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: history of present illness: the patient was admitted on with a chief complaint of confusion. the patient is a 66 year old female with a history of lithium toxicity who presented with increasing confusion, lethargy and dehydration for the last five days. the patient claims that on the day of admission she fell out of bed with increased confusion. the patient had an episode of increased lithium toxicity in with similar complaints. past medical history: past medical history includes depression, hypothyroidism and chronic renal insufficiency. medications on admission: 1. prozac 2. lithium allergies: no known drug allergies. social history: no alcohol, no drug use, had a 30 pack year smoking and had no children. physical examination: physical examination on admission included a temperature of 102, heartrate 45 ,blood pressure 127/55. general: the patient was confused, unaware and unalert. head, eyes, ears, nose and throat: pupils are equal, round, and reactive to light and accommodation, extraocular movements intact. extremely dry mucous membranes. neck was supple, no lymphadenopathy was felt. chest was clear to auscultation bilaterally. cardiovascular: bradycardia. no murmurs, rubs or gallops. gastrointestinal, soft, nontender, nondistended with positive bowel sounds. rectal, stool was guaiac negative. extremities, no cyanosis, clubbing or edema. skin had no evidence of any rashes. laboratory data: electrocardiogram on admission had bradycardia with 46 rate per minute, old right bundle branch block compared with an electrocardiogram of which was the same. labs on admission included a white count of 20.1, hematocrit 40.7, platelets 472,000. 88.9% neutrophils, 0 bands, 7 lymphs, 3 monocytes. chem-7 was 140/4.9, 96/31, bun with creatinine of 45/3.0, glucose 146. urinalysis had a trace protein and otherwise negative. lithium on admission is level of 1.6, tsh was done and was pending. chest x-ray was negative. hospital course: the patient was admitted to the medical intensive care unit for aggressive hydration. blood cultures were done. the patient also had a head computerized tomography scan and an lumbar puncture performed at that time. the patient had an arterial blood gases done at 7:45 on the day of admission which revealed 7.41, 53, and 63 with lactate of 2.3 and free calcium of 2.08. the night the patient was admitted the patient began developing some electrocardiogram changes including progression of loss of p waves near the right bundle branch block over serial electrocardiograms. the patient down to 30s and atropine was given. her heartrate then recovered. the patient then developed severe swelling of her vocal cords. the patient was intubated for airway protection and began aggressive hydration and lasix diuresis to push calcium down. central line and arterial lines were placed at that time. the patient had her ionized calcium monitored that went from 2.08 down to 1.65 on . in addition the lithium levels went down to 1.1. tsh came back, it was to 6.3 at that time. cerebrospinal fluid gram stain had no polys seen, no organisms. the cultures were pending, otherwise the lumbar puncture was normal. chest x-ray at that time also with elevated right hemidiaphragm. the patient on had an echocardiogram performed which was essentially unchanged from the previous study from . left ventricular function was 55%, ascending aorta was mildly dilated. the aortic valve leaflets were mildly thickened, no aortic regurgitation, 1+ tricuspid regurgitation, borderline pulmonary hypertension. precordium had a fat pad versus small effusion of question. the patient remained somewhat hypotensive in the unit with heartrates in the bradycardiac range of 30s to 50s. the patient was worked up for dic with a fibrinogen level of 247, d-dimer less than 500, also cks were negative and troponin i were negative. urinalysis remained clear. the patient had hypotensive episodes, was febrile and was with infiltrates versus effusion on chest x-ray with chronic renal insufficiency. the patient was then started on antibiotics for what was presumed to be pneumonia. the patient was started on levofloxacin, vancomycin and flagyl for a ten day course of levofloxacin and seven day course of vancomycin and a seven day course of flagyl. endocrinology was consulted due to the patient's increased hypercalcemia as well as the patient's hypothyroidism. it was felt that the increased calcium was probably due to the lithium toxicity as well as the hypothyroidism. the patient was continued on the current medication of synthroid. from an infectious disease standpoint the patient remained febrile and had an lumbar puncture which was negative for any source of infection. the patient had multiple blood cultures which none ever having grown any organisms. the patient also had a bronchoscopy for finding organisms which was negative. no stressor or any evidence of any infection was ever found. the patient remained intubated in the newborn intensive care unit due to what they thought was pneumonia or sepsis like syndrome and hypertension and decreased respirations. the patient was extubated on as the patient's oxygenation and respiratory drive improved. the patient was transferred to the floor on . the patient's oxygen saturations were 94% on 2 liters and was stable. the patient was being transferred to the medicine service for further evaluation of her psychological issues which she developed while she was in the intensive care unit, monitoring of her calcium and thyroid status and correction of hypernatremia with continuing monitoring of her blood pressure which had been