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: ativan / amoxicillin / bactrim / codeine / ibuprofen / lamictal / naproxen / tetanus toxoid,fluid / cephalexin / peanuts attending: chief complaint: tracheal stenosis major surgical or invasive procedure: rigid bronchoscopy history of present illness: history of present illness: ms. is a 53yo f with a history of respiratory distress s/p trach c/b tracheal stenosis, ckd on pd and htn who was transferred from to for tracheal stenosis and need for ip procedure. . she was originally admitted to on following a hyponatremic seziure felt to be precipitated by a golytely prep for colonoscopy; the patient was intubated for respiratory failure and managed in the intensive care unit. the patient received a tracehostomy during her long hospital course and underwent a diagnostic bronchoscopy on for lll pna and collapse. she was sent to where she was eventually weaned from the ventilator. she underwent repeat bronchoscopy by dr. for inspiratory stridor and respiratory distress in addition to difficulty passing a catheter through her trach site. the procedure was complicated by an inability to pass the bronchoscopy entirely through the tracheostomy. the 8.0 trach was replaced with a 7.0. there also appeared to be cartilage fracture with tracheal stenosis. the patient represented to on for bleeding from the trach site, hemoptisis and sob. she did not appear to have any new infectious processes at this admission, however, attempt to pass the bronchoscope through the vocal cords was not successful. she was transferred to on for bronchoscopy and tracheotomy replacement by interventional pulmonology. past medical history: prolongued respiratory failure secondary to hyponatremic seizure status post trach complicated by tracheal stenosis ckd lithium toxicity on peritoneal dialysis bipolar diorder htn previous breast ca s/p lumpectomy s/p parathyroidectomy with reimplantation in left arm diverticulosis social history: - tobacco: never - alcohol: previously occasionally - illicits: denies family history: mother with ovarian ca father with cad physical exam: on admission: vs: t: 37 ??????c (98.6 ??????f) hr: 100 bpm bp: 172/105(122) rr: 15 spo2: 100% general: alert, oriented, no acute distress heent: sclera anicteric but mildy injected, mmm, oropharynx clear neck: supple, no lad, trach in place, c/d/i lungs: upper airway ronchi but otherwise cta cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly. pd catheter site c/d/i gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema on discharge: vs: t 98.3 bp 104/56 p 72 rr 18 o2 97-100% on 35%o2 per tm general: aaox3, no acute distress heent: sclerae anicteric, mmm, op clear neck: supple, no lad, trach in place, c/d/i lungs: upper airway ronchi but otherwise cta cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly. pd catheter site c/d/i gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: on admission: wbc-4.2 rbc-2.83* hgb-9.1* hct-27.7* plt ct-149* neuts-67.7 lymphs-18.1 monos-4.8 eos-9.1* baso-0.4 pt-12.7 ptt-40.7* inr(pt)-1.1 glucose-85 urean-48* creat-11.3*# na-131* k-5.8* cl-94* hco3-26 angap-17 calcium-9.4 phos-7.5* mg-2.0 lithium-0.9 ct trachea/chest impression: tracheomalacia and subglottic tracheal stenosis. both lungs are clear. no consolidation or atelectasis. enlarged left lobe of the thyroid with small ill-defined focal hypodensity measuring 5 x 3 mm. a thyoid ultrasound may be suggested for further evaluation. ascites. morgagni hernia and moderated sized sliding hiatus hernia. chronic renal changes with generalized increased bone density s/o renal osteodystrophy. right upper extremity doppler ultrasound findings: real-time grayscale and color doppler evaluation of the right internal jugular, subclavian, axillary, brachial, basilic, and cephalic veins was performed. normal compressibility, wall-to-wall color flow, and augmentation were seen in the right internal jugular, axillary, brachial, basilic, and cephalic veins. normal color flow within the right subclavian vein, symmetric to the left. picc line was identified in the basilic and axillary veins although not seen in the mid subclavian or internal jugular vein. impression: no evidence of right upper extremity deep venous thrombosis. brief hospital course: 53yo f with a history of respiratory distress status post tracheotomy complicated by tracheal stenosis, chronic kidney disease on peritoneal dialysis, and hypertension who was admitted to on for bleeding from the trach site, hemoptysis, and sob, who was transferred to for tracheal stenosis and need for tracheotomy replacement and brochoscopy by interventional pulmonology. . # tracheal stenosis: the patient has a history of tracheal stenosis due to a fractured tracheal ring and prolonged intubation. she presented to with hemoptysis which resolved at presentation from the osh for tracheal stenosis assessment. on admission, her oxygen saturations were normal with 35% oxygen by trach mask. a ct scan of the chest which showed tracheamalacia. on hospital day 2 she had a bronchoscopy which revealed severe supraglottic edema. her portex/ tts #7.0 was changed to a portex cuffed #6.0, and she tolerated the procedure well. on the medicine floors, she had no respiratory complaints and continued to have good oxygen saturation. . # esrd on peritoneal dialysis: at , the patient received alternating doses of 2.5% and 4.25% dextrose dialysate