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: motrin / latex attending: chief complaint: altered mental status, respiratory distress major surgical or invasive procedure: intubation extubation tracheostomy placement history of present illness: 62 yo f pmh of afib, tia, memory loss s/p hypoglycemic coma, chronic low back pain, anemia, gerd, asthma recently admitted with subarachnoid/intraparenchymal hemorrhage and readmitted to micu with acute change in mental status being readmitted with acute hypercarbic respiratory failure. . she was just discharged yesterday from micu course for altered mental status and hypercarbia. her altered mental status was likely multifactorial to include medications (diazepam, percocet) and hypercarbia osa and sleep hypoventilation. she returned to baseline on discharge. her hypercarbia was thought related to her copd and likely newly diagnosed sleep disordered breathing. she underwent a sleep study and was discharged on bipap to follow up in sleep clinic for a complete sleep study. . she was found somnolent this morning, was not placed on bipap last night. sent to for co2 115. at placed on bipap with excellent response and transferred to . on the ems she was taken off bipap and placed on high flow oxygen. by arrival she was altered with saturations in 70s. she was trialed on cpap with no success and bagged to try and take off co2 with no success and subsequently intubated and admitted to micu. cth negative. past medical history: left temporal intraparenchymal hemorrhage copd- no prior h/o tobacco use, + secondhand exposure afib- was on coumadin for last few years tia- had prior episodes of flashes of light going across her visual field, was placed on plavix. dementia- secondary to diabetic coma chronic low back pain anemia gerd social history: lives with husband until recent admission, used to work as the press secretary to a state senator in the state house. no /etoh or illicits. family history: nc physical exam: general appearance: overweight / obese eyes / conjunctiva: perrl head, ears, nose, throat: endotracheal tube, ng tube lymphatic: cervical wnl cardiovascular: (s1: normal), (s2: normal), distant heart sounds peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: present), (left dp pulse: present) respiratory / chest: (expansion: symmetric), (breath sounds: diminished: b/l) abdominal: soft, non-tender, obese extremities: right: absent, left: absent skin: warm neurologic: attentive, follows simple commands, pertinent results: : cta chest: impression: 1. probable pulmonary hypertension. no emboli in the main, right, left, or lobar pulmonary arteries, peripheral circulation is not evaluated by this study. 2. right lower lobe collapse and heterogeneous opacification in the right upper lobe and lingula, more likely aspiration than pneumonia at this stage, are sufficient to explain hypoxia. 3. tracheomalacia. upper tracheal mass or organized secretions or aspirated material. bronchoscopy recommended. 4. probably pulmonary arterial hypertension. . : echo: the left atrium is mildly dilated. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. there is a minimally increased gradient consistent with minimal aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. . head ct impression: 1. expected evolution of left medial temporal parenchymal hemorrhage without evidence of new hemorrhage or intraventricular hemorrhage. 2. air within the mandibular veins as well as the vertebral veins is likely related to recent phlebotomy although clinical correlation is advised. 