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 / dilantin kapseal / codeine / cipro cystitis / ceftin / zithromax / bactrim ds / clindamycin / influenza virus vaccine / doxycycline / dicloxacillin / vancomycin / percocet attending: chief complaint: respiratory distress major surgical or invasive procedure: none history of present illness: ms. is an 85-year-old female with a history of inflammatory polyarthritis, htn, hl, s/p bowel resection for sbo, oa, ms, restrictive lung disease, c.diff, and recent admission for high grade sbo who presents from rehab with hypoxia, shortness of breath, and altered mental status. . from limited history available during initial evaluation, it appears as though patient was hypoxic into the 70s at rehab in , and was started on pna treatment with doxycycline on . labs obtained on the same day also showed a wbc of 15 and a bicarb of 40. patient was initially resistant to coming into the ed, but eventually acquiesced. . in the ed, initial vitals were: 98.4 76 168/60 24 98% 4l nasal cannula. patient was given linazolid (allergy to vancomycin) and levofloxacin for presumed hap. she was also given a stress dose of steroids as she is on prednisone at baseline. pressures dropped into the 70s and rij was placed. a fluid bolus was given and pressures came up; no pressors were started. labs were significant for a wbc of 11, a bun of 40 and creatinine of 1.2 (baseline of 0.6). troponin was elevated though only non-specific changes on ekg and patient was given asa 81. patient was confirmed dnr/dni. vitals on admission were: hr of 86, bp: 113/39, rr 29, 95% on 4l. 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 -recurrent pnas social history: she currently lives in nursing home after most recent admission. son and daughter live nearby and are involved. she has been using a wheelchair most of the time, can walk with walker. family history: no family history of pulmonary issues physical exam: admission exam vs: 97.2, 82, 119/54, 95% 5l general: elderly woman, tachypneic, ucomfortable appearing heent: mucous membranes dry chest: diffusely rhonchorous with crackles bilaterally, coughs throughout exam cardiac: rrr, no mrg abdomen: +bs, distended, non-tender extremities: no edema bilaterally discharge exam patient passed early morning of pertinent results: admission labs 10:20pm blood wbc-10.9 rbc-3.66* hgb-8.7* hct-29.4* mcv-80* mch-23.8* mchc-29.6* rdw-19.9* plt ct-363 10:20pm blood neuts-84.4* lymphs-10.7* monos-4.4 eos-0.4 baso-0.2 10:20pm blood pt-12.9* ptt-30.9 inr(pt)-1.2* 10:20pm blood glucose-128* urean-40* creat-1.2* na-143 k-3.5 cl-95* hco3-42* angap-10 10:20pm blood alt-41* ast-35 ck(cpk)-71 alkphos-70 10:20pm blood lipase-23 10:20pm blood ck-mb-4 probnp-9323* 10:20pm blood ctropnt-0.21* 10:20pm blood calcium-10.1 phos-3.9 mg-2.1 10:33pm blood lactate-1.0 discharge labs ########################## patient passed studies cxr a new central venous catheter has been placed via right internal jugular venous approach. the tip terminates in the right atrium. a right-sided picc line has been removed. the cardiac, mediastinal and hilar contours appear unchanged. there is a new patchy left basilar opacity suggesting pneumonia. otherwise background opacities show no definitive change, although there may be additional developing right basilar opacity. bony deformities are similar. impression: new line terminating in the right atrium. no evidence for pneumothorax, although a flexed chin does obscure the medial right lung apex. findings suggesting pneumonia, particularly in the left lower lung. brief hospital course: ms. is an 85-year-old woman with a pmhx. significant for inflammatory polyarthritis on prednisone, htn, hl, sbos, recent c.diff colitis, and recent pna who resides in a nursing home and presented with shortness of breath and elevated white count. . #. pneumonia: the patient was noted to be hypoxic into the 70s at rehab in . she was started on pna treatment there with doxycycline on . labs obtained on the same day showed a wbc of 15 and a bicarb of 40. ed visit was suggested but the patient was initially resistant. at the urging of her family, the patient was brought to the ed on . in the ed the patient was initially hd stable. given linezolid and levofloxacin for presumed hap. also given stress dose steroids. while in the ed the patient's sbp dropped into the 70s and rij was placed. a fluid bolus was given and pressures came up; no pressors were started. transferred to the micu. in the micu the patient was placed on linezolid and cefepime initially. the cefepime was changed to levofloxacin. the patient remained afebrile and bps remained stable. she