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: roxicet attending: chief complaint: respiratory distress major surgical or invasive procedure: j-tube replacement x 2. 2 blood transfusions history of present illness: 40yo female with a history of esophageal cancer s/p trach was admitted from the ed with respiratory distress. . she has a tracheostomy in place due to esophageal cancer. according to her family, she was exerting herself when she was "air hungry." ems presented and took the tracheostomy out and noted a small plug in the tracheostomy itself. upon arrival to the ed, 97.9, hr 119, 111/82, rr 19, and pulse ox 99% on 12l trach mask. her exam was notable for tachycardia only. her labs were notable for elevated wbc to 12.9, and her imaging was notable for cxr with left-sided pneumonia. she received levofloxacin 750mg iv x 1, vancomycin 1g iv x 1, zosyn 4.5g iv x 1, potassium chloride 40meq x 1, and morphine 4mg iv x 1. she was evaluated by thoracics who replaced her tracheostomy and they recommended further evaluation for her pneumonia. past medical history: - metastatic esophageal cancer ---> egd - that was successful on the third attempt and tissue biopsy at that time revealed an invasive squamous cell carcinoma. ---> - started on cetuximab with concurrent radiation. she completed her radiation therapy on for a total of 6600 gy. she also completed her erbitux therapy at that time. ---> she was admitted with nausea and vomiting and found to have evidence of tracheal obstruction. in addition, she had a ct of her neck, which was concerning for perforation. thoracics was consulted and felt that she would benefit from a tracheostomy for airway protection, which was placed on . she tolerated this well. she was noted to have a left upper lobe cavitary lesion on the ct scan. she underwent a wedge resection on , which revealed carcinomatous plaques on the pleural wall. this was confirmed to be a metastatic disease on frozen section. in terms of her tracheostomy, she was decannulated on . during the hospitalization she was treated for pharyngeal abscess and had issues with tachycardia as well as hypotension. she was discharged home on . ---> - began a palliative chemotherapy regimen of 5-fu and carboplatin on . - anemia. - j tube placed by surgery via an open procedure in - constipation - hypercalcemia - tachycardia of unknown etiology - tracheostomy ----> - tracheostomy placed due to supraglottic edema in the setting of esophageal perforation ----> - tracheostomy placed due to vocal cord paralysis and stridor social history: home: originally from and portuguese-creole speaking only lives at home with her cousin and husband who care for her. etoh: none tobacco: none drugs: none family history: maternal aunt - breast cancer. her mother and father are alive and healthy and siblings are all alive and healthy. physical exam: gen: no acute distress, resting comfortably in bed, fatigued but interacting appropriately heent: clear op, mmm neck: supple, no lad, no jvd, trach in place without erythema, tenderness, or discharge cv: rr, tachycardic, nl s1, s2. no murmurs, rubs or gallops lungs: decreased breath sounds at the left lower base abd: soft, nt, nd. nl bs. no hsm. g tube in place without erythema, drainage. ext: no edema. 2+ dp pulses bl skin: no lesions neuro: a&ox3. appropriate. cn 2-12 grossly intact. preserved sensation throughout. 5/5 strength throughout. normal coordination. gait assessment deferred psych: listens and responds to questions appropriately, pleasant pertinent results: admission labs 08:10pm blood wbc-12.9* rbc-3.98* hgb-11.9* hct-35.5* mcv-89 mch-29.9 mchc-33.6 rdw-16.0* plt ct-514* 08:10pm blood neuts-88.8* lymphs-7.1* monos-2.9 eos-1.0 baso-0.2 08:10pm blood pt-13.6* ptt-21.5* inr(pt)-1.2* 08:10pm blood glucose-158* urean-19 creat-0.7 na-135 k-3.1* cl-96 hco3-31 angap-11 08:10pm blood ck(cpk)-35 08:10pm blood ck-mb-notdone ctropnt-<0.01 08:16pm blood k-3.1* 08:33pm blood lactate-2.0 sputum gram stain-final; respiratory culture-final urine legionella urinary antigen -final mrsa screen mrsa screen-final blood culture blood culture, routine-final blood culture blood culture, routine-final cxr: 1. left lower lobe pneumonia with subjacent effusion. 2. no definite tracheostomy tube is seen. recommend clinical correlation. cxr: interval placement of a tracheostomy tube. left basilar effusion, pneumonia, unchanged. ct c/a/p w contrast: 1. interval increase in size of left pleural effusion and associated atelectasis. 2. increase in size and number of cavitary masses in the lungs bilaterally, consistent with progression of metastatic disease. 3. distended gallbladder without evidence of acute cholecystitis. 4. 2-mm non-obstructing left renal calculus. j-tube change: impression: uncomplicated replacement of jejunostomy tube via existing tract. the jejunostomy tube is ready to use. lue us: impression: no evidence of left upper extremity dvt. technically limited comparison of the right subclavian which showed normal color flow although venous waveform was not demonstrated. cta: impression: 1. near complete venous obliteration at the level of the junction of the left subclavian vein/left brachiocephalic vein, by invasion of adjacent pleural mass. please note that the arterial structures including the left subclavian artery are patent. 2. interval worsening of left lung consolidation. left lower lobe bronchi is filled with secretion. 