q6h. renal was consulted and she received pd while in the micu. she continued to receive pd on the medical floors with 2.5% dialysate. on the pd catheter fell out of its connector (but did not fall out of the patient's abdomen). the patient received vancomycin and ciprofloxacin x 1 as peritonitis prophylaxis, was monitored for signs and symptoms of peritonitis, and underwent ascitic fluid analysis x 2. she did not develop peritonitis. the pd catheter was replaced without complication. the patient also developed hyponatremia ot 126. nephrology recommended workup for pseudohyponatremia (posm,uosm,lipid panel, serum protein), which is still pending. patient was on fluid restriction (<1000ml/day) in hospital for hyponatremia, and nephrology recommends continuing this in rehab. sevelamer was initiated to control serum phosphate. additionally, the patient was started on nephrocaps. . # htn: her bp was elevated on admission and was transiently high to a maximum systolic pressure of 178 before stabilizing below 150. she continued to receive amlodipine and metoprolol. . # bipolar disorder: the patient's mood was stable during admission. she was continued on lithium and olanzapine. . # restless leg syndrome: well controlled with olanzapine during this hospitalization. . # anemia: the patient is anemic at baseline. iron studies were sent, which were consistent with anemia of chronic admission and did not suggest iron deficiency anemia. accordingly, ferrous sulfate was discontinued. . # thyroid nodule: a nodule was detected on ct scan. the patient will follow up with her primary care physician for further workup of this problem. . # dispo: rehab at # labs pending at discharge: posm, uosm, lipid panel, serum protein medications on admission: metoprolol tartrate 12.5 mg po bid gentamicin 0.1% cream 1 appl tp daily to pd catheter site lithium carbonate 150 mg po daily olanzapine 10 mg po bid amlodipine 5 mg po fluoxetine 20 mg po ferrous sulfate 325 mg po docusate sodium 100 mg po bid topiramate 25 mg po hs senna 1 tab po bid omeprazole 20 mg po bid discharge medications: 1. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed for indigestion. 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 3. topiramate 25 mg tablet sig: one (1) tablet po hs (at bedtime). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. fluoxetine 20 mg capsule sig: one (1) capsule po daily (daily). 6. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 7. lithium carbonate 150 mg capsule sig: one (1) capsule po daily (daily). 8. gentamicin 0.1 % cream sig: one (1) appl topical daily (daily). 9. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 10. olanzapine 10 mg tablet sig: one (1) tablet po bid (2 times a day). 11. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 12. ranitidine hcl 150 mg tablet sig: one (1) tablet po hs (at bedtime). 13. sevelamer carbonate 800 mg tablet sig: one (1) tablet po tid w/meals (3 times a day with meals). 14. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours) as needed for wheezing. neb 15. nephrocaps 1 mg capsule sig: one (1) capsule po once a day. 16. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime). discharge disposition: extended care facility: - discharge diagnosis: primary: tracheal stenosis hyponatremia secondary: esrd hypertension bipolar disorder restless leg syndrome discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to for bronchoscopy and replacement of your tracheotomy tube by interventional pulmonology. during the procedure you were found to have laryngeal edema (swollen throat) consistent with acid reflux (heartburn). you were also found to have narrowing of your trachea (airway) which can be caused by having a tracheostomy tube and acid reflux. we recommend for you to keep the head of your bed elevated greater than 30 degrees, take antacid medications and follow up with interventional pulmonology for bronchoscope in weeks to reassess your airway (). no stent was placed in your airway. medication changes: start: pantoprazole 40 mg by mouth twice daily ranitidine 150 mg by mouth every evening sevelamer carbonate 800 mg by mouth three times daily with meals nephrocaps 1 capsule by mouth daily stop: ferrous sulfate otherwise, continue your home medications. otherwise, please resume all of your other home medications. followup instructions: please see pulmonology for rigid bronchoscopy in wk to reassess (call to schedule). once you have completed your stay at rehab, please see your primary care physician, . (), regarding a thyroid nodule detected on your ct scan and regarding your chronic anemia. procedure: peritoneal dialysis bronchoscopy through artificial stoma replacement of tracheostomy tube diagnoses: anemia of other chronic disease end stage renal disease renal dialysis status esophageal reflux hyposmolality and/or hyponatremia personal history of malignant neoplasm of breast diaphragmatic hernia without mention of obstruction or gangrene other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure hemorrhage of gastrointestinal tract, unspecified bipolar disorder, unspecified diverticulosis of colon (without mention of hemorrhage) other psychotropic agents causing adverse effects in therapeutic use tracheostomy status other diseases of trachea and bronchus restless legs syndrome (rls) other tracheostomy complications nontoxic uninodular goiter 

Answer: The patient is high likely exposed to