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: patient recorded as having no known allergies to drugs attending: chief complaint: dyspnea reason for micu admission: hypoxia major surgical or invasive procedure: none history of present illness: ms. is a yo f with history of htn, svt, hx cholangitis/e.coli bacteremia (), freq utis, who presents from her nursing home with acute dyspnea, hypoxia to low 80's on ra, and fever to 102. she was recently hospitalized for lll pna and d/c'd on on a course of levofloxacin and flagyl. she was changed at the nursing home from levofloxacin to cefpodoxime for better facility acquired coverage, but has no sputum cx data to date. she also had a urine cx sent on at the nh which is no growth to date. per nursing home staff, she had been doing well for the last 2 days (no o2 requirement) until 9am this morning when she was found to be confused and lethargic and an o2 sat was in the low 80s and did not respond to nasal cannula. she was also found at that time to have a fever to 102. on interviewing the patient, she denies chest pain, shortness of breath, abdominal pain or urinary sx. she reports r ear pain. . in the ed, her vs were t 99.8 bp 155/96 hr 160 (sinus) o2 84% on 4l. cxr showed a worsening lll pna compared to , u/a showed > wbc. she received ctx, azithro, and vanco as well as 2l ivfs which brought her hr to 115. on transfer she was satting 98% on nrb. after discussions w/ family members - she remains dnr/dni - plan for abx, supplemental o2, no pressors, no line, and if worsens or in increased distress plan to switch focus to comfort. . ros: other than above, pt unable to provide further hx. . past medical history: --history of svt --hyperthyroidism --htn --b12 deficiency --h/o cholangitis s/p ercp --macular degeneration --s/p tah bso --s/p nephrectomy --s/p appendectomy --s/p hip hemiarthroplasty social history: pt lives at at . denies tobacco, etoh. reportedly a retired math teacher (7th and 8th). played the organ in church for years. originally from upstate , married in and moved to at that time. widowed since . she is a non-smoker, no etoh, no illicit drugs. son = hcp = . daughter ( -) lives in and is ill with copd and home oxygen. patient has close friend who identifies herself as her "daughter" though admits that she is not related, her name is . son gives permission to speak with but says that he should be the first contact. family and friend , patient normally alert, fully oriented and coherent. family history: non-contributory. physical exam: vitals: t: 98.0 bp: 141/71 hr: 115 rr: 35 o2sat: 99% on nrb gen: respiratory distress with use of accessory muscles heent: surgical pupils b/l, mm dry, op clear neck: no jvd, carotid pulses brisk, no bruits, no cervical lymphadenopathy, trachea midline cor: tachycardic, no m/g/r, normal s1 s2, radial pulses +2 pulm: lungs decreased bs at bases, l > r. no crackles, wheezes or rhonchi. abd: soft, nt, nd, +bs, no hsm, no masses ext: no c/c/e, no palpable cords neuro: awake, answers simple questions. moving all extremities. skin: no jaundice, cyanosis, or gross dermatitis. no ecchymoses. . pertinent results: other labs/interpretation: resp cx: gram stain (final ): >25 pmns and <10 epithelial cells/100x field ? oropharyngeal flora. yeast, sparse growth. staph aureus coag +. sparse growth. mrsa . . ua >50wbc, mod bact, ucx >100k yeast ua 6wbc, no bacteria, ucx : >100k yeast . . imaging/results: cxr: increasing left lower lobe infiltrate and pleural effusion is concerning for progression of pneumonia. the remainder of the study is relatively unchanged. . unchanged area of worsening right basilar area of consolidation and stable appearance of left basilar consolidation. unchanged slight volume overload and bronchial wall thickening. . : increased right pleural effusions, bilateral basilar consolidations unchanged. pulm vasc congeston. brief hospital course: year old female with h/o svt, htn, recent admission with lll pna (discharged on levo/flagyl), admitted from with acute onset hypoxia/dyspnea/fevers 102, cxr with worsening lll pna, which has now progressed to b/l pna, clinical evidence of