refused a picc line. her respiratory status was tenuous and she was confirmed dnr/dni. intermittently desaturated to the 60-70% range on nasal cannula but refused face-tent or nrb. family was consulted who did not want to force the patient to accept nrb/face-tent against her wishes. picc line was also refused. on the patient continued to maintain adequate bps and was transferred to the medical floor for further management. . #. goals of care: the patient is dnr/dni. her son is her health care proxy. on admission here the paitent was refusing multiple interventions including mask ventilation and picc line placement. discussion was initiated with the patient's son and daughter who confirmed dnr/dni but were not prepared to accept comfort focused care. would like the patient to continue recieving antibiotic therapy. palliative care was consulted who met with the patient and her family. on the floor patient was made comfortable and passed a few hours after transfer to the floor. . #. elevated troponins: troponin was elevated to 0.21 on admission without worrisome ekg changes. ckmb was reassuring. likely strain in the setting of acute infection. little concern for plaque rupture given absence of st changes on ekg, chest pain, or other classic signs/symptoms of mi. continued asa and statin. . #. acute renal failure: patient with creatinine of 1.2 up from a baseline of 0.6. likely dehydration or could represent poor forward flow from chf exacerbation. resolved with fluid administration. . #. ild: continued home inhalers and pulmonary toilet . #. hyperlipidemia: continued statin medications on admission: 1. sodium phosphates 19-7 gram/118 ml enema sig: one (1) enema rectal daily (daily) as needed for constipation. 2. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 3. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 4. polyethylene glycol 3350 17 gram/dose powder sig: seventeen (17) grams po daily (daily) as needed for constipation. 5. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po daily (daily) as needed for constipation. 6. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 7. furosemide 40 mg tablet sig: one (1) tablet po daily (daily): note that prior dose was 40 and 20 , if po intake is not good may need to change back to above dosing. 8. alendronate 70 mg tablet sig: one (1) tablet po qsat (every saturday). 9. multivitamin tablet sig: one (1) tablet po daily (daily). 10. prednisone 5 mg tablet sig: 1.5 tablets po daily (daily). 11. senna 8.6 mg tablet sig: one (1) tablet po once a day. 12. cholecalciferol (vitamin d3) 1,000 unit capsule sig: one (1) capsule po once a day. 13. advair diskus 250-50 mcg/dose disk with device sig: puffs inhalation twice a day. 14. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 15. baclofen 10 mg tablet sig: one (1) tablet po tid (3 times a day). 16. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: two (2) tablet, chewable po bid (2 times a day). 17. calcitonin (salmon) 200 unit/actuation spray, non-aerosol sig: sprays nasally nasal daily (daily). 18. dronabinol 2.5 mg capsule sig: one (1) capsule po bid (2 times a day). 19. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours). 20. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 21. zofran odt 4 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po every six (6) hours as needed for nausea. 22. tizanidine 2 mg tablet sig: two (2) tablet po tid (3 times a day). 23. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). 24. duoneb 0.5 mg-3 mg(2.5 mg base)/3 ml solution for nebulization sig: one (1) nebulizer inhalation every 6-8 hours as needed for shortness of breath or wheezing. 25. acidophilus capsule sig: one (1) capsule po three times a day. 26. gabapentin 100 mg capsule sig: one (1) capsule po at bedtime as needed for pain: please give for back pain only if needed, this may cause sedation in this patient. discharge medications: patient passed discharge disposition: expired discharge diagnosis: patient expired discharge condition: patient expired discharge instructions: patient expired followup instructions: patient expired md procedure: central venous catheter placement with guidance diagnoses: pneumonia, organism unspecified unspecified essential hypertension long-term (current) use of steroids acute kidney failure, unspecified other chronic pulmonary heart diseases other and unspecified hyperlipidemia acute respiratory failure hypotension, unspecified postinflammatory pulmonary fibrosis encounter for palliative care do not resuscitate status dehydration multiple sclerosis unspecified inflammatory polyarthropathy 

Answer: The patient is high likely exposed to