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: codeine / percocet attending: chief complaint: nose bleed. major surgical or invasive procedure: none. history of present illness: yo with question h/o cad presents from osh with bloody nose that began on the day pta. pt reports she was in her usual state of health when she had the sudden onset of nose bleeding yesterday. she indicates that this has happened a few times to her over the years though not with any regularity. she thought she would be able to get it to stop by holding compression but was unable to do so. the pt also noticed some bpbpr associated with moving her bowels. the pt presented to an osh ed for evaluation of these sxs where her plts were found to be 3. she was transferred then to for further workup. in the ed, hematology was consulted and the pt's peripheral smear reviewed. it was thought that she most likely has itp. the pt was transfused one unit of prbcs and two bags of platelets. she is now admitted to the micu for further care. on ros, the pt denies any recent fevers, chills, nausea, vomiting or change in weight. no chest, jaw or arm pain. no palpitations. no abd pain. no change in stools. no urinary sxs. no msk sxs. no neuro sxs. past medical history: 1. cad s/p mi 2. htn 3. gerd 4. aortic aneurysm 5. cervical spondylosis 6. osteoporosis social history: the pt lives by herself in senior housing. she does not smoke or drink. she has a son who lives in . she had another son who died at age 41. retired homemaker. family history: pt's parents died of natural causes at 90 (father) and 83 (mother). sister died of "bleeding." pt states sister had a bleeding disorder, but does not know the details. physical exam: gen: well appearing adult female, no acute distress. heent: perrl, eomi. mmm. conjunctiva well pigmented but diffuse petechial bleeding noted. neck: supple, without adenopathy or jvd. no tenderness with palpation. chest: few crackles at bases bilat. cor: normal s1, s2. rrr. iii/vi sem heard best at lusb. abdomen: soft, non-tender and non-distended. +bs, no hsm. extremity: warm, without edema. 2+ dp pulses bilat. neuro: alert and oriented. cn 2-12 intact. motor strength intact in all extremities. sensation intact grossly. appears to have mild, non-focal cognative impairment. pertinent results: 10:20pm blood wbc-5.2 rbc-2.55* hgb-8.5* hct-23.1* mcv-91 mch-33.4* mchc-36.9* rdw-14.0 plt ct-62*# 04:54am blood wbc-3.5* rbc-2.13* hgb-7.0* hct-19.0* mcv-89 mch-33.1* mchc-37.1* rdw-14.4 plt ct-11*# 04:35am blood wbc-7.0 rbc-3.58* hgb-11.8* hct-31.0* mcv-87 mch-32.9* mchc-38.0* rdw-14.6 plt ct-42* 10:20pm blood pt-13.7* ptt-28.2 inr(pt)-1.2* 10:20pm blood fibrino-332 d-dimer-1433* 10:20pm blood ret aut-3.2 10:20pm blood glucose-116* urean-25* creat-1.1 na-140 k-3.7 cl-103 hco3-28 angap-13 10:20pm blood alt-12 ast-28 ld(ldh)-273* totbili-0.7 10:20pm blood calcium-9.4 phos-3.4 mg-2.1 04:54am blood tsh-2.7 04:54am blood totprot-4.6* iron-62 04:54am blood caltibc-209* vitb12-219* folate-7.9 hapto-72 ferritn-58 trf-161* plt: 25 () -> 34 () -> 42 () spep/upep negative . - virus vca-igg ab (final ): positive by eia. - virus ebna igg ab (final ): positive by eia. - virus vca-igm ab (final ): negative <1:10 by ifa. . cmv igg antibody (final ): positive for cmv igg antibody by eia. cmv igm antibody (final ): negative for cmv igm antibody by eia. . parvovirus b19 (igg) 6.95 (positive) antibody parvovirus b19 (igm) negative antibody . ct head w/o contrast (): impression: no acute intracranial hemorrhage or calvarial fracture. . cxr (): moderate cardiomegaly is longstanding. patient has known large ascending aortic aneurysm. the cardiomediastinal silhouette is unchanged which also includes a calcified right upper paratracheal lymph node. there is no evidence of chf or pneumonia. the lungs are grossly clear. there is no pneumothorax or pleural effusion. brief hospital course: # itp/anemia: transfered from osh with severe epistaxis, brbpr, and plts 3. peripheral smear not diagnostic. hematology was consulted and itp suspected. her hematocrit was as low as 19. she was transfused one unit of prbcs and two bags of platelets. in the micu, received one more unit prbcs, and hct has since remained stable around 30 with no further bleeding. she was started on prednisone 40mg (1mg/kg), later increased to 80mg. her platelets began to rise, moving from 25 to 42 at discharge. asa and plavix were held during the admission. she will need to have her platelets monitored twice weekly in