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: patient recorded as having no known allergies to drugs attending: chief complaint: left hip fracture noted at s/p mechanical fall major surgical or invasive procedure: left hemiarthroplasty history of present illness: 74 yo female with who presented to s/p fall, found to have left subcapital fracture by ct of hip, transferred to for further management. she initally was in an mva last year when it was noted that she had a aaa on cxr. she then had an elective thoracoabdominal aortic aneurysm resection/repair with hospital course c/b post-op respiratory failure, recurrent afib, multiple bronchs, l sided lung collapse, trach on after failed extubation of . trach was removed at rehab, however she was readmitted in with slight hyperfunction of false vocal cords, bilateral vocal cord immobility with ~1mm glottic gap requiring trach placement on . pt was walking with her walker when she tripped on the carpet and fell onto her left l hip hitting her head at home. denies loc, ha, neck pain, cp, sob, weakness, lh. assisted to bed, able to bear wt for 2 steps. pain localized to medial thigh with movement of lle. was brought to , initially xray unrevealing, ct though showed fx of l hip. ortho evaluated in ed, plan to perform orif during this admit after risk stratified; nwb on l, no traction indicated, anticoagulate. given extensive comorbidities, she was admitted to medicine for periop management. past medical history: 1. thoracic and abdominal aortic aneurysm, repair , c/b resp failure and trach. 2. bilateral vocal cord paralysis, s/p repeat trach . 3. clostridium difficile positivity. 4. vre positivity. 5. postoperative atrial fibrillation requiring cardioversion. 6. hypertension. 7. type 2 diabetes. 8. osteoarthritis. 9. lower back pain. 10. hypercholesterolemia. 11. left breast cancer - s/p lumpectomy 12. atrial fibrillation - this was first noted post op from the aaa repair. she was started on a bb and amio at that time then dccv. she has not been on coumadin. . past surgical history: -thoracic/abdominal aortic aneurysm repair, . social history: retired rn, she was living at home at the time of the hip fracture. her husband and daughter involved in her care. no tob, etoh, other drugs. globe reporter has been following her in s/p her hip fracture family history: dm, ? type - in mother physical exam: vitals: t 98.4 hr 64 bp 130/61 rr 24 sat 92% on mist o2 gen: elderly caucasian woman with trach mask in place, breathing comfortably, a+ox3, nad heent: ncat, no bruising or ecchymosis, perrl, eomi, mmm, op clear neck: supple, trach in place, no lad cv: rrr nl s1 s2 no m/g/r lungs: cta b/l abd: soft, nt, nd, +bs ext: l medial thigh pain with external rotation neuro: no sensory deficit in affected limb ekg: sinus, nl rate, nl axis, nl intervals, lae, q iii, avf; flat t's throughout limb leads and v4-v6, twi in v1-v3, no sig change since prior ekg pertinent results: admission labs: glucose-132* urea n-14 creat-0.9 sodium-139 potassium-3.6 chloride-104 total co2-22 anion gap-17 wbc-9.9 rbc-4.31 hgb-12.1 hct-36.6 mcv-85 mch-28.0 mchc-32.9 rdw-16.5* neuts-84.0* lymphs-11.9* monos-3.5 eos-0.2 basos-0.4 anisocyt-1+ microcyt-1+ plt count-179 pt-14.7* ptt-25.5 inr(pt)-1.5 cxr : cardiomegaly unchanged. the aorta is very tortuous and dilated as seen previously. there are postoperative changes in the left hemithorax with rib fractures/ressections, which is unchanged when compared to prior study. there is again noted a left retrocardiac opacity silhouetting the left hemidiaphragm, which is improved when compared to the prior study likely representing atelectasis or scarring. the right lung is grossly clear. the patient is status post tracheostomy. tracheostomy tube appears to be in appropriate position. in the left upper quadrant, there are metallic wires and surgical clips. there is mild s-shaped scoliosis of the thoracolumbar spine with some mild dextroconvex thoracic component and levoconvex lumbar component. no evidence of pneumothorax. there is mild upper zone redistribution of the pulmonary vascularity, which could represent mild chf. there are degenerative changes of the sternoclavicular joints bilaterally. hip unilat min 2 views left : unusual small lucency involving the medial cortex of the left proximal femur without clear fracture line