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: respiratory distress major surgical or invasive procedure: none history of present illness: patient is 77 yo female with pmhx sig. for recent massive stemi at osh 10 days ago, s/p 3 stents complicated by cardiogenic shock requiring iabp x 3 days and pneumonia treated with flagyl and levaquin. she was sent to rehab on and presents from rehab with increasing sob. . pt reports that at rehab, every night she had chest tightness, rating , associated with heavy breathing and nausea. no diaphoresis. the discomfort would last all night, preventing her from sleeping. she states it's a different pain than her mi. she denied any f/c. she reports that she has a chronic cough, but is blood-tinged. notablely, she has a cough with lisinopril, which she is currently on. at 3pm, she c/o sob wtih wheezing. vs were 90/54, 72, 18, 97% on 2l o2, t 98. she was taken to the ed. . in the ed, initial vs: 85/47, on exam, pt was using accessory muscles. a bedside ultrasound showed minimal pericardial effusion, no evidence of tamponade. cxr showed r-sided pneumonia. pt received vanc/zosyn and 1 l ns. rij placed. initially she was on dopamine without much response and was switched to levophed, currently at 0.18. 70, 97/78, 18, 99% on 2 l. cvp 11-16. cardiology to perform formal echo when patient hits the floor. past medical history: asthma hyperlipidemia hypertension coronary artery disease diabetes mellitus type 2 gerd social history: pt is divorced, has 2 children. worked as a housewife. she smoked from -. no etoh or recreational drug use. family history: father died with dm. mother died with kidney disease physical exam: vitals - t: 97.5 bp: 119/71 hr: 83 rr: 17 02 sat: 98% on 2l nc general: anxious. no apparent distress. heent: no lad. jvp is slightly elevated. supple cardiac: regular rate and rhythm, no m/r/g lung: bilateral inspiratory crackles and expiratory wheezes. good respiratory effort- no signs of accessory muscle use. abdomen: +bs, soft, non-tender, non-distended ext: trace edema in b/l le. no c/c. neuro: aao x 3. grossly intact derm: no rashes or lesions noted. pertinent results: 05:16pm blood wbc-20.1* rbc-3.38* hgb-9.6* hct-29.4* mcv-87 mch-28.4 mchc-32.7 rdw-15.0 plt ct-383 03:53am blood wbc-30.8*# rbc-3.35* hgb-9.7* hct-29.0* mcv-87 mch-28.9 mchc-33.3 rdw-15.0 plt ct-510* 04:54am blood wbc-26.2* rbc-3.33* hgb-9.4* hct-29.1* mcv-88 mch-28.3 mchc-32.4 rdw-14.9 plt ct-522* 04:16am blood wbc-20.5* rbc-3.19* hgb-9.2* hct-28.1* mcv-88 mch-28.8 mchc-32.7 rdw-15.0 plt ct-556* 04:13am blood wbc-16.5* rbc-3.24* hgb-9.3* hct-28.3* mcv-87 mch-28.7 mchc-32.8 rdw-15.1 plt ct-457* 09:37pm blood wbc-11.7* rbc-2.94* hgb-8.4* hct-25.5* mcv-87 mch-28.4 mchc-32.8 rdw-15.2 plt ct-320 03:06am blood wbc-13.1* rbc-3.02* hgb-8.7* hct-26.2* mcv-87 mch-28.8 mchc-33.2 rdw-15.3 plt ct-355 03:40am blood wbc-16.5* rbc-3.19* hgb-9.1* hct-27.6* mcv-87 mch-28.7 mchc-33.1 rdw-15.4 plt ct-410 04:10am blood wbc-21.3* rbc-3.25* hgb-9.4* hct-28.0* mcv-86 mch-29.0 mchc-33.7 rdw-15.2 plt ct-421 05:21am blood wbc-23.9* rbc-3.35* hgb-9.5* hct-28.7* mcv-86 mch-28.2 mchc-32.9 rdw-15.2 plt ct-368 05:10am blood wbc-21.3* rbc-3.29* hgb-9.6* hct-28.1* mcv-86 mch-29.2 mchc-34.1 rdw-15.2 plt ct-334 05:16pm blood neuts-88* bands-2 lymphs-4* monos-4 eos-0 baso-0 atyps-0 metas-1* myelos-1* 05:16pm blood pt-53.0* ptt-45.4* inr(pt)-5.9* 11:00pm blood pt-57.8* ptt-46.4* inr(pt)-6.5* 03:53am blood pt-45.1* ptt-44.5* inr(pt)-4.8* 02:20pm blood pt-27.6* ptt-36.4* inr(pt)-2.7* 04:54am blood pt-23.8* ptt-34.5 inr(pt)-2.3* 04:16am blood pt-24.2* ptt-31.4 inr(pt)-2.3* 04:13am blood pt-25.7* ptt-31.5 inr(pt)-2.5* 03:06am blood pt-36.0* ptt-32.9 inr(pt)-3.7* 03:40am blood pt-44.1* ptt-34.5 inr(pt)-4.7* 04:10am blood pt-42.0* ptt-34.8 inr(pt)-4.4* 05:21am blood pt-33.7* ptt-34.2 inr(pt)-3.4* 05:10am blood pt-29.5* ptt-31.9 inr(pt)-2.9* 05:10am blood pt-28.2* ptt-30.0 inr(pt)-2.8* 05:10am blood plt ct-317 03:53am blood fibrino-799* 02:20pm blood fibrino-817* 02:20pm blood fdp-10-40* 05:16pm blood glucose-153* urean-35* creat-1.6* na-133 