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: cardizem / lipitor attending: chief complaint: chest pain with respiratory distress major surgical or invasive procedure: ventricular drain placed by neurosurgery central venous catheter placement history of present illness: 70 y.o. f with a history of cabg x 2 in and , s/p des to rca-svg in , who was admitted to osh icu on from rehab complaining of shortness of breath with substernal chest pain radiating to her back for 1 hour. cp was , and resolved with sl nitro x3. her ekg at that time was nsr and unchanged from her baseline. of note, patient has a history of mva trauma in , as a result has multiple fractures and is trach-vent dependent. . patient was admitted to osh icu. she was ruled out for mi with 3 negative cardiac enzymes. cxr showed bilateral pulmonary infilatrates. they were concerned for recurrent aspiration vs. hospital acquired pneumonia vs. pulm edema. bnp was elevated. sputum culture grew mrsa. she was continued on vancomycin. legionella antigen was negative. . during hospitalization, the patient was briefly extubated, but developed recurrent respiratory distress on , and the ventilator was resumed. bnp 1800. she was diuresed with good effect. echo showed ef 35%, 2+ mr, 1+ tr. her plavix for some reason was stopped at rehab. it was resumed at osh on . three days prior to admission she was found to have pneumonia at rehab and was started on vanc and zosyn because she grew mrsa from her sputum. two days later she developed diarrhea, and was treated with po flagyl for presumed c.diff. she was transfused 1u prbcs on for hct of 26. . the patient was transferred to for cardiac catheterization. on transfer vitals tm 98, bps 130-180/50-70, hr 70-80, 94% on 65% fio2. . on arrival to the ccu, patient has some epigastric pain. she denies chest pain or difficulty breathing. she nods her head yes to having a frontal headache. she is non verbal and nods/shakes her head yes/no. currently, . ros: denies fever, chills, night sweats, headache, vision changes, rhinorrhea, congestion, sore throat, cough, shortness of breath, chest pain, abdominal pain, nausea, vomiting, diarrhea, constipation, brbpr, melena, hematochezia, dysuria, hematuria. past medical history: - diabetes - dyslipidemia - congestive heart failure, systolic -cabg: at osh in and --angiography in : severe 3 vessel disease --occluded lima graft to the lad --patent side vein bypass graft to posterolateral branch, rca was a sequential graft supplying either the diag or circumflex territories, those branches occluded. ef 25-30% --cath : severe 2 vessel cad (lad and rca), mid lad: 100% stenosis, 1st diagnoal -100% distal to graft anastomosis, 100% mid-rca stenosis, graft to the distal rca: there was a tubular 95% stenosis at the distal anastomosis. global lv function ef 40%, moderate mr, des with balloon angioplasty on 95% lesion in the distal anastomosis of the svg from the 1st diagonal to the distal rca. - s/p mva . she was hit by a car as a pedestrian, and unconscious for 12 days. injuries include sah/sdh w/small midline shift, r l2 transverse process fx, t12 burst fx, r acetabular non-displaced fx, r inf and l sup pubic ramus fx, r 6th rib fx, l medial femoral condyle, proximal fibula - s/p trach - s/p multiple cervical and lumbar laminectomy - chronic pain - h/o cva in -r sided muscle weakness at baseline - aaa - pvd s/p aorto-bifem bypass - depression social history: daughter is a nurse. pt lives at home w/ husband who has been with her during much of this hospitalization. -tobacco history: used to smoke 1ppd but quit 20 years ago. family history: mother died of mi. father had heart problems and died young. physical exam: vs: t=98.2 bp=149/61 hr=79 rr=22 o2 sat= 95% on 0.65 fio2 general: wdwn f with trach in place, in nad. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp just above clavicle while sitting up. assessment partially obstructed by trach device. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no s3 or s4. lungs: no chest wall deformities. resp were unlabored, no accessory muscle use. diffuse expiratory wheezes bilaterally. crackles at bases bilaterally. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: warm, well perfused. 1+ le edema bilaterally. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ neuro: interactable. 5/5 strength of lue and lle. unable to move rle. 3/5 strength in rue. + reflexes bilaterally. pertinent results: labs on admission: 12:19am blood wbc-12.3* rbc-2.77* hgb-8.6* hct-24.8* mcv-90 mch-31.1 mchc-34.8 rdw-15.5 plt ct-196 12:19am blood pt-11.3 ptt-23.2 inr(pt)-0.9 12:19am blood glucose-193* urean-21* creat-0.5 na-134 k-3.4 cl-92* hco3-34* angap-11 12:19am blood calcium-8.4 phos-3.0 mg-1.8 03:44am blood caltibc-176* ferritn-1828* trf-135* 01:59pm blood type-art po2-72* pco2-53* ph-7.46* caltco2-39* base xs-11 labs/studies osh blood cultures x2 negative respiratory culture +mrsa c diff negative urine culture: yeast sputum culture +mrsa resp culture +mrsa . bnp 712 . : trop 0.02, ck 19 trop 0.04 . cta (because of elevated d-dimer and sob): negative for pe . osh ct t spine fracutres of t7, t 11, t 12, l1 ct head: no intracranial hemorrhage or mass . ekg: nsr @ 79bpm. nl axis. lvh. st depressions in v3-v6, i, ii. st elevations in avr. t wave inversions diffusely in all leads. st depressions and twi are more pronounced compared to previous ekg on (admission to osh). . . . 