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: adhesive tape / ativan attending: chief complaint: s/p cardiac arrest, ? need for plasmapheresis major surgical or invasive procedure: laryngoscopy. flexible bronchoscopy with secretion aspiration. rigid bronchoscopy and button-on tracheostomy placement. history of present illness: this is a 54 yo female with history of myasthenia , tracheomalacia s/p y stent placement, history of multiple admissions for respiratory failure presents from osh s/p cardiac arrest. she was in her usual state of health until about 2 days prior to her presentation at osh, when she began to have sob associated with greenish brownish sputum. on , she activated ems. upon ems arrival, she was apparently noted to be in pea arrest. received cpr, epinephrine, atropine and had lma placed. in ed at osh, had lma tube exchanged for ett. ett then noted to be placed outside of y stent. bronchoscopy performed and ett replaced over stent and secretions removed. x-rays thought to be consistent with bilateral infiltrates c/w ards. she was treated with vancomycin and zosyn for pneumonia, apparently required pressors briefly. culture data negative. she was extubated today on the day of transfer without event. pt was also noted to have new global cm with ef 20%, thought to be seconadry to sepsis per osh cardiology c/s and started on asa, lisinopril. currently denies sob, chest pain, palpitations. she does not recall the events leading up to her hospitalization. ros: the patient denies any fevers, chills, weight change, nausea, vomiting, abdominal pain, diarrhea, constipation, melena, hematochezia, chest pain, orthopnea, pnd, lower extremity oedema, cough, urinary frequency, urgency, dysuria, lightheadedness, gait unsteadiness, focal weakness, vision changes, headache, rash or skin changes. past medical history: --myasthenia (+musk ab): dx , treated with pyridostigmine, prednisone, cellcept, ivig, plasmapheresis; difficult fibroscopic intubation, unable to tolerate bipap. --tracheomalacia s/p flexible and rigid bronchoscopy with stent placement on , y stent replacement --sinus tachycardia when awake or anxious, thought to autonomic instability from myasthenia --dmii, diet controlled, on iss while on steroids --anxiety --gerd --obesity --anxiety --s/p cholecystectomy, appendectomy, tonsillectomy --nephrolithiasis social history: no smoking, etoh, illicit drug use. lives alone. does not use home o2 since she has a gas stove, feels uncomfortable with bipap. used to work as a case manager. family history: father with cad and dm, brother with bronchitis, no family hx of myasthenia , autoimmune disease. physical exam: vs: 96.8 96/40 80 20 99% 2l gen: nad, not using accessory muscles to breathe heent: perrl, sclera anicteric, mmm, o/p clear neck: no lad cor: rrr nl s1 s2 no m/r/g pulm: rhonchorous bronchial sounds diffusely abd: obese, soft, nt nd ext: +dp and pt pulses b/l neuro: alert, oriented x 3. mild eyelid droop, cn otherwise in tact,5/5 strength upper and lower extremities. neck extension and flexion. pertinent results: 01:26am blood wbc-5.9# rbc-3.83*# hgb-10.5* hct-32.5*# mcv-85 mch-27.5 mchc-32.4 rdw-20.4* plt ct-156# 07:20am blood wbc-5.9 rbc-4.11* hgb-11.4* hct-34.3* mcv-83 mch-27.6 mchc-33.1 rdw-19.5* plt ct-160 07:05am blood wbc-6.6 rbc-4.00* hgb-11.5* hct-33.6* mcv-84 mch-28.7 mchc-34.2 rdw-19.8* plt ct-308# 06:45am blood wbc-5.4 rbc-4.09* hgb-11.2* hct-34.2* mcv-84 mch-27.4 mchc-32.7 rdw-19.9* plt ct-411 08:05am blood wbc-5.8 rbc-3.80* hgb-10.6* hct-32.0* mcv-84 mch-28.0 mchc-33.3 rdw-19.0* plt ct-296 01:26am blood pt-13.3 ptt-30.4 inr(pt)-1.1 07:20am blood pt-13.1 ptt-30.9 inr(pt)-1.1 01:26am blood glucose-44* urean-19 creat-0.5 na-140 k-3.5 cl-100 hco3-32 angap-12 07:20am blood glucose-104 urean-13 creat-0.5 na-142 k-3.3 cl-104 hco3-33* angap-8 07:05am blood glucose-121* urean-16 creat-0.6 na-141 k-4.3 cl-101 hco3-32 angap-12 06:45am blood glucose-118* urean-11 creat-0.6 na-139 k-4.3 cl-98 hco3-34* angap-11 08:05am blood glucose-102 urean-12 creat-0.7 na-139 k-4.0 cl-101 hco3-32 angap-10 01:26am blood alt-37 ast-22 alkphos-57 totbili-0.4 01:26am blood calcium-7.9* phos-3.2 mg-2.1 07:20am blood calcium-8.2* phos-2.2* mg-1.9 06:45am blood cholest-149 06:45am blood triglyc-167* hdl-40 chol/hd-3.7 ldlcalc-76 01:26am blood tsh-0.53 01:26am blood ferritn-37 . imaging: . cxr :findings: there is a right ij catheter with tip in the superior vena cava. there is a orogastric tube, with tip in the stomach. linear opacity is present at the left base, likely representing discoid atelectasis. similar opacity is present at the right base. otherwise, there is no gross infiltrate or effusion. there is no pneumothorax. impression: likely atelectasis as described above. support lines and tubes as described above. . cxr : findings: the subsegmental atelectatic changes do not appear differently compared to the prior study. a right cvl has been removed, and there is no ptx. i do not clearly see the y-stent on this radiograph. however, i do note a narrowing of the trachea just above the carina overlying vertebral body interspace t4-5, a finding that was not apparent on the prior study. impression: new apparent narrowing