *you see blood or dark/black material when you vomit or have a bowel movement. *you experience burning when you urinate, have blood in your urine, or experience a discharge. *your pain is not improving within 8-12 hours or is not gone within 24 hours. call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. followup instructions: follow up with dr. on , , at 9:45 am to have your blood drawn and your inr and a hematocrit level checked. his office phone number is if you have further questions. the appointment has already been arranged. follow-up with dr. on in 2 weeks. please call to schedule the appointment. the office is aware of you and your need to see dr. , the appointment will likely be on wednesday, . please call the office on to confirm the appointment. follow-up with dr. from ob/gyn on at 10:00 am in the ob/ clinic. office phone number for questions is . provider: , md phone: date/time: 10:00 md, procedure: interruption of the vena cava diagnoses: diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled depressive disorder, not elsewhere classified long-term (current) use of anticoagulants primary hypercoagulable state anticoagulants causing adverse effects in therapeutic use tachycardia, unspecified other pulmonary embolism and infarction heparin-induced thrombocytopenia (hit) encounter for therapeutic drug monitoring malignant melanoma of skin of trunk, except scrotum excessive or frequent menstruation secondary and unspecified malignant neoplasm of lymph nodes of inguinal region and lower limb hemoptysis, unspecified 

Answer: The patient is high likely exposed to