3. edema of subcutaneous tissues of left chest. 4. no significant interval change in the thickness of circumferential pleural mass with loculated pleural effusion. 5. no significant change in the focal consolidations and cavitary lesions in the right lung. 6. multiple osteolytic lesions in the left side ribs from local invasion. : j-tube change: uncomplicated j-tube exchange. : j-tube check: impression: jejunostomy tube terminates within the bowel with no extravasation noted. brief hospital course: 40f ( portuguese speaking only) with metastatic esophageal cancer c/b respiratory failure requiring trach admitted initially with respiratory distress due to mucous plugging as well as hypercalcemia. her course was complicated by progressive lung mets on the left resulting in subclavian/brachiocephalic venous obstrution causing left facial edema. she was made dnr. she receeved treatment for hap with persistent hypercalcemia and worsening facial edema due to compression of vessels by her tumor. she worsened clinically and goals of care ultimately were focused on her comfort. she passed away with her family at her bedside after several days of progressive cognitive and respiratory decline. . #. esophageal cancer: per her primary oncologist, dr. , she would not benefit from further chemo. hospice care as an inpatient with abx, feedings, and steroids as appropriate. palliative care consulted actively in her care. patient made dnr/dni after discussion held on between dr. from palliative care and the patient's husband. pt pulled out jtube . a 14fr foley was placed in the jtube tract as a bridge to repeat jtube placement at ir. jtube replaced at ir. . # enteric - vesicular fistula: after jtube replacement on pt developed bilious output from her vagina. concern for entero-vaginal fistula so injected methylene blue into the jtube at 0945am on . seems to be having blue urine consisent enteric-vesicular fistula. jtube feeds were held thereafter. . # pleural mass/left-sided swelling: cta of her chest on showed near obliteration at the left subclavian vein and left brachiocephalic vein by a pleural mass. per rad-onc consult the patient has had radiation in the area which would need to be irradiated earlier in her disease and the risks of radiating her again would outweigh the questionable benefit it could given her. symptomatic treatment with pain control. steroids as needed to decrease inflammation. this treatment had to be used judiciously as she became agitated with steroids and suffered a fall. . # respiratory distress: occasionally has respiratory distress secondary to mucous plugging which improves with suctioning. she had completed a 7 day course of vanc/zosyn on . chest cta on showed interval worsening of left lung consolidation. continued on humidified air via trach mask, suctioning per nursing to decrease mucous plugging. atrovent nebs q6h with xopenex nebs prn. steroids as above. . # chronic pain: the patient suffered chronic pain under her left arm near a previous scar which continued to cause her pain. also had local invasion of her left ribs which contributed to her pain. received standing tylenol 1000 mg po tid, and a lidocaine patch, morphine 4-8 mg iv for breakthrough pain, methadone 6 mg iv q8h. palliative care guided her pain management. . #. hypercalcemia: received palmidronate in the beggining of . as her calcium remained elevated despite hydration, she was given zolendrenic acid on . calcium had decreased to the normal range since getting zolendrenic acid, but then rose again. pthrp returned negative and imaging showed multiple osteolytic lesions in the left ribs from local invasion. given this, bony mets are likely the cause of her hypercalcemia. she received another dose of pamidronate 90 mg iv on . her calcium was refractory to intervention. medications on admission: 1. oxygen - 35% continuous via tracheal mask with cool mist via compressor. 2. methadone 10 mg po qhs / 5mg po qam 3. lorazepam 0.5 - 1mg po bid 4. lactulose 20gm po bid 5. lansoprazole 30mg po daily 6. nortriptyline 10mg po qhs prn insomnia 7. compazine 25mg pr q6h prn nausea 8. acetaminophen prn pain 9. lidocaine patch q12h on and off 10. guaifenesin prn 11. morphine 10mg po q4h prn pain discharge medications: none discharge disposition: expired discharge diagnosis: primary: hypoxia secondary mucous plugging in tracheostomy hypercalcemia of malignancy metastatic esophageal cancer compression multiple blood vessels causing left upper extremity and left facial swelling chronic anemia chronic pain anxiety pneumonia discharge condition: death discharge instructions: death followup instructions: none procedure: replacement of tracheostomy tube replacement of gastrostomy tube diagnoses: anemia, unspecified secondary malignant neoplasm of pleura hypopotassemia anxiety state, unspecified other specified cardiac dysrhythmias other constipation accidents occurring in other specified places secondary malignant neoplasm of lung mechanical complication of colostomy and enterostomy malignant neoplasm of other specified part of esophagus hypercalcemia neoplasm related pain (acute) (chronic) mechanical complication of tracheostomy bacterial pneumonia, unspecified surgical operation with formation of external stoma causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation 

Answer: The patient is high likely exposed to