aspirartion. afebrile and mostly stable, but episodes of clinical deterioration. . . pneumonia, admitted with acute hypoxic resp failure, much improved. cxr with progressive infiltrates, lll->now bilateral (infection vs fluid). acuity suggests component of aspiration pneumonitis. has resp and oral secretions, aspirating oral secretions, but has trouble bringing up tracheal secretions (weak cough) and requires deep suctioning. no fevers. white count finally coming down. she will be treated to complete a 14 day course of vanc/zosyn. . given likely aspiration risk, she had multiple swallow evaluations, with evidence of aspiration. based on family discussion, there is a goal of primarily comfort for patient, with thin liquids, despite risk of aspiration. if there is evidence of significant coughing, further evaluation or discussions regarding goals of care should continue with her family. . . pleural effusions: developing over 3days, likely due to tachycardia and fluid. diuresis for the most part was deferred further, given minimal oral intake. . . leukocytosis: she had a leukocytosis that worsened, likely due to pneumonia. this had resolved by . . atrial fibrillation, with intermittent tachycardia: while in the icu, she had evidence of tachycardia, possibly atrial fibrillation, which broke with iv metoprolol. she continued to have intermittent episodes of tachycardia throughout her stay, likely sinus tachycardia in the setting of mucous plugging and anxiety. she was maintained on iv lopressor, and transitioned on d/c to oral lopressor. . contaminated ua: ua/ucx on admission wtih >100k yeast, foley removed, 1 dose diflucan in micu, but repeat ucx again >100k yeast, though ua less wbc 50->6. no treatment pursued. . . encephalopathy: she had evidence of intermittent confusion, consistent with delirium, due to icu stay, pneumonia. she gradually improved, though remains off her baseline. . . htn: well controlled on metoprolol . . pud. cont ppi . . oa/shoulder pain: lidocaine patch, no narcotics, esp given aspiration risk . . fen/proph: hliv, monitor lytes, soft diet with honey thick liquids per speech only when awake, otw npo, strict aspiration precautions, teds/scds, heparin , ppi . . dispo/code status: dnr/dni. goals of care defined with goal toward comfort, based on family meeting between geriatrics service and her family (son, daughter, daughter in law). they would like her to return to her nursing home. a do-not-rehospitalize order will likely need to be discussed on return to . . is hcp(wife , c . daughter ( - ) lives in (but is ill). medications on admission: 1. metoprolol tartrate 12.5 mg po bid 2. docusate sodium 200mg po bid 3. acetaminophen 1g q8hr 4. prilosec 20mg po q24hr 5. cefpodoxime 100mg po bid 6. metronidazole 500 mg po bid 7. mvi with iron 8. remeron 15mg po qhs 9. -128 5% eye gtt 4x daily to each eye . discharge disposition: extended care facility: of discharge diagnosis: pneumonia, bilateral aspiration, chronic pleural effusions atrial fibrillatoin encephalopathy discharge condition: stable. prognosis is poor. discharge instructions: you were admitted secondary to pneumonia that is likley secondary to aspiration. you were treated for pneumonia with antibiotics. . we had extensive discussion with you and your family regarding the risk of aspiration depending on what type of food/liquids you consume but you will be allowed to eat food with aspiration precautions. . your doctor will discuss future plans for rehospitalization with your family. followup instructions: follow up with dr. on return to . procedure: venous catheterization, not elsewhere classified diagnoses: unspecified pleural effusion unspecified essential hypertension atrial fibrillation acute respiratory failure other specified cardiac dysrhythmias pneumonitis due to inhalation of food or vomitus macular degeneration (senile), unspecified pressure ulcer, heel encephalopathy, unspecified hip joint replacement other diseases of trachea and bronchus pressure ulcer, stage i osteoarthrosis, localized, not specified whether primary or secondary, shoulder region 

Answer: The patient is high likely exposed to