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: tolectin 200 / dilantin / codeine / cipro / ceftin / zithromax / bactrim ds / clindamycin / influenza virus vaccine / doxycycline / dicloxacillin / vancomycin / percocet attending: chief complaint: fever, cough, chest pain reason for icu admission: sirs/pneumonia, early sepsis major surgical or invasive procedure: central venous line placement history of present illness: 84 y/o female, resident of nursing home, with post-inflammatory pulmonary fibrosis following her episode of severe ards, interstitial lung disease with pulmonary hypertension, multiple sclerosis (on prednisone), inflammatory polyarthritis, osteoporosis with multiple lumbar compression fractures, and frequent bouts of pneumonia, who presents with one day of cough, fever, chills, pleuritic chest pain, and green sputum. associated symptoms included nausea with dry heaves and one loose stool. . in the ed, initial vs were: t 100.8, hr 96, bp 132/95, rr 16, o2 95% 4l nc. she was felt to "look toxic" with a respiratory rate in the mid to upper 20s. she was responsive, alert, and coughing up green sputum at the bedside, but appeared tired. her jvp was flat, with dry mm. pulmonary exam notable for diffuse rales. cardiac exam felt to be normal. there was some concern for cellulitis on her right ankle. . cxr initially read as poor inspiratory effort and difficult to interpret, ?atelectasis vs. rml opacity. ekg was felt to be unremarkable. patient received 2l ivf, linezolid, aztreonam, and levofloxacin for hcap, coverage of mrsa and pseudomonas, and given her numerous allergies. . vitals on transfer: 99.8, 105/51, 84, 20, 98% 4l nc. access: 18g and 20g. . on the floor, patient reports chest pressure with deep inspiration and coughing. she denies sob. . review of systems: (+) per hpi (-) denies night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies wheezing. denies palpitations or weakness. denies diarrhea, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies rashes or skin changes. past medical history: -inflammatory polyarthritis -htn -hyperlipidemia -s/p bowel resection for small bowel obstruction -osteoarthritis -s/p left shoulder fracture -multiple sclerosis -restrictive lung disease after episode of ards -interstitial lung disease -mild pulmonary hypertension -iron deficiency anemia -recurrent utis (k pneumo r to nft; vre) -multiple lumbar compression fractures -recurrent c.diff social history: widowed. as above, had been in rehab until and then moved in with son. is quite independant at baseline. son and daughter live nearby and are involved. 15pack year smoker, quit , no etoh or illicits. has help at home with adls. family history: mother lived to 101, died . sister w/ psych history. father - unknown physical exam: on admission: general: ill appearing female, appears stated age, mild distress heent: sclera anicteric, mm dry, oropharynx clear neck: supple, jvp 6 cm, no lad lungs: inspiratory and expiratory crackles diffusely and bilaterally, rhonchi right > left, occasional expiratory wheezing 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 gu: foley draining clear yellow urine ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: on admission: 12:47am blood wbc-19.5*# rbc-4.54# hgb-12.4# hct-38.3# mcv-84 mch-27.2 mchc-32.3 rdw-16.6* plt ct-357 12:47am blood neuts-79* bands-3 lymphs-5* monos-11 eos-2 baso-0 atyps-0 metas-0 myelos-0 12:47am blood pt-12.6 ptt-26.4 inr(pt)-1.1 12:47am blood glucose-90 urean-28* creat-0.7 na-140 k-3.9 cl-99 hco3-29 angap-16 07:25am blood calcium-8.3* phos-2.6* mg-1.8 12:47am blood cortsol-28.7* 12:54am blood lactate-1.6 . radiology: ap cxr - impression: low lung volumes and chronic interstitial lung disease. mild right middle lobe opacity may represent a focal pneumonia. rotated positioning. allowing for this, there is no definite change compared with . there is equivocal slight increase in the degree of opacity in both upper zones, but this is likely accentuated by differences in technique. impression: no definite change. a subtle difference might not be appreciated due to differences in positioning and technique. . cxr 10/31rotated positioning. allowing for this, there is no definite change compared with . there is equivocal slight increase in the degree of opacity in both upper