3. air-fluid levels within the sphenoid sinuses may represent sinusitis in the right clinical context. labs on discharge: wbc-5.4 rbc-2.78* hgb-8.1* hct-25.3* mcv-91 mch-29.2 mchc-32.0 rdw-15.0 plt ct-286 glucose-181* urean-9 creat-0.5 na-142 k-4.1 cl-99 hco3-39* probnp-1874* calcium-8.5 phos-1.7* mg-1.7 brief hospital course: 62 yo f pmh of afib, tia, memory loss s/p hypoglycemic coma, chronic low back pain, anemia, gerd, asthma recently admitted with subarachnoid hemorrhage readmitted with acute change in mental status acute on chronic hypercarbic respiratory failure . # acute on chronic hypercarbic respiratory failure: patient was felt to have a multifactorial etiologies for her respirtory failure including central and obstructive apnea, a chronic paralyzed r hemidiaphragm, and obesity hypoventilation which all contibuted to her difficulty with respiration. she underwent tracheostomy and had significant improvement in oxygenation and acid base status. she remained mostly on ac vent settings with daily pressure support trials which were sometimes limited by hypercarbia. in addition, during pressure support trials she occasionally desat in setting of decreasing tv to 280's. in addition, she would benefit from diamox prn to aid with alkalosis while on vent. she was also noted to be volume overloaded with a length of stay net +7l. her cxr was suggestive of pulmonary edema, and lasix gtt was started on with goal for 1-2l fluid removal. after discharge, her lasix gtt should be adjusted to pulmonary exam. . # tracheal tear: on , pt underwent a cta to rule out pe given tachycardia and hypoxia. ct revealed and abnl trachea. the next day, patient was taken to or for fiberoptic intubation and rigid bronch which showed a 5cm tracheal tear. ip was involved and recommended prolonged intubation to allow tear to heal as well as ppx abx with unasyn and fluconazole (both started on ) for total 10 day course (last day ). after further discussion with family and ip, it was felt that the most cautious management for be for tracheostomy to bypass the area of the tear given that she is at very high risk for repeated intubation and the risk of causing perforation of the tear would be greater in setting of re-intubation. she tolerated the tracheostomy. she will need follow-up with dr. in weeks. trach can not be changed until after . sutures can be removed after . . # ? mass in l hilum: pt reportedly has a mass on osh chest ct in l hilum at location of bleed which was noticed by ip during bronchoscopy. this will need to be assessed with contrast ct as an outpatient. please arrange with her pcp to have this follow-up. . # recent left temporal hemorrhage: unclear etiology, less likely due to trauma, more likely htn and anticoagulation. no evidence of rebleeding or new bleed on head ct. she will need follow-up with neurosurgery (dr. , ) within one month post-discharge. at that time, he will re-evaluate restarting coumadin and aspirin. she was maintained on keppra for seizure ppx in setting of bleed. . # paroxysmal atrial fibrillation: hr remained mostly well controlled int he 60's. coumadin and aspirin were held given recent hemorrhage. she will need to discuss restarting anticoagulation with neurosurgeon. . # htn: her bp was variable. her regimen was adjusted to include enalapril 30 mg daily and hydralazine 25 mg po qid. her metoprolol was intermittently held given bradycardia, but it was felt that she does need nodal blockade for her paroxsysmal afib. . # altered mental status: improved steadily over hospital course, but pt still frequently confused. per her husband, this is near her baseline following anoxic brain injury and hypoglycemia in the past. head ct unchanged, chest cta w/o pe, no evidence of mi, tte w/ nl ef, ua unremarkable. . # hypernatremia: she was found to be intermittently hypernatremia and her free water flushes were adjusted accordingly. #type ii dm: normally taking po agents at home, but switched to insulin while npo -glargine/hiss medications on admission: 1. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler : 2-4 puffs inhalation q4h (every 4 hours) as needed. 2. fluticasone 110 mcg/actuation aerosol : two (2) puff inhalation (2 times a day). 3. heparin (porcine) 5,000 unit/ml solution : one (1) injection injection tid (3 times a day). 4. miconazole nitrate 2 % powder : one (1) appl topical qid (4 times a day) as needed. 5. omeprazole 20 mg capsule, delayed release(e.c.) : one (1) capsule, delayed release(e.c.) po daily (daily). 6. simvastatin 40 mg tablet : two (2) tablet po daily (daily). 