k-5.7* cl-96 hco3-26 angap-17 11:00pm blood glucose-230* urean-37* creat-1.6* na-133 k-4.6 cl-99 hco3-22 angap-17 03:53am blood glucose-206* urean-35* creat-1.4* na-134 k-4.5 cl-101 hco3-24 angap-14 04:54am blood glucose-251* urean-36* creat-1.3* na-138 k-4.8 cl-106 hco3-23 angap-14 04:16am blood glucose-191* urean-42* creat-1.3* na-141 k-5.0 cl-110* hco3-25 angap-11 04:13am blood glucose-182* urean-46* creat-1.2* na-141 k-5.0 cl-109* hco3-26 angap-11 09:37pm blood glucose-243* urean-48* creat-1.2* na-139 k-4.6 cl-107 hco3-25 angap-12 03:06am blood glucose-180* urean-50* creat-1.2* na-141 k-4.8 cl-107 hco3-25 angap-14 05:57pm blood glucose-281* urean-47* creat-1.1 na-139 k-4.6 cl-104 hco3-26 angap-14 03:40am blood glucose-199* urean-45* creat-1.1 na-138 k-4.4 cl-103 hco3-29 angap-10 03:54pm blood glucose-308* urean-42* creat-1.2* na-135 k-4.3 cl-97 hco3-31 angap-11 04:10am blood glucose-176* urean-41* creat-1.2* na-139 k-4.0 cl-97 hco3-34* angap-12 05:21am blood glucose-161* urean-39* creat-1.0 na-138 k-3.4 cl-96 hco3-35* angap-10 05:10am blood glucose-121* urean-37* creat-1.1 na-139 k-3.9 cl-97 hco3-32 angap-14 05:10am blood glucose-183* urean-32* creat-0.8 na-139 k-4.0 cl-101 hco3-29 angap-13 05:16pm blood ck(cpk)-110 11:00pm blood ck(cpk)-94 03:53am blood ld(ldh)-446* ck(cpk)-79 totbili-0.6 02:20pm blood ck(cpk)-80 04:54am blood ck(cpk)-77 08:12pm blood ck(cpk)-84 03:06am blood ck(cpk)-73 05:16pm blood ck-mb-3 05:16pm blood ctropnt-2.08* 11:00pm blood ck-mb-notdone ctropnt-1.93* 03:53am blood ck-mb-notdone ctropnt-1.48* 02:20pm blood ck-mb-notdone ctropnt-1.30* 04:54am blood ck-mb-notdone ctropnt-1.06* 03:06am blood ck-mb-notdone ctropnt-0.60* 05:57pm blood probnp-* 03:40am blood probnp-* 11:00pm blood calcium-7.7* phos-4.5 mg-1.9 05:10am blood calcium-7.9* phos-2.9 mg-2.1 03:53am blood hapto-285* 06:09am blood vanco-12.6 05:43am blood vanco-13.0 09:54am blood type-art temp-35.4 po2-74* pco2-41 ph-7.34* caltco2-23 base xs--3 intubat-not intuba comment-left radia 01:58pm blood type-art po2-99 pco2-44 ph-7.32* caltco2-24 base xs--3 05:07am blood type-central ve temp-36.7 rates-/12 peep-5 fio2-50 po2-79* pco2-53* ph-7.27* caltco2-25 base xs--2 intubat-intubated vent-spontaneou 06:19pm blood type-art po2-40* pco2-47* ph-7.33* caltco2-26 base xs--1 10:35pm blood type-art temp-36.5 rates-18/ tidal v-500 peep-5 fio2-40 po2-137* pco2-28* ph-7.54* caltco2-25 base xs-3 -assist/con intubat-intubated 11:48pm blood type-art temp-36.1 rates-12/ tidal v-500 peep-5 fio2-40 po2-128* pco2-36 ph-7.45 caltco2-26 base xs-2 -assist/con intubat-intubated 01:12am blood type-art temp-36.1 rates- tidal v-450 peep-5 fio2-40 po2-123* pco2-48* ph-7.36 caltco2-28 base xs-1 -assist/con intubat-intubated 02:12am blood type-art temp-36.1 peep-5 fio2-35 po2-120* pco2-43 ph-7.40 caltco2-28 base xs-1 intubat-intubated 06:21am blood type-art temp-35.8 fio2-35 po2-125* pco2-46* ph-7.45 caltco2-33* base xs-7 intubat-intubated 06:00pm blood lactate-3.1* 11:13pm blood lactate-2.1* 09:54am blood lactate-2.5* 01:58pm blood lactate-1.5 05:07am blood lactate-1.7 10:35pm blood lactate-1.7 10:35pm blood freeca-1.13 echo ()- the left atrium is mildly dilated. the estimated right atrial pressure is 0-5 mmhg. left ventricular wall thicknesses and cavity size are normal. there is moderate to severe regional left ventricular systolic dysfunction with near akinesis of the septum and anterior walls, apex, and distal lateral wall. the apex is mildly aneurysmal. the remaining segments contract normally (lvef = 25-30 %). no intraventricular thrombus is seen. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is a small pericardial effusion. no right ventricular diastolic collapse is seen. impression: extensive regional left ventricular systolic dysfunction c/w cad. moderate mitral regurgitation. mild pulmonary artery systolic hypertension. cxr ()- impression: right middle lobe opacity concerning for pneumonia. cxr ()- comparison is made with a prior study performed a day earlier. mild pulmonary edema has improved. cardiac size is top normal. there is mild bilateral pleural effusions, greater on the right side. left lower lobe atelectasis has increased. opacity in the right lower lobe is most likely atelectasis. right ij catheter, et tube and ng tube remain in place. cxr ()- comparison: ; . portable upright chest radiograph: again seen is a right internal jugular catheter with tip projecting over the mid svc. heart size and mediastinal contours are unchanged. the aorta is mildly calcified and unfolded. there is persisting bu t improved retrocardiac and right basilar opacity. there are no large pleural effusion. no pneumothorax. lenis ()- conclusion: 1. there is no ultrasound evidence of deep venous thrombosis of the lower extremities. 2. there is evidence of edema of the soft tissues of both lower limbs. brief hospital course: # sepsis: patient presented from rehab for increasing sob. patient was recently discharged from and osh for stemi and was being treated for a pneumonia with levaquin and flagyl. on arrival here, she was noted to have hypotension with cxr consistent with rml pneumonia. she was started on pressors for blood pressure control. she was intubated to respiratory distress. she was started on vanco/zosyn initially for her pneumonia and was switched to vanco/cefepime/ciprofloxacin on the morning of for treatmed of health care associated pneumonia. she was weaned off of pressors. on , she was extubated and then reintubated the following day respiratory distress. cardiology was consulted given recent history of stemi with ef of 20% as chf was thought to be contributing to her respiratory distress and difficulty with extubation. she was diuresed with lasix gtt and re-extubated successfully on which was successful. she was transferred to the medical floor on . upon transfer, she was continued on po vanc. patient remained afebrile but continued to have an elevated wbc. she was ruled out for c.diff x 3 and cxr improved daily. shortness of breath also improved. her bp's returned to limits and she remained hemodynamically stable. upon discharge, patient was doing well. she was started on amiodarone at osh but it was held while here given her hemodynamic status- we continued to hold it on discharge and will ask that her outpatient cardiologist re-evaluate giving her amiodarone. she was restarted on her home dose of lisinopril 5mg daily. her beta-blocker was also restarted but, instead of toprol xl 50mg daily, she was given metoprolol tartrate 12.5mg po bid. her aldactone was also held on discharge. patient will have her cardiac medications re-evaluated once she see her outpatient cardiologist in weeks. # health care associated pneumonia: patient presented with a right middle lobe pneumonia s/p recent discharge from hospital for her stemi. she was treated with vanco/zosyn/cipr as above. she was transitioned to po vancomycin and did well. cxr improved daily. she also remained afebrile. she is to continue po vanc for a 14 day course (day 1 was ). # acute systolic heart failure: mr. had a recent stemi complicated by new ef of 20%. she was treated with lasix as above with improvement in her respiratory status. she diuresed well she was discharged on lasix 40mg by mouth daily. # diarrhea: patient initially complained of diarrhea and was started on flagyl empirically for c.difficile infection. during her hospitalization, wbc became elevated on treatment for her hap and diarrhea became more significant so she was staretd on vanco po for presumed for c.diff. c.diff was then sent and was negative x 3. patient's diarrhea had resolved by discharge. # cad, s/p recent stemi, now with ef 20%: cardiology was consulted as above. beta blocker was held intitially hypotension. she was continued on her asa, plavix, statin. beta-blocker (metoprolol tartrate 12.5mg po bid), ace-i (lisinopril 5mg daily) were restarted. her home dose of aldactone was held on discharge. she was chest-pain free on discharge. she will continue aspirin 325mg daily and plavis # afib: patient was in sinus rhythm. amiodarone and beta-blocker were held intially as patient was hypotensiv. her blood pressures returned to