identified. knee film : the alignment appears normal. there are some mild degenerative changes. no fracture is identified. echo : normal regional with low normal left ventricular systolic function. dilated ascending aorta. mild-moderate pulmonary artery systolic hypertension. compared with the prior study (tape reviewed) of , the ascending aorta is minimally more dilated. global left ventricular systolic function is similar. micro: sputum grew pseudomonas aeruginosa and escherichia coli, both pan-sensitive. vre and mrsa screens were negative here. has had a h/o of this in the past. discharge labs: 05:32am blood wbc-9.3 rbc-3.82* hgb-10.5* hct-33.2* mcv-87 mch-27.5 mchc-31.7 rdw-15.4 plt ct-260 05:52am blood pt-14.6* ptt-26.3 inr(pt)-1.4 05:32am blood glucose-84 urean-10 creat-0.8 na-137 k-4.0 cl-102 hco3-27 angap-12 07:00pm blood %hba1c-5.7 -done -done brief hospital course: 74 yo f s/p fall, found to have left subcapital hip fracture by ct, admitted to medical service for risk stratification prior to orif. she then had resp failure following orif requiring micu stay for diuresis and suctioning. she was transferred to the floor and has been recovering well. #) left hip fx. she was kept non weight bearing until left hemiarthroplasty on . she has multiple cardiac risk factors making her intermediate risk and could achieve at least 4 mets prior to recent surgery. she had a normal perfusion on a persantine mibi preop in at hosp. a pre-op echo was preformed on revealing normal regional wall motion with low normal left ventricular systolic function and mild-moderate pulmonary artery systolic hypertension. when compared with the prior study of , the ascending aorta is minimally more dilated with similar global left ventricular systolic function. she received aggressive pulmonary toilet (chest pt, incentive spirometry, encourage coughing) prior to surgery to maximize her lung function. her pain was well controlled with acetaminophen 1000mg q6h and oxycodone 5mg q4h prn prior to surgery. the cemented left unipolar hip hemiarthroplasty was done on without complications. she was transfused 2 units of blood for post-op anemia. she received lovenox sc bid for prophylaxis. she should remain on this until she has adequate activity. on discharge her wound was without evidence of infection and had some serous drainage. #) post-op hypoxemia - after the hip surgery, she was persistently and progressively hypoxemic and was requiring increasing suctioning. she was transferred to the micu on . her micu course was significant for low grade temps and increased sputum production. she was started on empiric zosyn and vanco for hospital-acquired pna. her o2 sats gradually improved and she made less secretions. in rehab, she will continue to need suctioning and incentive spirometry as well as to continue zosyn/vanc for a total of 7 days, ending on . her sputum culture grew pseudomonas (pansensitive), e.coli (pansensitive), and staph aureus (mrsa). . #) pain management: she hallucinations with the iv dilaudid given to her for her post-op pain. therefore, her post op pain was controlled with tylenol 1 gm q6 hrs and oxycodone 5 mg po prn. she also has chronic abdominal pain from her aaa surgery since . the pain service was consulted who recommended starting neurontin 600 mg qhs. this should be titrated as tolerated. neurontin is for chronic pain from thoracoabdominal aneurysm repair. at discharge, the neurontin was controlling her pain somewhat. . #) cad (no known cad though multiple cardiac risk factors including age, dm, htn). she had a normal stress test at prior to aneurysm repair. she was continued on asa 81mg qd, simvastatin 10mg daily, and metoprolol. . #) mild dystolic disfunction. she was on lasix qod prior to admission. this was not restarted at present, but if she continues to require large amounts of tm o2, then consider restarting. . #) afib: h/o postoperative atrial fibrillation requiring cardioversion in . she was in nsr and well rate controlled with amiodarone 400 daily and metoprolol. she will f/u with dr. as an outpatient about this. she will likely need coumadin once she is no longer on lovenox. . #) trach care: she takes guaifenesin prn, atrovent neb prn, and needs aggressive pulm toilet. scheduled outpt pulm f/u. she also needs ent f/u (?h/o laryngeal dysfunction) . #) type 2 diabetes: she