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: history of present illness: a 46-year-old woman with a history of asthma, status post multiple intubations and tracheostomy in , osa, cad, type 2 diabetes mellitus who presents with 2 days of progressive shortness of breath. the patient was admitted on through ; during which she was intubated for hypercarbic respiratory failure. during that admission she received steroids, albuterol, and atrovent with improvement allowing extubation and transfer to the floor. however, her respiratory status again worsened and she was readmitted to the micu for bipap. she was also noted to have several episodes of laryngeal spasm management with inhalers, racemic epinephrine, and inhaled ativan. an airway ct showed tracheal narrowing 10 mm to 4 mm with exhalation. ip did a rigid bronchoscopy which showed a large amount of granulation tissue in the trachea. the patient refused the plan to take her to the or for debridement of the granulation tissue and possible airway stent placement and was discharged on a prednisone taper, to follow up with her pcp. the patient reports that she has noticed worsening of her baseline dyspnea over the past 2 days, improved with inhalers. she reports that a relative has recently been ill with an upper respiratory infection, but denies a personal history of cough, sputum production, fevers, chills, myalgias, chest pain, palpitations, diaphoresis, nausea, vomiting, abdominal pain. history is limited secondary to a decrease in the patient's mental status, despite the use of an interpreter. in the ed, her temperature was 99.1, heart rate was 107, blood pressure was 126/64, breathing 15 times a minute, and saturating 75% on room air. she received solu-medrol 125 mg iv x 1 and combivent nebulizers x 3. she was placed on bipap at her home settings of 15 and 5. about 1 hour after placement of bipap, abg was 7.18/136/113. she was given a chest x-ray which showed prominent hilar vasculature, and the patient was treated with lasix 20 mg iv for suspected chf. past medical history: 1. asthma, status post multiple intubations and tracheostomy in . 2. osa, on bipap 15 and 5 at night. 3. tracheal stenosis; discovered by airway ct on ; findings consistent with focal tracheal stenosis with a component of malacia associated with disruption of tracheal cartilage. 4. diastolic congestive heart failure. 5. cad; ef of 65% with a small inferolateral wall reversible defect per persantine mibi in . 6. type 2 diabetes mellitus. 7. vitamin b12 deficiency. 8. status post appendectomy. 9. lumbar djd. 10. psychotic disorder not otherwise specified. physical examination on admission: temperature of 98, pulse of 118, blood pressure of 165/100, respiratory rate of 24, and o2 saturation of 99% on bipap (15 and 5). in general, an obese middle-aged spanish-speaking woman who was speaking in short sentences. bipap in place. moderate respiratory distress. heent revealed anicteric. pupils were equal and minimally reactive to light. normal conjunctivae. bipap in place. oral mucous membranes dry. the oropharynx was clear. the neck was supple. no lymphadenopathy. no jvd. cardiac revealed regular s1 and s2. no murmurs, rubs, or gallops. pulmonary with decreased breath sounds throughout with occasional wheezes. the abdomen with positive bowel sounds. soft, nontender, and nondistended. extremities were warm. dorsalis pedis pulses of 2+ bilaterally. no edema. neurologic limited by patient cooperation. positive coarse tremor. moved all four extremities equally. sensation grossly intact proximally and distally in the upper and lower extremities bilaterally. pertinent results: ekg: sinus tachycardia at 109 beats per minute, normal intervals, t wave inversion in avl, q wave in lead iii. no significant change since . a chest x-ray: bilateral increased hilar vascularity with in infiltrates. brief hospital course: 1. asthma exacerbation: the patient was admitted with dyspnea, hypercarbia, and hypoxia secondary to an asthma exacerbation. there was no evidence of precipitating event. there was no evidence of pneumonia. flu dfa was negative, and the patient ruled out for mi by cardiac enzymes and normal ekg. she was initially admitted to the micu and maintained on bipap resulting in good oxygenation and ventilation. she was also treated with albuterol and atrovent aerosols and a steroid taper, beginning with solu- medrol and tapering to prednisone over her hospital course. her dyspnea showed important over her 3 days in the micu such that she was called out to the medicine floor for ongoing care. on the medicine floor, she appeared to be at her baseline respiratory status. she was treated with a 5-day course of azithromycin, which she completed before her discharge from the hospital. at discharge, the patient appeared to be at her baseline respiratory status with no acute dyspnea. she was to continue atrovent and albuterol aerosols and was to continue a prednisone taper over a period of 2 weeks after discharge. 