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: pseudoephedrine attending: chief complaint: decreasing o2 sat major surgical or invasive procedure: none history of present illness: this is a 25 year old woman with pmh significant for chronic respiratory failure of unclear etiology who presents for direct admission to the micu with increasingly frequent episodes of desaturation. her mother says that she has had an increasing o2 requirement over the last few weeks, beginning with an episode of sinusitis in early . she had been on room air previously, but had needed to be on oxygen per trach tube and occasionally ventilated during the day more recently. in she was treated for sinusitis with doxycycline for 2 days, then changing to levofloxacin for 10 days. on monday she was started on -nebs. on she went to the ed where a cxr reportedly showed no infiltrate. dur to her mom's increasing concern over her respiratory status, it was agreed with dr. that she be directly admitted to the micu. she denies fevers, chills, shortness of breath, abdominal pain, or other concerns. past medical history: cerebral palsy, inciting event unclear chronic respiratory failure, s/p trach starting age 12, with nocturnal ventilation nonprogressive neuromuscular disease starting age 12 restrictive lung disease premature ovarian failure chronic sinusitis nephrolithiasis gerd anxiety social history: lives at home with her parents. has home health aids and nurse part time at home. her mom is her primary caretaker. physical exam: t99.3 bp 154/76 p121 r33 94% 8l tc gen: nad, lying in bed heent: perrl, eomi, op clear without thrush neck: no jvd no thyromegaly resp: crackles r base. insp/exp wheezes throughout cv: rrr nl s1s2 no mgr abd: soft ntnd +bs ext: no edema skin: no rash neuro: cn 2-12 intact. not able to move legs. hands in extended position, cn squeeze to command. responsive with 1-2 work phrases and cooperative. pertinent results: 06:22a 141 103 10 / agap=10 --------------- 110 4.1 32 0.4 \ ca: 9.4 mg: 2.0 p: 3.3 other blood chemistry: cortsol: 17.8 normal diurnal pattern: 7-10am 6.2-19.4 / 4-8pm 2.3-11.9 91 10.3 \ 13.8 / 204 / 40.7 \ pt: 12.8 ptt: 28.3 inr: 1.0 other hematology d-dimer: 230 01:15a 142 100 10 / agap=9 -------------104 4.0 37 0.5 \ ca: 9.9 mg: 2.2 p: 3.3 alt: 25 ap: 89 tbili: 0.3 alb: 4.6 ast: 23 ldh: 190 dbili: tprot: : lip: tsh:1.0 92 10.0 \ 15.0 / 220 / 46.2 \ n:70.6 l:20.8 m:6.4 e:0.6 bas:1.5 12:39a ucg: negative comments: for quantitation of positives, send serum for hcg color straw appear clear specgr 1.013 ph 7.0 urobil neg bili neg leuk neg bld neg nitr neg prot neg glu neg ket neg rbc 2 wbc 0 bact occ yeast none epi 3 other urine counts mucous: rare 12:39am urine ucg-negative 4:07 pm sputum site: endotracheal gram stain (final ): >25 pmns and <10 epithelial cells/100x field. no microorganisms seen. respiratory culture (preliminary): no growth. 12:08 pm sputum site: endotracheal source: endotracheal. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. no microorganisms seen. respiratory culture (final ): no growth. 12:39 am urine **final report ** urine culture (final ): mixed bacterial flora ( >= 3 colony types), consistent with skin and/or genital contamination. cardiology echo conclusions: the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. ecg technically difficult study sinus tachycardia rsr'(v1) - probable normal variant borderline intraventricular conduction delay nondiagnostic inferior q waves inferior/lateral t changes radiology ct sinus/mandible/maxillofacial w/o contrast impression: 1. small polyps or mucus retention cysts within the left frontal sinus. 2. minimal mucosal thickening involving the sphenoid sinus and left maxillary sinus. radiology ct chest w/o contrast impression: 1. significant rotary scoliosis to the thoracic spine with fusion and bilateral rods. this scoliosis significantly deforms the chest wall and thoracic cavity which reduces the lung volumes. 2. no evidence of bronchiectasis or parenchymal disease. radiology chest (portable ap) findings: no prior comparisons. scoliosis status post fusion with type rods. allowing for this, the heart is probably within the upper limits of normal for overall size. no florrid chf is appreciated. no obvious consolidating pulmonary infiltrates are identified. the tip of the tracheostomy tube appears in unremarkable position approximately 5 cm above the carina. impression: no obvious acute process identified. brief hospital course: 1) falling o2 sats/increased sputum production - the patient has a complicated respiratory history. her baseline is apparently on room air before 3 months ago per her mother, and she is generally ventilated only at night. on admission, she appeared comfortable on 8l tc with a stable o2 sat on exam. her hco3 was noted to be high at 37 and she is presumably retaining co2. she had a negative d-dimer. her nif was measures at -16 and vc was 900 cc. to rule out parynchymal pathology, a ct was performed which showed decreased lung volumes and scoliosis but no parynchymal disease. given her history of sinusitis, a sinus ct was performed which showed minimal thickening of the left sinuses and a polyp in the left frontal sinus. she was continued on her home dilators and sinus medications and suctioned as needed, more than every 4 hours. some secretions and mucus plugs were noted. she was thought to have more than usual oral/nasal secretions and started on 21 day course of levofloxacin for possible sinusitis, and atrovent spray in the mouth and nose to decrease nasal secretions. her mother was given specific care recommendations at discharge, reflected below. 