was on avandia 4mg daily prior to the surgery. however, she has bot been requiring insulin here on a riss. she also has not been eating much. she may need to start the avandia again in the future as she eats more. #) gerd: she is on protonix 40 daily. #) insomnia: we continued her on outpatient dose of ativan 0.5mg qhs:prn #) depression: celexa 40mg qd. her mood was hopeful on discharge. medications on admission: -apap prn -protonix 40 daily -avandia 4mg daily -amiodarone 400 daily -aspirin 81 daily -simva 10 daily -bisoprolol 5mg daily -senna prn -colace qd -celexa 40mg qd -citracal 2 tabs -kcl 20 meq qd -gaifenesin prn -vicodin prn -lasix 20mg qod -ativan 0.5mg qhs:prn -atrovent neb prn discharge medications: 1. vancomycin in dextrose 1 g/200 ml piggyback sig: one (1) intravenous every twelve (12) hours for 7 days: last dose is on . 2. piperacillin-tazobactam 4.5 g recon soln sig: one (1) recon soln intravenous q8h (every 8 hours) for 7 days: last dose is . 3. amiodarone 200 mg tablet sig: two (2) tablet po daily (daily). 4. lorazepam 0.5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 5. ipratropium bromide 0.02 % solution sig: one (1) inhalation q8h (every 8 hours). 6. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed. 7. enoxaparin 40 mg/0.4ml syringe sig: one (1) subcutaneous daily (daily): continue this until that patient is ambulatory or at least one month. check weekly cr and adjust the dose if necessary. 8. simvastatin 10 mg tablet sig: 0.5 tablet po daily (daily). 9. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po tid (3 times a day): hold for sbp < 110, hr < 55 . 10. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 11. prochlorperazine 10 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for nausea. 12. albuterol sulfate 0.083 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 13. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours): max 4gm per day. 14. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain: give before washing or pt. 15. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily): hold for sbp < 110 . 16. citalopram 20 mg tablet sig: two (2) tablet po daily (daily). 17. insulin regular human 100 unit/ml solution sig: asdir injection asdir (as directed). 18. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 19. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 20. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 21. gabapentin 300 mg capsule sig: two (2) capsule po hs (at bedtime). 22. heparin flush picc (100 units/ml) 2 ml iv daily:prn 10 ml ns followed by 2 ml of 100 units/ml heparin (200 units heparin) each lumen daily and prn. inspect site every shift. 23. lasix 20 mg tablet sig: one (1) tablet po every other day: hold if npo. discharge disposition: extended care facility: - discharge diagnosis: primary diagnosis: left hip fracture hypoxic respiratory failure pneumonia secondary diagnoses: s/p thoracoabdominal aortic aneurysm repair diabetes hypertension tracheostomy discharge condition: good, o2 sat is 99% on 35% trach mask. all other vitals are normal. discharge instructions: please call your primary care physician or return to the hospital if you experience chest pain, shortness of breath, worsening pain, or have any other concerns. followup instructions: please follow-up with dr. (pcp), in weeks. please follow-up the clinic regarding your history of vocal cord paralysis. ( please follow-up in the clinic. ( in weeks. you have the following appointments scheduled: 1. provider: . /dr. (pulmonary) where: medical specialties phone: date/time: 3:45 2. you have an appointment with dr. (cardiologist) on at 11:00am at the office. call if you are unable to make this. 3. you have an appointment with dr. (orthopedics) on at 2:20pm on the of the center at . call if you are unable to make this. procedure: venous catheterization, not elsewhere classified partial hip replacement transfusion of packed cells diagnoses: esophageal reflux pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation acute on chronic diastolic heart failure personal history of malignant neoplasm of breast unspecified fall pulmonary collapse acute respiratory failure pneumonia due to pseudomonas osteoporosis, unspecified tracheostomy status other closed transcervical fracture of neck of femur 

Answer: The patient is high likely exposed to