the outpatient setting and she will follow up with heme, who will manage her steroids. a bone marrow biopsy may be indicated if there is no improvement, as there was some transient leukopenia as low as 3.1 during the admission. also of note, she has low b12 and is receiving daily b12 treatment to be transitioned to weekly x1 month at rehab. this may need to be continued qmonth long term as an outpatient. . # htn: her metoprolol was decreased from 25mg to 12.5mg due to hr in the low 50s and high 40s, although asymptomatic. even at the lower dose, the med was still often held for bradycardia. had systolic pressures as high as 180s without symptoms. her amlodipine was increased from 5 to 10mg daily and she remained well controlled most of the time, with occasional increases in sbp to 160-170. this can be addressed in the outpatient setting. . # neck pain, chronic left sided trapezius stiffness noted. she had relief with scheduled tlyenol. . # dispo: her other chronic health problems remained stable. she will be discharged to rehab due to unsteadiness on her pt evaluation. we are encouraging ambulation as the primary mode of dvt prophylaxis as the pneumoboots worsen her bruising, and her platelets remain too low for heparin. medications on admission: plavix 75 mg daily mvi with fe lisinopril 20 mg fosamax 70 mg weekly simvastatin 10 mg daily omeprazole 20mg norvasc 5 mg daily metoprolol 25 mg oxybutynin 10 mg daily caco3 500 mg discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. multivitamin tablet sig: one (1) tablet po daily (daily). 4. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 5. alendronate 70 mg tablet sig: one (1) tablet po qthur (every thursday). 6. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily): hold if sbp <100. 7. lisinopril 20 mg tablet sig: one (1) tablet po bid (2 times a day): hold if sbp < 90. 8. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day): hold for hr <55, sbp <90. 9. oxybutynin chloride 5 mg tablet sig: two (2) tablet po daily (daily). 10. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 11. calcium carbonate 500 mg tablet, chewable sig: three (3) tablet, chewable po bid (2 times a day). 12. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po bid (2 times a day). 13. prednisone 20 mg tablet sig: four (4) tablet po daily (daily). 14. acetaminophen 500 mg tablet sig: two (2) tablet po q8h (every 8 hours). 15. aluminum-magnesium hydroxide 225-200 mg/5 ml suspension sig: 15-30 mls po qid (4 times a day) as needed. 16. cyanocobalamin 1,000 mcg/ml solution sig: one (1) injection once a week for 5 doses: give each friday. discharge disposition: extended care facility: discharge diagnosis: primary: immune thrombocytopenic purpura secondary: hypertension, coronary artery disease discharge condition: stable, no evidence of active bleeding. discharge instructions: you were admitted to with a severe nosebleed and some blood in your stool. you were found to have low platelets (blood components that help form clots) that were causing the bleeding. we transfused you two units of blood and two bags of platelets, and you have had no bleeding since. we are treating you with steroids to improve your platelet count, and they are slowly rising. . please take all medications as prescribed and go to all follow up appointments. we are holding your aspirin and plavix due to your recent bleeding. we have started prednisone, a steroid that we are using to treat your low platelets. we are also giving you b12 as your levels of this vitamin were low. for your blood pressure, we have lowered your metoprolol dose due to your low heart rate, but have increased your amlodipine. . please do not drive due to your neck weakness, as we discussed. . if you experience any nosebleeds, bloody stools, other types of bleeding, falls, injuries, or any other concerning symptoms, please seek medical attention or come to the emergency room immediately. followup instructions: provider: , hematology. phone: date/time: 3:00. bldg, , , ma provider: , md, mph: date/time: 2:15 md, procedure: transfusion of packed cells transfusion of platelets diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux unspecified essential hypertension acute posthemorrhagic anemia osteoporosis, unspecified old myocardial infarction other vitamin b12 deficiency anemia hemorrhage of gastrointestinal tract, unspecified epistaxis immune thrombocytopenic purpura cervical spondylosis without myelopathy 

Answer: The patient is high likely exposed to