1. tracheal obstruction: the patient had a known tracheal obstruction on admission that was discussed on airway ct. she had previously refused operative intervention, but agreed to further investigation on this admission. she underwent a rigid bronchoscopy on that demonstrated 70% tracheal obstruction secondary to granulation tissue that had presumably resulted from prior tracheostomy. during her rigid bronchoscopy, the obstructing granulation tissue was dilated resulting in decreased tracheal obstruction and good airflow. it is suspected that the dilatation will allow stabilization of the patient's acute illness and weaning of her steroid taper before her obstruction can be definitively treated with surgery in 1 to 2 months after discharge. at discharge, there was no evidence of stridor or complication of airway obstruction. the patient was discharged with instructions to follow up in the interventional pulmonary clinic to assess the timing of surgical intervention. 1. diabetes mellitus type 2: the patient was initially treated with an insulin drip while in the micu for tight glucose control. when she was called out to the medicine floor, she was started on her home regimen of glargine insulin and covered with a humalog insulin sliding scale with good affect. 1. coronary artery disease: the patient had no ekg changes on admission, and ruled out for a mi by normal cardiac enzymes. however, given report of minor reversible defect on prior persantine mibi and the need for clearance for upcoming surgery the patient underwent a persantine mibi on that demonstrated normal cardiac perfusion with no reversible perfusion defects. during her admission, treatment was continued with the patient's outpatient doses of aspirin, lipitor, captopril, and lopressor. 1. hypertension: controlled during admission with outpatient dose of captopril. 1. schizoaffective disorder: the medical team contact the patient's psychiatric case worker during this admission and clarified that the patient suffers schizoaffective disorder. the patient was intermittently agitated over this admission with occasional myoclonic jerks that were a baseline symptom, according to her pcp. was treated with her outpatient dose of paxil with good affect, and zyprexa was used intermittently for acute agitation. 1. code status: full code during this admission. discharge status: stable to go home, at baseline respiratory status with no evidence of infection. primary discharge diagnoses: 1. asthma exacerbation. 2. tracheal obstruction. secondary discharge diagnoses: 1. diabetes mellitus type 2. 2. coronary artery disease. 3. hypertension. 4. schizoaffective disorder. medications on discharge: 1. ipratropium bromide actuation aerosol 2 inhalations q.4.h. 2. atorvastatin 10 mg p.o. daily. 3. paroxetine 40 mg p.o. daily. 4. aspirin 81 mg p.o. daily. 5. folic acid 1 mg p.o. daily. 6. pantoprazole 40 mg p.o. daily. 7. tiotropium bromide 1 inhalation daily. 8. lisinopril 10 mg p.o. daily. 9. metoprolol 25 0.5 tablets p.o. b.i.d. 10. ambien 5 mg p.o. at bedtime p.r.n. 11. prednisone taper: 40 mg for 3 days, then 30 mg for 3 days, then 20 mg for 3 days, then 10 mg for 3 days, then stop. 12. levalbuterol solution 1 inhalation q.4.h. p.r.n. 13. ipratropium bromide solution 1 inhalation q.6h. p.r.n. 14. glargine insulin take 65 units before breakfast and 20 units before dinner. discharge follow-up plans: 1. follow up with your pcp, . , in 2 weeks. 2. follow up with dr. in ct surgery clinic in 3 to 4 weeks to plan for surgery to treat your tracheal stenosis. , dictated by: medquist36 d: 13:43:07 t: 14:51:36 job#: procedure: non-invasive mechanical ventilation other operations on trachea bronchoscopy through artificial stoma diagnoses: congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute respiratory failure long-term (current) use of insulin chronic obstructive asthma with (acute) exacerbation schizoaffective disorder, unspecified mechanical complication of tracheostomy 

Answer: The patient is high likely exposed to