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: ms is an 85 year old nursing home patient with a past medical history significant for stroke, hypertension, chronic obstructive pulmonary disease who came in on , for a percutaneous endoscopic gastrostomy tube replacement. the patient was intubated for the procedure and after the procedure the patient was extubated and was maintaining good oxygen saturation of about 92 to 94% on 2 liters of oxygen through the nasal cannula. all of a sudden the patient became apneic and a chest x-ray was obtained which showed a right upper lung collapse which appeared to be secondary to some bronchial mucous plugging. at that time it was decided to reintubate the patient and the patient was reintubated and a bronchoscopy was done and a significant amount of secretion/bronchial mucous plugging was removed. a repeat chest x-ray was done which showed reinflation of the right upper lobe after the bronchoscopy. at that time the patient was in the post anesthesia care unit. in addition, the patient also became very hypotensive and was started on lopressor, neo, 1 mcg/kg/min and her blood pressure improved from systolic of 60s to 70s to 110s. the patient also has a history of methicillin-resistant staphylococcus aureus colonization in the past and so the surgery team who did the percutaneous endoscopic gastrostomy tube replacement contact the intensive care unit and asked the patient to be transferred to the intensive care unit for further workup and evaluation. past medical history: left atrial myxoma, stroke, hypertension, recurrent pneumonia, chronic obstructive pulmonary disease, diverticulosis, breast cancer, status post left mastectomy, questionable gastric cancer, hiatal hernia, left proximal humeral fracture, status post wide cataract surgery. medications on admission: trazodone 50 mg p.o. q.d., paxil 20 mg p.o. q.d., aspirin 81 mg p.o. q.d., neurontin 600 mg p.o. t.i.d., calcium carbonate 650 mg p.o. b.i.d., albuterol, atrovent nebulizers, timoptic 0.5%, xalatan 0.005%, multivitamin one tablet p.o. q.d. allergies: digoxin and erythromycin physical examination: physical examination on admission, in general the patient was intubated, was awake and responded to some verbal commands. head, eyes, ears, nose and throat, pupils equal, round and reactive to light and accommodation. jugulovenous distension is flat, no lymphadenopathy noted. lungs, mild wheezing in the bilateral lower lobes. heart, s1 and s2, regular rate and rhythm, no murmurs, rubs or gallops heard. abdomen, soft, nondistended, nontender, no hepatosplenomegaly noted. positive percutaneous endoscopic gastrostomy tube on the left side. extremities, no edema, no cyanosis and no clubbing, 2+ distal pulses. laboratory data: on admission white count was 24.9, hematocrit 41.7, platelets 542, sodium 135, potassium 4.6, chloride 98, bicarbonate 25, bun 27, creatinine 1.0, glucose 274, calcium 9.0, phosphorus 6.6, magnesium 2.0, pt 12.6, ptt 26.9, inr 1.1. electrocardiogram, normal sinus rhythm, sinus tachycardiac to 110s, no st elevation noted, normal intervals. chest x-ray, no evidence of pneumothorax, resolution of right upper lung collapse as compared to the previous x-ray that was done prior to the reintubation. hospital course: pulmonary, the patient was initially intubated for the procedure. after the procedure the patient was extubated but became apneic and her oxygen saturation dropped and her chest x-ray showed a right upper lobe collapse, and so the patient was reintubated and a bronchoscopy was done with a significant amount of mucous clubbing, secretions were removed. a repeat chest x-ray after the bronchoscopy showed reinflation of the right upper lobe. an attempt was made on , to extubate the patient but the patient failed secondary to increase of secretions and at that time it was also thought to volume overload. the patient was receiving a significant amount of fluid boluses because of the patient was hypotension, and as we were trying to wean off of the pressor, she was getting more and more fluid. after the failure of extubation on , it was decided to extensively diurese the patient and treat the patient for her secretions. initially the patient was on assist control but then she would be switched over to pressor support of 15 or pressor support of 10, positive end-expiratory pressure of 5, fio2 of 35% and the patient would tolerate that well. however, whenever an attempt was made to wean her off of mechanical ventilation by lowering the pressor support to 5, the patient would become tachypneic, tachycardiac and the title volumes would decrease and the patient would not tolerate that very well. despite multiple attempts to wean off of her mechanical ventilation an extensive discussion was held with the family in which it was decided that if we would try to extubate her one more time and she would fail extubation, what would be the next thing to do. at that time her two sons, and , had reached an agreement to go ahead and extubate the patient and if the patient would fail extubation we would make her comfortable but