7. levetiracetam 500 mg tablet : one (1) tablet po bid (2 times a day). 8. acebutolol 200 mg capsule : one (1) capsule po bid (2 times a day). 9. rosiglitazone 2 mg tablet : two (2) tablet po daily (daily). 10. glipizide 5 mg tablet : 0.5 tablet po bid (2 times a day). 11. acetaminophen 325 mg tablet : 1-2 tablets po q6h (every 6 hours) as needed. 12. olanzapine 5 mg tablet, rapid dissolve : one (1) tablet, rapid dissolve po (once a day (at bedtime)) as needed for agitation. 13. brimonidine 0.15 % drops : one (1) drop ophthalmic q8h (every 8 hours): both eyes. 14. latanoprost 0.005 % drops : one (1) drop ophthalmic hs (at bedtime): both eyes. 15. humalog/regular insulin sliding scale per protocol qachs 16. januvia 100 mg tablet : one (1) tablet po once a day. discharge medications: 1. chlorhexidine gluconate 0.12 % mouthwash : one (1) ml mucous membrane (2 times a day). 2. heparin (porcine) 5,000 unit/ml solution : one (1) injection tid (3 times a day). 3. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler : two (2) puff inhalation q6h (every 6 hours) as needed. 4. simvastatin 40 mg tablet : one (1) tablet po daily (daily). 5. acetaminophen 325 mg tablet : one (1) tablet po q6h (every 6 hours) as needed. 6. brimonidine 0.15 % drops : one (1) drop ophthalmic q8h (every 8 hours). 7. latanoprost 0.005 % drops : one (1) drop ophthalmic hs (at bedtime). 8. miconazole nitrate 2 % powder : one (1) appl topical tid (3 times a day) as needed. 9. dextromethorphan-guaifenesin 10-100 mg/5 ml syrup : five (5) ml po q6h (every 6 hours) as needed. 10. docusate sodium 50 mg/5 ml liquid : one (1) po bid (2 times a day). 11. metoprolol tartrate 25 mg tablet : one (1) tablet po bid (2 times a day): hold for sbp<60. 12. levetiracetam 500 mg tablet : one (1) tablet po bid (2 times a day). 13. senna 8.6 mg tablet : one (1) tablet po daily (daily). 14. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 15. polyvinyl alcohol-povidone 1.4-0.6 % dropperette : drops ophthalmic tid (3 times a day). 16. fluconazole 100 mg tablet : two (2) tablet po q24h (every 24 hours). 17. ampicillin-sulbactam 1.5 gram recon soln : one (1) recon soln injection q6h (every 6 hours). 18. ondansetron hcl (pf) 4 mg/2 ml solution : one (1) injection q8h (every 8 hours) as needed for nausea. 19. insulin glargine 100 unit/ml solution : ten (10) units subcutaneous at bedtime. 20. furosemide 10 mg/ml solution : as needed injection infusion (continuous infusion): titrate lasix dose as needed. 21. hydralazine 25 mg tablet : one (1) tablet po q6h (every 6 hours). 22. enalapril maleate 10 mg tablet : three (3) tablet po daily (daily). discharge disposition: extended care facility: discharge diagnosis: primary: hypercarbic respiratory failure tracheal tear secondary: intracranial hemorrhage hypertension morbid obesity discharge condition: stable, oxygenating well on ventilator discharge instructions: you were found to have altered mental status and found to have acute hypercarbic respiratory failure. this is most likely due to sleep apnea as well as diaphragm paralysis. you were also found to have a tracheal tear which was allowed to heal. you were treated for the respiratory failure as well as the tear by having a tracheostomy tube placed. followup instructions: please make an appointment to follow-up with dr. in weeks. please make an appointment to follow-up with dr. in neurosurgery within one month to follow-up regarding your head bleed. please make an appointment to follow-up with your pcp, , . procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube insertion of endotracheal tube temporary tracheostomy diagnoses: anemia, unspecified esophageal reflux diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation accidental puncture or laceration during a procedure, not elsewhere classified acute and chronic respiratory failure unspecified sleep apnea accidental cut, puncture, perforation or hemorrhage during other specified medical care chronic obstructive asthma with (acute) exacerbation hyperosmolality and/or hypernatremia disorders of diaphragm 

Answer: The patient is high likely exposed to