2) tachycardia - new according to patient's mother, as she used to be bradycardic at home. tsh normal. echo normal. her rate fluctuated over the course of the hospitalization from 80-140 but she was asymptomatic. 3) cerebral palsy - topamax was continued. the patient was able to move her hands and mouth, and respond in one word phrases, or use facial expressions for yes/no answers while her trach collar was inflated. 4) premature ovarian failure. hcg was negative. estrogen patch was continued. 5) gerd - protonix was substituted for nexium. medications on admission: nebs 300 mg/5 ml inhalation vivelle-dot0.025 mg/24 hr transdermal qmon and qfri multivitamins with iron 1 cap po daily fexofenadine 60 mg po bid nexium 20 mg po bid fluticasone propionate 110mcg 2 puff ih albuterol 0.083% neb soln 1 neb ih mupirocin cream 2% 1 appl tp to trach stoma montelukast sodium 10 mg po daily topiramate 50 mg po bid astelin 137 mcg/spray nu 2 sprays nasacort 2 sprays nu calcium carbonate 500 mg po qd elidel *nf* 1 % topical to face discharge medications: 1. elidel 1 % cream sig: one (1) thin layer topical once a day: to cheeks. 2. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po qd (). 3. topiramate 25 mg tablet sig: two (2) tablet po bid (2 times a day). 4. montelukast sodium 10 mg tablet sig: one (1) tablet po daily (daily). 5. mupirocin calcium 2 % cream sig: one (1) appl topical (2 times a day): (bactroban). 6. albuterol sulfate 0.083 % solution sig: one (1) nebs inhalation twice a day as needed: and q2h prn. 7. nexium 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 8. fexofenadine hcl 60 mg capsule sig: one (1) capsule po bid (2 times a day). 9. multivitamin capsule sig: one (1) cap po daily (daily): with iron. 10. estradiol 0.05 mg/24 hr patch biweekly sig: one (1) patch biweekly transdermal qmon and qfri (): (vivelle dot). 11. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 18 days: take 4 hours before or after calcium supplements. disp:*18 tablet(s)* refills:*0* 12. azelastine hcl 137 mcg/spray aerosol, spray sig: two (2) sprays each nose nasal 2 sprays qhs (). 13. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours) as needed. 14. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) sprays inhalation three times a day: please deliver to each nostril and mouth to decrease secretions. . disp:*1 actuator* refills:*6* 15. nasacort aq 55 mcg/actuation aerosol, spray sig: two (2) sprays each nostril nasal once a day. 16. flovent 220 mcg/actuation aerosol sig: two (2) puffs inhalation twice a day. discharge disposition: home with service facility: denmarks discharge diagnosis: mucus plugging and inability to tolerate secretions sinus tachycardia with normal echo chronic respiratory failure secondary to nonprogressive neuromuscular disease, s/p trach starting age 12 cerebral palsy restrictive lung disease premature ovarian failure chronic sinusitis nephrolithiasis gerd anxiety discharge condition: patient was satting 96% on 34% via trach collar, and 87-88% off oxygen. she wanted to return home and felt better. she was still having secretions. the discharge instructions were reviewed in detail with her family, and her mother was prepared and had no hesitation about taking care of her at home. discharge instructions: you may return home with services. please read treatments section for specific instructions on treatments. please finish a 21 day course of levoquin. please return to the emergency department or contact dr. if the patient has shortness of breath or respiratory distress despite therapy, or other concerns. followup instructions: with dr. as scheduled below, or in the next week if possible. provider: , internal medicine where: off campus internal med. date/time: 1:30 with dr. as scheduled or next available. provider: , m.d. where: rehab services (dyspnea) phone: date/time: 12:00 with dr. ( ent) next week as scheduled. with ear/nose/and throat, next available suggestions include: , m.d. ( , m.d. ( md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: esophageal reflux chronic respiratory failure tracheostomy status infantile cerebral palsy, unspecified unspecified sinusitis (chronic) other tracheostomy complications other ovarian failure 

Answer: The patient is high likely exposed to