stabilized. the patient is being followed by psychiatry, endocrine and physical therapy at that time. because she was found to be sating fairly well on 94% on 2 liters by nasal cannula, it was planned to decrease her oxygen as tolerated. her pneumonia had resolved and no treatment was needed at that time. her blood pressure was stable and she came to the floor and her previous hypotensive state was attributed to hypothyroidism, but she was now being treated with synthroid. from a psychiatry standpoint, we obtained rpr which came back negative, and b12 and folate were within normal limits. an magnetic resonance imaging scan of her head was obtained which also was negative for any acute events or acute ischemia. on , it was noted on examination that she had some proximal weakness of her right upper extremity with 2/5 strength in the right upper extremity, abduction. this was later attributed to brachyopathy secondary to just having her longstanding stay in the intensive care unit. in subsequent days it appeared to resolved with increasing strength. given her persistent low level hypernatremia, we obtained a urine osmolality on which revealed a urine osmolality of 176 and a urine sodium of 44. at that time her serum sodium was 149. because of her relative hypernatremia, her expected urine osmolality should have been slightly higher. given her long history of lithium use we attributed her hypernatremia thus to nephrogenic diabetes insipidus secondary to lithium use. we then started her subsequently on ddavp. on at approximately 7:45 am the patient had a witnessed tonoclonic generalized seizure which lasted 2 to 3 minutes. her oxygen saturation decreased and she was placed on 100% nonrebreather after which her oxygen saturation recovered into the mid 90s. the patient never recovered to her pre-seizure mental status following the event. approximately one hour later she suffered another generalized tonoclonic seizure witnessed by the house officer and nursing staff. the patient did not lose fecal incontinence. the patient had a foley catheter and the patient was afebrile at the time. she was found to be confused and restless postictally and with only partial recovery of her mental status over the following hours. the patient was loaded with 1000 mg of phenytoin intravenously. then there were no further events or seizure activity. upon neurological consult we discontinued any other phenytoin treatment and she has not had any recurrence of her seizures. the etiology of her seizures was attempted to be found, however, all cultures were negative. chest x-ray was negative and given her old cerebrospinal fluid cultures being negative and a negative magnetic resonance imaging scan of her head several days prior to the event there was no clear etiology upon further workup. but, given the fact that she had no recurrence of seizures and her electrolytes were stable at the time, it was concluded that it would be safe to discontinue any antiseizure medications. from until the day of discharge the patient was stable. vital signs were stable and there were was no recurrence of seizure activity. the patient remained clinically stable from to , when the patient was going to be discharged. her temperatures remained afebrile as well as her blood pressures remained relatively well at 130/80. physical examination had no change from previously when the patient was taken out of the unit. urine cultures remained negative. chest x-rays remained negative. urine osmolality and urine sodium continued to show the patient had some evidence of some nephrogenic diabetes insipidus. the patient was stable upon discharge with no further electrolyte abnormalities other than her mild hypothyroidism as well as her hypernatremia. discharge medications: 1. synthroid 150 mcg by mouth once a day 2. colace 100 mg by mouth twice a day 3. multivitamin one tablet by mouth once a day 4. nystatin swish and swallow 5 cc four times a day 5. nystatin powder apply to affected areas twice a day 6. ddavp 10 mcg per spray, one spray to one nostril twice a day 7. albuterol/atrovent metered dose inhaler, 2 puffs inhaled every 4 hours as needed for shortness of breath 8. boost shakes by mouth three times a day discharge diagnosis: 1. sepsis-like syndrome which needed some intubation 2. status post hypotension 3. respiratory distress 4. hypercalcemia which eventually was treated successfully which resulted in hypocalcemia which was then treated and calcium levels eucalcemic on discharge. 5. nephrogenic diabetes insipidus, probably secondary to her lithium toxicity. the patient will continue on ddavp for increased serum sodium 6. depression/bipolar disorder, the patient will be followed by psychiatry as an outpatient as well as given psyche medications 7. chronic renal insufficiency 8. new onset seizures which were initially treated with intravenous-loaded dilantin, however, did not occur after the patient was stopped on that medication 9. hypothyroidism which was treated with synthroid follow up care: the patient will follow up with dr. for further evaluation and workup. the patient was stable upon discharge with marked improvement from her status on the medical intensive care unit. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances other bronchoscopy insertion of temporary transvenous pacemaker system diagnoses: pneumonia, organism unspecified unspecified septicemia other convulsions other specified cardiac dysrhythmias hypotension, unspecified infection and inflammatory reaction due to other vascular device, implant, and graft nephrogenic diabetes insipidus hypercalcemia 

Answer: The patient is high likely exposed to