of the trachea just above the carina at the t4-5 interspace level. ct scan might be helpful in further evaluation. status post line removal. no interval change in basilar atelectatic features. . cxr : findings: ap single view obtained with patient in sitting semi-upright position is analyzed in direct comparison with a preceding similar study of . a metallic ring shape, approximately 1.5 cm diameter, structure has been placed in the trachea at the level of c7. there is no evidence of any pneumothorax or soft tissue emphysema in the lower neck area. comparison with the preceding study, heart size is unchanged. there is no evidence of pulmonary vascular congestion. plate atelectasis on left base without significant progression. lateral pleural sinuses are free. no new parenchymal infiltrates. as on previous examination a simple radiograph does not clearly identify the previously mentioned y-shaped tracheobronchial stent. a certain degree of narrowing is present as it was described before. impression: no pneumothorax or any other significant changes status post bronchoscopy. . tte : the left atrium is dilated. left ventricular wall thicknesses and cavity size are normal. there is moderate global left ventricular hypokinesis (lvef = 30-35 %). 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. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: moderate global hypokinesis (the septum may have relatively worse function). mild mitral regurgitation. compared with the prior study (images reviewed) of , hypokinesis is now global and overall ef has decreased slightly. brief hospital course: # respiratory distress and cardiomyopathy s/p pea arrest - initially transferred from osh to icu on after extubation and treatment of ards/sepsis with iv antibiotics. as clinical status had improved and cxrs were clear, iv abx were stopped. echocardiogram at osh showed global hypokinesis w/ ef 20-25%, decline from baseline ef 45% on echo in , and thought due to a septic state at the osh. repeat echocardiogram prior to discharge showed partial improvement to ef 30-35%. a tsh was checked and was normal. patient was continued on home diuretic. no hemodynamic instability (sinus tachycardia discussed below) or breathing difficulties. . # airway clearance: evaluted by interventional pulmonology with significant mucous plugging cleared by bronchoscopy on , likely precipitant of pea arrest on . pt underwent a button-hole tracheostomy placement on for self-suctioning at home. received mucomyst and saline nebs while hospitalized, however did not tolerate mucomyst due to taste/smell. physical therapy evaluated and cleared patient. teaching was provided concerning self-suctioning by respiratory therapy and interventional pulmonology. . # myasthenia - on transfer to icu, evalauted by neurology service who found myasthenia to be well-controlled with no indications for plasmapheresis or ivig. remained clinically well with no diplopia or other cn palsies or overt muscle fatiguability and good nif's while hospitalized. stayed on her home regimen of azathioprine, prednisone, pyridostigmine. bactrim prophylaxis had been initially held due to illness but was restarted prior to discharge. . # throat soreness: developed after extubation and noted by ent to have viral pharyngitis, with pink/white papules and non-displacable plaques. sent throat cx for strep, hsv, and other viruses. started nystatin, acyclovir, and fluconazole for possible candidal and hsv pharyngitis. pain relief provided with visouc lidocaine. throat cultures negative for strep and + for hsv. fluconazole and acyclovir were continued on discharge for 7 day courses. . # s/p nstemi: noted to have an nstemi on presentation to osh in pea arrrest (), thought likely related to demand ischemia. was started on aspirin 81 mg. lipid profile was normal. . # diarrhea: on , had multiple bouts of abdominal cramping followed by watery, non-bloody diarrhea, w/ resolution of cramping with bowel movement, with resolution by afternoon. no further bowel movements to test for c. diff. . # sinus tachycardia: long-standing sinus tachycardia thought due to autonomic instability from myasthenia . while hospitalized, hr ranged at baseline was 100's-110's with no symptoms/complaints. . # diabetes mellitus, type ii: diet-controlled at home and placed on insulin sliding scale while hospitalized and on prednisone, with blood sugar's in 100's-200's. . # asthma: was well-controlled without symptoms/complaints and was continued on fluticasone nasal spray, ipratropium nebs. albuterol nebs were not given due to baseline sinus tachycardia, and xopenex nebs were given instead. . # gerd: was at baseline during stay, continued ppi treatment. medications on admission: medications at time of transfer: asa 325 calcium carbonate 1250 tid fluticasone 50 lasix 20 qd hycosamine 0.125 glargine 20 units qhs atrovent 1 neb lansoprazole 30 lisinopril 2.5 ativan 2 q4h prn mestinon 60 qid morphine 2 mg q4h prn mucinex 1200 mg omeprazole 40 paroxetine 15 zosyn vancomycin azathioprine 100 methylprednisolone 125 discharge medications: 1. portable suction machine with supplies needs portable suctions for health care appointment for 6 hours/week