they would not want her to go ahead with any trach at that point. on at around 10:15 am the patient was extubated and after extubation the patient was doing well. her oxygen saturations were 96 to 98% on 2 liters through the nasal cannula cardiovascular - rate and rhythm, the patient was mostly normal sinus rhythm and would get occasional premature atrial contractions and premature ventricular contractions. electrolytes would need to be rechecked and repeated as needed. ischemia, no ischemic changes or signs noted on electrocardiogram. pump, the patient was initially on a pressor, neo 1 mcg/kg/min, however, that was weaned off within a day or two after the patient transferred to the intensive care unit. the patient also received multiple fluid boluses to help her maintain her blood pressure. infectious disease - the patient is known to have a baseline white blood cell count between the range of 9 to 11. initially on admission to the intensive care unit her white count was 25.6. at that time we decided to start her on broad coverage of levofloxacin and flagyl for questionable aspiration pneumonia since she did have the bronchial plugging that lead to the right upper lung collapse. however, that was discontinued in one day or two when the white count came down significantly. at that time it was thought that the reason why she had a elevated white count of 25.6 was probably secondary to the stressfulness of the procedure. in addition, the patient was also started on vancomycin initially at 1 gm q. 12 hours for her known methicillin-resistant staphylococcus aureus colonization. a vancomycin trough level was obtained which was slightly elevated and so based on the pharmacy recommendations, her vancomycin was changed to 1 gm q. 24 hours. in addition on , the patient was also started on cefepime 2 mg intravenously q. 12 for pseudomonas coverage since her sputum grew out mild to moderate pseudomonas aeruginosa which was sensitive to cefepime and mild to moderate methicillin-resistant staphylococcus aureus. gastrointestinal - the patient is questionable status post gastric cancer, needs further verification. the patient has a percutaneous endoscopic gastrostomy tube placed. dressings were changed as per protocol and the patient has been receiving tube feeds through that without any difficulty. heme - hematocrit had fallen from 40 to 29. it was initially thought that this drastic fall is secondary to overhydration since the patient was becoming hypotensive. iron studies were obtained which were found to be unremarkable. since then her hematocrit had been in the range of anywhere between 25 to 30. the patient was not transfused any units of blood. fluids, electrolytes and nutrition - as mentioned earlier the patient received multiple boluses since she was initially hypotensive. her baseline blood pressure is found to be anywhere between systolics of 80s and 90s. the patient was also given lasix 20 mg p.o. b.i.d. to help with the diuresis since we thought she was volume overloaded. in addition, the patient is also getting tube feeds through the percutaneous endoscopic gastrostomy tube and she was having her electrolytes checked, usually b.i.d. and repeated as needed since she was on the lasix. contact - son , phone . prophylaxis - the patient was on subcutaneous heparin and proton pump inhibitors. code - the patient is do-not-resuscitate, do-not-intubate. laboratory data the day before discharge revealed a white count of 11.5, hematocrit 29.7, platelets 537, sodium 138, potassium 4.2, chloride 101, bicarbonate 28, bun 19, creatinine 1.0 and glucose 91. calcium 8.5, magnesium 2.0, phosphorus 4.9. discharge medications: 1. cefpodoxime 400 mg b.i.d. times seven days 2. colace 100 mg p.o. b.i.d. 3. ferrous sulfate 325 mg p.o. q.d. 4. flovent 110 mcg 6 puffs i.h. b.i.d. 5. timolol 0.5% one drop left eye b.i.d. 6. heparin 5000 units subcutaneously b.i.d. 7. prevacid 30 mg p.o. q.d. 8. aspirin 81 mg p.o. q.d. 9. miconazole nitrate to be applied for yeast infection 10. trazodone 50 mg p.o. q.h.s. prn 11. miconazole powder 2% apply q.i.d. prn to affected area 12. neurontin 600 mg p.o. t.i.d. 13. calcium carbonate 650 mg p.o. b.i.d. 14. albuterol/atrovent nebulizers 15. multivitamin one tablet p.o. q.d. condition on discharge: fair discharge status: the patient is being discharged back to her center where she came from. the geriatric fellow, dr. was informed of her being transferred and he had talked to the center and has made the appropriate arrangements. discharge diagnosis: 1. chronic bronchiectasis 2. chronic obstructive pulmonary disease 3. hypertension 4. recurrent pneumonia , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances replacement of gastrostomy tube diagnoses: unspecified essential hypertension chronic airway obstruction, not elsewhere classified pulmonary collapse acute respiratory failure pneumonitis due to inhalation of food or vomitus bronchiectasis without acute exacerbation mechanical complication of gastrostomy malignant neoplasm of other specified sites of stomach 

Answer: The patient is high likely exposed to