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: metoprolol attending: chief complaint: respiratory distress major surgical or invasive procedure: bipap history of present illness: 79 yo f with afib on coumadin, 3+ mitral regurgitation, and recent icu admission for pneumonia, presenting with worsening shortness of breath during past 2 weeks. . in the ed, initial vital signs were t 97.3 bp 133/97 hr 110 rr 22 sat 80%/ra. she was initially put on a non-rebreather, with abg showing 7.32/57/92. labs were otherwise notable for wbc 14.3, inr 4.1, bnp . cxr showed bilateral pleural effusion, diffuse bilateral ground glass opacities, concerning for multifocal pneumonia. she was given cefepime 2 gm iv, vancomycin 1 gram iv, and levaquin 750 mg iv. she was put on bipap, with apparent improvement in her dyspnea. vitals on transfer to floor, hr 94 bp 116/80 rr 25 sat 97%/cpap. . on arrival to the floor, the patient denies any complaints other than shortness of breath. she said that her breathing was improved on bipap. review of systems was otherwise negative in detail. past medical history: atrial fibrillation on coumadin osteoporosis mitral valve prolapse with 3+ mr. moderate secondary pulmonary hypertension. s/p tah for leiomyoma . cyst on back removed in . s/p tonsillectomy. episode of shingles. breast fibroadenoma left, . social history: she is a retired professor of writing at , . she does not smoke. moderate alcohol consumption, no more than two glasses of wine. lives with her husband, recently both came back from where he was performing research. patient and husband developed cold after meeting someone in who was ill. 20 pack years smoking history. quit smoking 40 years ago. family history: father died of congestive heart failure in his 70's. mother died of congestive heart failure at age 88. she is married with three stepchildren and four grandchildren. physical exam: general: sleepy but arousable. tolerating bipap. answers yes/no questions appropriately. heent: anicteric sclerae. moist mucous membranes. neck: supple. jvd present. resp: diffusely rhonchorous. decreased breath sounds at bases. cv: rrr. normal s1, s2. difficult to appreicate presence or absense of murmur over breath sounds. abd: +bs. soft. nt/nd. ext: cool. 1+ bilateral lower extremity edema. neuro: history limited by bipap mask, but answers yes/no questions appopriately. perrl. moves all extremities. pertinent results: 10:30pm urine color-yellow appear-clear sp -1.019 10:30pm urine blood-neg nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.5 leuk-tr 10:30pm urine rbc-1 wbc-13* bacteria-few yeast-rare epi-0 10:30pm urine hyaline-1* 10:30pm urine mucous-rare 10:25pm type-art o2-100 o2 flow-15 po2-299* pco2-62* ph-7.28* total co2-30 base xs-1 aado2-368 req o2-64 intubated-not intuba comments-simple fac 10:25pm lactate-1.1 09:59pm lactate-2.4* k+-4.2 09:45pm glucose-116* urea n-39* creat-0.9 sodium-141 potassium-4.8 chloride-103 total co2-28 anion gap-15 09:45pm probnp-* 09:45pm calcium-8.8 phosphate-4.0 magnesium-2.3 09:45pm digoxin-1.2 09:45pm wbc-14.3* rbc-4.22 hgb-12.9 hct-40.7 mcv-96 mch-30.6 mchc-31.7 rdw-14.9 09:45pm neuts-88.8* lymphs-8.1* monos-2.3 eos-0.3 basos-0.6 09:45pm plt count-790* 09:45pm pt-40.1* ptt-31.5 inr(pt)-4.1* . cxr (portable ap) : bilateral pleural effusion, diffuse bilateral ground glass opacities, concerning for multifocal pneumonia . ekg: atrial fibrillation with ventricular rate 104. partial right bundle branch block. st-depression in i, v4-v6. twi in ii, iii, avf, v3. compared with prior study , st-depression in i and twi in ii, iii, avf is new. brief hospital course: 79 year old woman who presented with pulmonary edema from atrial fibrillation, acute diastolic heart failure, and prolapsed and regurgitant mitral valve. she initially presented with progressive shortness of breath with chest x-ray read as "multifocal pneumonia". she had leukocytosis, elevated lactate, and tachycardia in the setting of "suspected recurrent aspiration pneumonia". she tolerated bipap and did not require intubation. she was recently admitted to the icu with pneumonia; the micu staff treated her again with vancomycin, cefepime, levofloxacin for suspected aspiration pneumonia. however, i believe she had pulmonary edema and she appeared fluid overloaded with