zones, but this is likely accentuated by differences in technique. impression: no definite change. a subtle difference might not be appreciated due to differences in positioning and technique. j . cxr-findings: as compared to the previous radiograph, the patient has received a right-sided picc line. the tip of the picc line projects over the right atrium, the line should be pulled back by approximately 3 cm. there is no evidence of complications, notably no pneumothorax. the pre-existing parenchymal opacities have slightly decreased in severity and extent. otherwise, the radiograph is unchanged. the study and the report were reviewed by the staff radiologist. . 05:52am blood wbc-8.4 rbc-3.83* hgb-10.6* hct-32.5* mcv-85 mch-27.7 mchc-32.7 rdw-16.3* plt ct-321 05:52am blood plt ct-321 05:52am blood glucose-105* urean-10 creat-0.6 na-137 k-3.6 cl-99 hco3-32 angap-10 05:52am blood wbc-8.4 rbc-3.83* hgb-10.6* hct-32.5* mcv-85 mch-27.7 mchc-32.7 rdw-16.3* plt ct-321 07:15am blood wbc-7.2 rbc-3.84* hgb-10.5* hct-33.1* mcv-86 mch-27.4 mchc-31.7 rdw-16.4* plt ct-302 07:25am blood neuts-88.8* lymphs-6.4* monos-4.2 eos-0.3 baso-0.3 12:47am blood neuts-79* bands-3 lymphs-5* monos-11 eos-2 baso-0 atyps-0 metas-0 myelos-0 05:52am blood plt ct-321 07:15am blood plt ct-302 05:52am blood glucose-105* urean-10 creat-0.6 na-137 k-3.6 cl-99 hco3-32 angap-10 07:15am blood glucose-88 urean-10 creat-0.5 na-140 k-4.1 cl-101 hco3-35* angap-8 07:25am blood glucose-92 urean-11 creat-0.5 na-138 k-4.1 cl-100 hco3-31 angap-11 05:52am blood calcium-8.5 phos-2.6* mg-2.1 02:24pm blood %hba1c-6.6* eag-143* 12:47am blood cortsol-28.7* . stool clostridium difficile toxin a & b test-final inpatient negative. urine legionella urinary antigen -final inpatient negative. sputum gram stain-final; respiratory culture-final inpatient respiratory flora. mrsa screen mrsa screen-final inpatient urine urine culture-final emergency blood culture blood culture, routine-pending emergency blood culture blood culture, routine-pending brief hospital course: assessment and plan: 84 y/o female, resident of nursing home, with post-inflammatory pulmonary fibrosis, interstitial lung disease, multiple sclerosis (on prednisone), inflammatory polyarthritis, and frequent bouts of pneumonia, who presented with one day of cough, fever, chills, pleuritic chest pain, and green sputum. . # sirs/early sepsis/pneumonia: given her history of frequent bouts of pneumonia with current of fever, chills, cough, green sputum, elevated wbc, and cxr with suspicion of rml infiltrate, strongly suspected pneumonia. given her nursing home residence and two recent admissions for pneumonia, favor antibiotic coverage for hcap. she did report pleuritic chest pain, for which pe was also on the differential, however this is felt to be much lower on the differential given her overall clinical picture of pneumonia/sirs/early sepsis. with regard to her pneumonia, she has a curb 65 score of 2, which is associated with a 13% mortality. reassuring that her lactate remains within normal limits and uop is adequate. pt was started on linezolid (given vanc allergy), aztreonam and levofloxacin for hcap coverage (8 days) as well as coverage for rle cellulitis (linezolid) that was greatly improved compared to in the ed. urine legionella came back negative and pt oxygen requirement improved dramatically overnight in the icu. blood, urine, sputum cultures were sent and returned negative. bcx ngtd. pt was much improved on day 2 of admission and was felt stable and ready for call out to the floor. on the medical floor, pt continued to do well and was weaned to room air by time of discharge with improvement in cough and sob. last cxr shows improvement in pna. pt will continue levofloxacin, linezolid, and aztreonam for 3 more days. picc can be removed after abx course has ended. . # ?cellulitis: area of erythema and warmth over her right ankle. received a dose of linezolid in the ed for mrsa coverage, given her vancomycin allergy. have been a factor in the above picture. by time of transfer to the medical floor, pt no longer displayed signs of cellulitis. area did not have erythema upon transfer to medical floor. she can continue linezolid as above for possible cellulitis. . # restrictive lung disease: multifactorial. a component of this is related