dx: myasthenia , tracheobronchomalacia medicaid id# 2. fosamax 70 mg tablet sig: one (1) tablet po once a week: on sunday. tablet(s) 3. acyclovir 400 mg tablet sig: one (1) tablet po five times a day for 5 days. disp:*25 tablet(s)* refills:*0* 4. fluconazole 100 mg tablet sig: one (1) tablet po every twenty-four(24) hours for 5 days. disp:*5 tablet(s)* refills:*0* 5. furosemide 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 6. mucinex 1,200 mg tab, multiphasic release 12 hr sig: one (1) tab, multiphasic release 12 hr po twice a day. disp:*60 tab, multiphasic release 12 hr(s)* refills:*2* 7. bactrim ds 160-800 mg tablet sig: one (1) tablet po 3x/week on mwf. disp:*90 tablet(s)* refills:*2* 8. lidocaine hcl 2 % solution sig: one (1) ml mucous membrane qid (4 times a day) as needed for throat pain for 7 days. disp:*140 ml(s)* refills:*0* 9. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) for 7 days. disp:*140 ml(s)* refills:*0* 10. hyoscyamine sulfate 0.125 mg tablet, sublingual sig: tablet, sublinguals sublingual qid (4 times a day) as needed. 11. fluticasone 50 mcg/actuation spray, suspension sig: two (2) spray nasal daily (daily). 12. paroxetine hcl 30 mg tablet sig: 0.5 tablet po daily (daily). 13. prednisone 20 mg tablet sig: two (2) tablet po daily (daily). 14. calcium carbonate 500 mg (1,250 mg) tablet sig: one (1) tablet po daily (daily). 15. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 16. pyridostigmine bromide 60 mg/5 ml syrup sig: one (1) po q6h (every 6 hours). 17. azathioprine 50 mg tablet sig: two (2) tablet po bid (2 times a day). 18. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 19. k-dur 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po twice a day. discharge disposition: home with service facility: homecare discharge diagnosis: myasthenia . pea arrest. respiratory distress. tracheostomy placement. discharge condition: stable with baseline vital signs. able to ambulate without assistance. discharge instructions: you were transferred to the medical center for further management of your respiratory failure and myasthenia after cardiac arrest on . you came from another hospital after being extubated. while here, you were initially in the icu and the antibiotics you were receiving were stopped, as your chest x-rays showed significant improvement, with no fluid or infection in the lungs. you were evaluated by the neurology service, who felt your myasthenia was well-controlled and did not recommend urgent plasmapheresis or ivig treatment. you underwent laryngoscopy by the ent service on , who felt you had a viral infection/inflammation of your throat. you also underwent bronchoscopy by the interventional pulmonology service on with thick secretions cleared and had a new button-on tracheostomy placed on . we continued giving you your medications for your myasthenia . for your throat soreness, we gave you medications to help numb the pain and treat possible viral and fungal infections. you should complete the full course of these medications, acyclovir and fluconazole, unless instructed to stop by your physician. ultrasound of your heart on showed that you have gained back some of your pump function, though it has not yet completely normalized. it is important that you talk to your physician about getting repeat echocardiogram in several months. . you should continue to do suctioning through your tracheostomy at home as you practiced in the hospital and continue to do saline nebulizer treatments at least 3 times daily. . if you experience increased cough or secretions, of breath, wheezing, worsening or persistent sore throat, inability to swallow, neck pain, chest pain, nausea, vomiting, diarrhea or abdominal pain, or weakness, seek immediate medical attention. followup instructions: you have the following appointments scheduled with providers, including plasmapheresis next week. . provider: ,bed four rooms date/time: 10:15 provider: ,bed three rooms date/time: 10:15 provider: ,chair five rooms date/time: 10:15 . you have an appointment with your neurologists, dr. and on at 10am on the eighth floor of the building. . on the same day as your neurology appointment, you have a follow-up appointment with the ear nose and throat specialist, dr. on at 1:15om on the of the at . . you have an appointment with your primary care doctor, dr. , on at 4:00 pm. . you have an appointment with your interventional pulmonary physicians, . and , on at 8:30 am. procedure: laryngoscopy and other tracheoscopy temporary tracheostomy closed [endoscopic] biopsy of bronchus diagnoses: other primary cardiomyopathies subendocardial infarction, initial episode of care esophageal reflux diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled asthma, unspecified type, unspecified candidiasis of mouth anxiety state, unspecified diarrhea obesity, unspecified chronic respiratory failure other diseases of trachea and bronchus foreign body in respiratory tree, unspecified herpes simplex with other specified complications inhalation and ingestion of other object causing obstruction of respiratory tract or suffocation myasthenia gravis without (acute) exacerbation 

Answer: The patient is high likely exposed to