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: trovafloxacin / albuterol attending: chief complaint: transfer from osh with fever/shortness of breath/left sided effusion major surgical or invasive procedure: chest tube placement history of present illness: s/p cabg transferred to rehab after prolonged hospital stay on . transferred from rehab to on . transferred back to on past medical history: cad with ostial lcx 90% lesion per cath on with successful bms htn hyperlipidemia cva 4 yrs ago with r scotoma esophageal ulcer. + gerd + asthma/emphysema, home o2 not required osteoporosis r carpal tunnel surgery cardiac risk factors: - diabetes, + dyslipidemia, + hypertension social history: patient lives with husband in . quit smoking 11 yrs ago, smoked 1ppd since age 14. social etoh, no recreational drugs family history: family history is significant for mother who died from alcoholism at age 50. father died at age 62 of unknown cause. no early death. physical exam: admission vs t 99.7 hr 80 sr bp 98/63 rr 21 o2sat 96%(assist control) gen nad neuro alert, generalized weakness. non focal exam pulm coarse throughout, no wheezes cv rrr no m/r/g. sternal wound healing w/exception of distal wound which had vac in place abdm soft, nt/+bs ext warm, 2= edema bilat. doppler pulse pertinent results: radiology final report chest (portable ap) 10:48 am chest (portable ap) reason: eval effusion, ? pneumothorax- please do this study at 11 am medical condition: 74 year old woman s/p removal of left sided chest tube today reason for this examination: eval effusion, ? pneumothorax- please do this study at 11 am indication: 74-year-old female status post removal of left-sided chest tube. comparison: . frontal chest radiograph: a tracheostomy tube is in unchanged position. there has been interval removal of the left-sided chest tube. there is no recurrent or residual pneumothorax. the remainder of the examination is little changed with no significant improvement in the degree of moderate pulmonary edema, bibasilar atelectasis and small pleural effusions. impression: 1. no pneumothorax. 2. moderate pulmonary edema and small bilateral pleural effusions. the study and the report were reviewed by the staff radiologist. dr. dr. approved: mon 6:42 pm ct chest w/o contrast 10:09 am ct chest w/o contrast reason: re-evaluate left pleural effusion medical condition: 74 year old woman with reason for this examination: re-evaluate left pleural effusion contraindications for iv contrast: none. history: 74-year-old female for re-evaluation of left pleural effusion. comparison: . technique: mdct-acquired axial imaging of the chest without intravenous contrast. multiplanar reformatted images were obtained and reviewed. findings: left picc remains in place, tip in the upper right atrium. evidence of prior coronary artery bypass grafting is unchanged, with sternotomy wires, unchanged sternal dehiscence, and densely calcified native coronary arteries. moderate cardiomegaly is unchanged. multiple prominent mediastinal and hilar lymph nodes are unchanged. tracheostomy tube remains in place, approximately 5 cm above the carina. left chest tube remains in place, with tip positioned medially near the apex. new drainage catheter is in place at the left lung base, and the small left pleural effusion is slightly decreased in size, with small foci of gas now seen within the effusion . small right pleural effusion is little changed. diffuse ground-glass opacity throughout both lungs, along with small centrilobular nodules, and mild apical predominant interlobular septal thickening is again noted, slightly improved since prior exam. osseous structures are unremarkable. impression: 1. slightly decreased size of small left pleural effusion, with new left basilar chest tube in place, and second old left chest tube unchanged in position medially near the left apex. 2. unchanged small right pleural effusion. 3. slightly improved appearance of diffuse ground-glass opacity, small centrilobular nodules, and apical predominant interlobular septal thickening. this could represent improvement in pulmonary edema, infectious process, or both. 02:37am blood wbc-13.4* rbc-2.78* hgb-8.1* hct-25.1* mcv-90 mch-29.1 mchc-32.2 rdw-17.9* plt ct-303 01:46am blood pt-13.6* ptt-30.3 inr(pt)-1.2* 02:37am blood glucose-86 urean-37* creat-1.8* na-132* k-4.9 cl-99 hco3-23 angap-15 01:31am blood alt-21 ast-24 alkphos-149* totbili-0.3 echocardiography report , portable tte (complete) done at 11:34:54 am final referring physician information , division of cardiothoracic , status: inpatient dob: age (years): 74 f hgt (in): 58 bp (mm hg): 100/56 wgt (lb): 163 hr (bpm): 77 bsa (m2): 1.67 m2 indication: left ventricular function. right ventricular function. icd-9 codes: 428.0, 414.8, 424.0, 424.2 test information date/time: at 11:34 interpret md: , md test type: portable tte (complete) son: , rdcs doppler: full doppler and color doppler test location: west sicu/ctic/vicu contrast: none tech quality: suboptimal tape #: 2008w000-0:00 machine: vivid i-3 echocardiographic measurements results measurements normal range left atrium - four chamber length: *5.6 cm <= 5.2 cm right atrium - four chamber length: *5.1 cm <= 5.0 cm left ventricle - ejection fraction: 30% >= 