to her post-inflammatory pulmonary fibrosis following her episode of severe ards. her lung function is also compromised by severe kyphosis, osteoporosis, and generalized weakness. pt was continued on her home steroid dose and monitored for signs of need for increased dose. she was continued on her home inhalers and should continue her advair and duonebs upon discharge. . # inflammatory polyarthritis/multiple sclerosis: stable. pt was continued on prednisone at home dose. . #multiple sclerosis and weakness. pt was continued on tizanidine per outpatient regimen. physical therapy could be continued for the patient. . #l.cheek lesion-light brown plaque- with central raised area-light brown with some scaling-outpatient derm appointment was arranged for the patient for follow up and potential biopsy. pt was advised to discuss with her pcp if she would like an appointment arranged elsewhere. . #history of recurrent c diff and new-onset diarrhea in ed. c.diff toxin negative this admission. . #elevated blood glucose levels of 400 in the icu. aic 6.6% which classifies her as "diabetic". this was thought to be related to infection and steroid use. pts blood sugars remained well controlled this admission. she required 1unit of humalog overnight. she should have her finger sticks monitored and follow a diabetic diet as an outpatient. it can be decided in the outpatient setting if patient requires aspirin, acei etc. . #code status-after discussion with patient and her hcp, her code status was changed to dnr/dni in the icu. pt confirmed that this still remains her wish prior to discharge and she filled out dnr/dni form. medications on admission: alendronate - 70 mg tablet - 1 tablet(s) by mouth q week take first thing in morning with full glass of water atorvastatin - (prescribed by other provider) - 10 mg tablet - 1 tablet(s) by mouth hs baclofen - (prescribed by other provider) - dosage uncertain fluticasone - 50 mcg spray, suspension - 1 spray each nostril once a day fluticasone-salmeterol - (prescribed by other provider) - 250 mcg-50 mcg/dose disk with device - 1 puff twice a day furosemide - (dose adjustment - no new rx) - 40 mg tablet - 1 tablet(s) by mouth once a day lidocaine - 5 % (700 mg/patch) adhesive patch, medicated - apply once a day as needed for as needed for back pain nystatin - 100,000 unit/gram powder - apply to affected area three times a day as needed ondansetron - (prescribed by other provider) - 4 mg tablet, rapid dissolve - 1 tablet(s) by mouth q 8-12 h as needed for nausea prednisone - (dose adjustment - no new rx) - 5 mg tablet - 1.5 tablet(s) by mouth once a day as directed by md simvastatin - 20 mg tablet - 1 tablet(s) by mouth once a day tizanidine - (prescribed by other provider) - dosage uncertain . medications - otc acetaminophen - (otc) - 500 mg tablet - 2 (two) tablet(s) by mouth calcium citrate-vitamin d3 - (prescribed by other provider) - 315 mg-200 unit tablet - 2 (two) tablet(s) by mouth twice a day clear moisture barrier ointment - (otc) - - apply to affected areas once a day docusate sodium - (otc) - 100 mg capsule - 1 (one) capsule(s) by mouth once a day multivitamin-minerals-lutein - (otc) - tablet - 1 (one) tablet(s) by mouth once a day ranitidine hcl - (otc) - 150 mg tablet - 1 tablet(s) by mouth once a day as needed for heartburn sennosides - (otc) - 8.6 mg tablet - one tablet(s) by mouth twice a day as needed for constipation . fosamax 70mg weekly miralax prn prednisone 7.5mg daily daily multivitamin vitamin d 400u daily advair 250/50 1 puff twice daily colace 100mg twice daily tylenol 500mg three times daily as needed for pain oxycodone 2.5mg every six hours as needed for pain baclofen 10mg three times daily calcium with vitamin d three times daily tizanidine 4mg three times daily simvastatin 20mg daily bisacodyl 5mg as needed for constipation zofran 4mg po every six hours as needed for nausea senna 2 tabs daily as needed for constipatoin duonebs as needed for shortness of breath guiafenissin at night for cough discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 2. bisacodyl 5 mg tablet sig: one (1) tablet po once a day as needed for constipation. 3. alendronate 70 mg tablet sig: one (1) tablet po once a week. 4. miralax 17 gram powder in packet sig: one (1) po once a day as needed for constipation. 