levels so she was restarted on lisinopril and metoprolol. amiodarone was discontinued (per above). her inr was supratherapeutic on admission so her coumadin was initially held. it returned to a therapeutic level (2.9) on so her coumadin was resumed at 1mg po daily. # htn: per above. lisinopril 5mg daily and beta-blocker (metoprolol 12.5mg po bid) resumted. aldactone and amiodarone were held on discharge. patient hemodynamically stable on discharge. # hyperlipidemia: continued atorvastatin 80mg po daily # asthma: started on methylprednisolone on and was treated for a 5 day course, she was also treated with albuterol inhalers and placed on her home advair. she was also given ipratropium bromide. patient counseled not to over-use her asthma medications # diabetes mellitus type 2: metformin held as an inpatient, treated with insulin sliding scale while in-house, with good control of her sugars. she was restarted on home dose of metformin 500mg daily upon discharge. # gerd: continued patient on home dose of ranitidine 150mg daily medications on admission: atenolol 25 mg daily asa 325 mg daily plavix 75 mg daily atorvastatin 80 mg daily lasix 40 mg qod flagyl 500 mg po tid levofloxacin 750 mg qod lisinopril 5 mg po daily amiodarone 200 mg x 3 weeks then d/c aldactone 2.5 mg daily advair 250/50 i puff glucophage 500 mg daily zantac 150 mg daily atrovent nebulizers xanax 0.5 mg tid toprol xl 50 mg daily discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 3. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 6. ipratropium bromide 17 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 7. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q4h (every 4 hours) as needed for wheezing. 8. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 9. lorazepam 0.5 mg tablet sig: 0.5-1 tablet po q4h (every 4 hours) as needed for anxiety. 10. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 11. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 12. warfarin 1 mg tablet sig: one (1) tablet po once daily at 4 pm. 13. glucophage 500 mg tablet sig: one (1) tablet po once a day. 14. vancomycin 125 mg capsule sig: one (1) capsule po every six (6) hours for 9 days: 14 total days (day 1- ). last day is . discharge disposition: extended care facility: of discharge diagnosis: primary: anterior st-elevation myocardial infarction secondary: asthma, gerd, hypertension, hyperlipidemia discharge condition: good. vital signs stable. ambulated with physical therapy- cleared for rehab. discharge instructions: you were admitted to the hospital after suffering a heart attack. afterward, you developed some difficulty breathing that required a intubation. you were kept in the icu and did well. we diuresed you using lasix with good results. your chest x-rays improved daily and your shortness of breath continued to resolve. you denied any chest pain. upon discharge, you were stable and asymptomatic. the following changes were made to your medications: 1. please stop taking amiodarone 200mg by mouth twice daily 2. please stop taking toprol xl 50mg by mouth daily 3. please start taking metoprolol tartrate 12.5mg by mouth twice daily 4. please stop taking your aldactone 5. please start taking vancomycin 125mg by mouth every 6 hours for a total of 14 days (day 1- , last day is ) 6. please start taking ipratropium bromide inhaler- 2 puffs four times/day weigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: please set-up an appointment with a primary care physician of your choice (you mentioned someone in ) in weeks. , md (cardiology) phone: date/time: at 9:40am procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery esophageal reflux congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia severe sepsis atrial fibrillation asthma, unspecified type, unspecified percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia acute respiratory failure septic shock intestinal infection due to clostridium difficile acute systolic heart failure subendocardial infarction, subsequent episode of care 

Answer: The patient is high likely exposed to