55% aortic valve - peak velocity: 1.6 m/sec <= 2.0 m/sec mitral valve - e wave: 1.3 m/sec mitral valve - a wave: 0.4 m/sec mitral valve - e/a ratio: 3.25 mitral valve - e wave deceleration time: 172 ms 140-250 ms tr gradient (+ ra = pasp): 25 mm hg <= 25 mm hg findings right atrium/interatrial septum: increased ivc diameter (>2.1cm) with <35% decrease during respiration (estimated rap (10-20mmhg). left ventricle: depressed lvef. right ventricle: rv not well seen. aortic valve: mildly thickened aortic valve leaflets (3). no as. mitral valve: mildly thickened mitral valve leaflets. no mvp. mild mitral annular calcification. mild thickening of mitral valve chordae. calcified tips of papillary muscles. no ms. moderate (2+) mr. tricuspid valve: mildly thickened tricuspid valve leaflets. thickened/fibrotic tricuspid valve supporting structures. no ts. mild tr. normal pa systolic pressure. pericardium: no pericardial effusion. general comments: suboptimal image quality - poor echo windows. suboptimal image quality - poor parasternal views. suboptimal image quality - poor apical views. suboptimal image quality - poor subcostal views. suboptimal image quality - bandages, defibrillator pads or electrodes. conclusions the estimated right atrial pressure is 10-20mmhg. lv systolic function appears moderately-to-severely depressed (ejection fraction 30 percent). the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the supporting structures of the tricuspid valve are thickened/fibrotic. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. compared with the findings of the prior study (images reviewed) of , findings are grossly similar although the suboptimal nature of both studies precludes definitive comparison. electronically signed by , md, interpreting physician 12:27 brief hospital course: patient well know to our service, was transferred to rehabilitation on . transferred from rehabilitation center to because of hypotension associated with atrial fibrillation, started on neosynephrine gtt. patient then transferred from to for further management. atrial fibrillation converted to sinus rhythm after treatment with iv amiodarone, neosynephrine infusion then weaned to off. patient arrived on full ventilatory support and was changed to pressure support ventilation and weaned from there. she had a chest ct which revealed a left effusion thoracic surgery was consulted and a chest tube was placed, the pleural fluid was positive for vre. a subsequent pigtail catheter was placed to drain a small loculated effusion. after the pigtail catheter was removed the pleural chest tube was gradually pulled back by the thoracic surgery team. it was then changed to an empyema tube. tpa was instilled x 3. the patient was also followed by the infectious disease service. she remains on fluconazole (8 weeks from ) for her previous candidemia and candidal sternal wound infection, and daptomycin (total 6 weeks from ) and ciprofloxacin (4 weeks from ) for vre in pleural effusion and e coli and vre in thigh wound. bronchoscopy showed tracheomalacia and she was seen by ip. bal grew psuedomonas. on she again underwent bronchoscopy, a y stent was placed for severe tracheobroncheomalacia, and her trach was changed. she was started on mucinex, normal saline via trach tube and mucomyst nebs for stent maintenance. she continued to have low urine output, and her bun and creatinie rose. this did not improve with multiple interventions including milrinone, netrecor, lasix drip, and albumin. she was seen by renal, and eventually started on cvvh. she was continued on cvvh until and was going to be transitioned to hd. it was felt she would not tolerate hd and the family discussed the options with the patient. she had a living will and after multiple meetings with all of the family members and dr. they decided to withdraw support. on the ventilator was discontinued and the pt. expired at 3:16pm with the family present. medications on admission: asa 81' vit c 500" iron 325' metalazone 5' lasix 40' celexa 20' mvi colace 100' heparin 5000 tid cardizem 60 qid reglan 10 tid zosyn 3.25 qid discharge medications: none discharge disposition: extended care facility: - discharge diagnosis: cad s/p cabg respiratory failure s/p tracheostomy/peg htn afib asthma emphysema anemia gerd anxiety ^chol carpal tunnel discharge condition: expired discharge instructions: none followup instructions: none md procedure: insertion of intercostal catheter for drainage insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more hemodialysis injection or infusion of thrombolytic agent arterial catheterization other operations on trachea bronchoscopy through artificial stoma bronchoscopy through artificial stoma replacement of tracheostomy tube diagnoses: anemia, unspecified esophageal reflux other postoperative infection acute kidney failure, unspecified atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status pleurisy with effusion, with mention of a bacterial cause other than tuberculosis acute respiratory failure other emphysema streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] empyema without mention of fistula tracheostomy status other diseases of trachea and bronchus dependence on respirator, status 

Answer: The patient is high likely exposed to