5. prednisone 2.5 mg tablet sig: three (3) tablet po daily (daily). 6. multivitamin,tx-minerals tablet sig: one (1) tablet po daily (daily). 7. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 9. acetaminophen 325 mg tablet sig: two (2) tablet po tid prn () as needed for pain. 10. baclofen 10 mg tablet sig: one (1) tablet po three times a day. 11. calcium 600 + d(3) 600-400 mg-unit tablet sig: one (1) tablet po twice a day. 12. tizanidine 2 mg capsule sig: one (1) capsule po three times a day. 13. zofran odt 4 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po every eight (8) hours as needed for nausea. 14. duoneb 0.5 mg-3 mg(2.5 mg base)/3 ml solution for nebulization sig: one (1) inhalation every four (4) hours as needed for shortness of breath or wheezing. 15. guaifenesin 100 mg/5 ml syrup sig: ten (10) ml po q6h (every 6 hours) as needed for cough. 16. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 3 days. disp:*3 tablet(s)* refills:*0* 17. linezolid 600 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 3 days. disp:*6 tablet(s)* refills:*0* 18. aztreonam 1000 mg iv q8h day 1 19. picc care per protocol discharge disposition: extended care discharge diagnosis: major: health care associated pneumonia (pt lives in a nursing home) l.cheek lesion diarrhea cellulitis hyperglycemia normocytic anemia . minor: multiple sclerosis inflammatory polyarthritis interstitial lung disease discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were initially admitted to the icu for pneumonia. you were given antibiotics and your symptoms improved. you were transferred to the general medicine floor and continued to improve. you were no longer requring oxygen by day of discharge. serial chest x-rays have shown resolving pneumonia. you had a picc line placed so that you may receive antibiotics and this can be removed when your course is complete. . you reported diarrhea, but your test for c.diff was negative. . there initially was some concern of a skin infection on your r.ankle. this had resolved by the time you were transferred to the regular floor. the antibiotics you are taking for pneumonia will treat for a possible infection. . you also reported a l.cheek skin lesion. you were advised to follow up with dermatology for further evalution. an appointment has been made for you below. if you would prefer another location, please discuss this with your pcp. . your blood sugar was noted to be elevated when you were in the icu. you blood sugars were much better controlled on the floor. this is likely related to steroids and infection. you should continue to have your blood sugars monitored in the outpatient setting and follow a diabetic diet. no medication was started at this time. you can discuss this further with your pcp if needed. . you have a very mild anemia. you may follow up with your pcp for further evaluation. please be sure you discuss whether you need to have a colonoscopy. . medication changes: 1.levofloxacin 500mg daily for 3 more days 2.aztreonam 1000mgiv tid for 3 more days 3.linezolid 600mg for 3 more days . none of your other medications were changed. . please follow up with the appointments below and take your medications as prescribed. followup instructions: department: medical specialties when: monday at 11:30 am with: , m.d. building: campus: east best parking: garage department: rheumatology when: tuesday at 11:30 am with: , md building: lm bldg () campus: west best parking: garage . department: - adult med when: friday at 11:30 am with: , md building: (, ma) campus: off campus best parking: free parking on site department: dermatology when: tuesday at 11:00 am with: , md building: sc clinical ctr campus: east best parking: garage please call the office in weeks so they can get you a sooner appointment. thanks. procedure: injection or infusion of oxazolidinone class of antibiotics central venous catheter placement with guidance diagnoses: pneumonia, organism unspecified long-term (current) use of steroids unspecified septicemia other chronic pulmonary heart diseases sepsis cellulitis and abscess of leg, except foot osteoporosis, unspecified postinflammatory pulmonary fibrosis do not resuscitate status multiple sclerosis other abnormal glucose benign essential hypertension 

Answer: The patient is high likely exposed to