jugular venous distension and peripheral edema with very suggestive cxr of edema. her atrial fibrillation was rate controlled with increased doses of diltiazem ( 90 mg q 6 hours then 360 of cardiazem cd; she could not swallow the latter and therefore she was discharged on the short acting). her coumadin was held for supra therapeutic inr and the rate was controlled with digoxin and diltiazem. she was then treated with coumadin and heparin bridge as well as iv lasix and her antibiotics were stopped. she was found to have severe esophageal narrowings by egd (upper narrowing and ge narrowing with dilated esophagus between) that made tee difficult. micu team ordered tsh/crp/rf/b12/folate/cortisol and were all normal. they also ordered ruq ultrasound. she tolerated thin liquids and regular consistency solids without any overt or soft signs of aspiration. she denied any pneumonia prior to these recent 2 episodes. she did not have symptoms consistant possible reflux and aspiration and she was be advanced to thin liquids and regular consistency solids. she did not undergo tee with cardioversion because of the severe esophageal narrowing. dr. strongly cautioned against doing a tee. under anesthesia, he could not pass a standard 8 mm scope. he had to use an ultra-thin 4.5 mm scope, leave a wire, dilate up with dilators to 12 mm. only then, he could pass his scope over a wire-guide to do the injections (at the gej, 100 units of botox was injected successfully in four quadrants into the les). the upper narrowing was most likely from an osteophyte and the lower from achalasia (!?). she was asked to keep head of bed elevated at 45 degrees at all times to minimize risk of gastroesophageal reflux and aspiration and to avoid eating for 3 hours prior to sleep. in any case she did well and was discharged home after she received adequate diuresis, good rate control, and several days of antibiotics. she will need her valve fixed soon. discharge medications: 1. digoxin 125 mcg tablet : one (1) tablet po daily (daily). 2. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). disp:*30 tablet,rapid dissolve, dr(s)* refills:*2* 3. warfarin 2 mg tablet : two (2) tablet po once daily at 4 pm. disp:*60 tablet(s)* refills:*2* 4. furosemide 20 mg tablet : one (1) tablet po daily (daily). disp:*20 tablet(s)* refills:*2* 5. outpatient physical therapy 3 time a week 6. diltiazem hcl 90 mg tablet : one (1) tablet po four times a day. disp:*120 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: pulmonary edema atrial fibrillation acute diastolic heart failure prolapsed and regurgitant mitral valve cardioversion esophageal narrowings that was treated with botox injections. discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted because of pulmonary edema (water in the lungs) from atrial fibrillation (fast and abnormal heart rhythem), diastolic heart failure (weak heart), and prolapsed (floppy) and regurgitant (leaky) mitral valve. you did not have tee (echo from the mouth) with cardioversion. we also found esophageal narrowings that was treated with botox injections. keep head of bed elevated at 45 degrees at all times to minimize risk of gastroesophageal reflux and aspiration avoid eating for 3 hours prior to sleep. we adjusted several medications. followup instructions: department: cardiac services when: monday at 11:00 am with: building: sc clinical ctr campus: east best parking: garage department: cardiac services when: wednesday at 9:20 am with: , md building: campus: east best parking: garage department: medical specialties when: wednesday at 2:30 pm with: dr. building: sc clinical ctr campus: east best parking: garage procedure: other endoscopy of small intestine non-invasive mechanical ventilation injection or infusion of other therapeutic or prophylactic substance endoscopic excision or destruction of lesion or tissue of esophagus diagnoses: mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation other chronic pulmonary heart diseases pneumonitis due to inhalation of food or vomitus osteoporosis, unspecified long-term (current) use of anticoagulants acute diastolic heart failure stricture and stenosis of esophagus acquired absence of both cervix and uterus achalasia and cardiospasm essential thrombocythemia 

Answer: The patient is high likely exposed to