2d-echocardiogram: . the left atrium is normal in size. the estimated right atrial pressure is 0-5 mmhg. left ventricular wall thicknesses are normal. the left ventricular cavity is unusually small. regional left ventricular wall motion is normal. no mid-cavitary gradient is identified. no apical intracavitary gradient is present. the right ventricular cavity is dilated with depressed free wall contractility. the number of aortic valve leaflets cannot be determined. there is no aortic valve stenosis. no aortic regurgitation is seen. mild (1+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: normal systolic left ventricular systolic function with small cavity size. dilated right ventricle. depressed right ventricular systolic function. mild mitral regurgitation. mild-to-moderate tricuspid regurgitation. moderate pulmonary hypertension. . the left atrium is normal in size. the estimated right atrial pressure is 0-10mmhg. left ventricular wall thicknesses and cavity size are normal. there is severe global left ventricular hypokinesis (lvef = 20 %). the right ventricular cavity is mildly dilated with moderate global free wall hypokinesis. there is abnormal septal motion/position consistent with right ventricular pressure/volume overload. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the estimated pulmonary artery systolic pressure is normal. there is a trivial/physiologic pericardial effusion compared with the prior study (images reviewed) of , the left ventricular function has deteriorated and the right ventricular pressure and volume overload is more evident (the anterior wall "dyskinesis" is a result of abnormal septal motion and poor left ventricular systolic function). . pmibi no evidence of dipyridamole-induced perfusion abnormality. mild global hypokinesis with a left ventricular ejection fraction of 42%. /nkg mini bal cx: klebsiella . ct chest/abdomen/pelvis: impression: 1. diffuse bilateral ground-glass opacity and interlobular septal thickening is slightly improved. differential considerations are wide and include pulmonary edema, ards, in the right clinical setting pulmonary hemorrhage and pcp . 2. extensive mediastinal adenopathy may be reactive to the inflammatory and infectious process involving the lungs. . cxr: the diffuse interstitial and ground-glass pulmonary abnormality seen on chest ct on has been subsequently stable. heart is not particularly enlarged and pleural effusion, if any, is small and unchanged. tracheostomy tube is in standard placement, left jugular line ends low in the svc. right jugular sheath and swan-ganz catheter have been removed. no pneumothorax . cxr : provisional findings impression: new pneumomediastinum and pneumopericardium is likely secondary to progression of pulmonary interstitial emphysema in the setting of prior trauma. unchanged extent of mass of interstitial and ground-glass abnormality, given clinical presentation, likely ards. . c.diff negative . mini-bal: negative pcp, , legionella. ct head 1. new small amount of left intraventricular hemorrhage status post left ventricular shunt placement. 2. no change in the degree of hydrocephalus since . 3. new left mastoid air cells and middle ear opacification. clinical correlation for otomastoiditis is suggested. ct chest 1. interval increase in the extensive diffuse ground-glass and interstitial abnormalities, in conjunction with clinical history and presentation, characteristic for worsening ards, however, superimposed infection is also a consideration. 2. interval increase in the bibasal effusions and basal atelectasis. 3. stable mediastinal lymphadenopathy, likely reactive. 4. tracheostomy tube remains in standard position, and the cuff appears slightly overinflated brief hospital course: hypoxemic respiratory failure - due to ards and ventilator-associated pneumonia. treated with mechanical ventilation and antibiotics. . acute respiratory distress syndrome - attributed to mvc trauma and ventilator-associated pneumonia. treated with low tidal volume ventilation via tracheostomy. . ventilator-associated pneumonia - treated with vancomycin and meropenem based on sensitivities of staph aureus and klebsiella oxytoca species isolated from bronchoscopy and sputum cultures. . septic shock - treated with aggressive fluid resuscitation, broad-spectrum antibiotics, and ultimately neosynephrine infusion. . subarachnoid hemorrhage complicated by intracranial hypertension - ct showed progressive ventriculomegaly since and a ventricular drain was placed by neurosurgery. treated with keppra for seizure prophylaxis. subsequent ct showed intraventricular hemorrhage. coma persisted despite weaning of sedation and treating causes of toxic-metabolic encephalopathy. . cardiopulmonary collapse - in light of little clinical progress despite aggressive medical management and an overall poor prognosis, the patient's family decided to withdraw support on in favor of comfort measures and the patient expired peacefull at 7:20 am. the medical examiner accepted the case for postmortem examination. medications on admission: home medications: (fyi - she was not on plavix at rehab) 1. lantus +ssi 2. solumedrol 3. zosyn 4. lovenox 5. niacin 6. keppra 7. carvedilol 8. lisinopril 9. prevacid 10. vancomycin 11. flagyl 12. lasix 13. mvi . medications on transfer: 1. iv access: peripheral line order date: @ 1232 20. lisinopril 10 mg po/ng daily hold for sbp<100 order date: @ 0814 2. iv access: peripheral line order date: @ 1232 21. meropenem 500 mg iv q6h order date: @ 3. iv access: temporary central access (icu) location: left internal jugular, date inserted: order date: @ 1618 22. midazolam 0.5-2 mg/hr iv drip titrate to sedation patient must have adequate airway support prior to administration of dose. order date: @ 2355 4. ok to use line order date: @ 1618 23. morphine sulfate 2-4 mg iv q2h:prn pain hold for sedation or rr<12 order date: @ 0432 5. 1000 ml ns continuous at 10 ml/hr kvo order date: @ 1540 24. multivitamins 1 tab ng daily order date: @ 1227 6. acetaminophen 325-650 mg po/ng q6h:prn pain, fever do not exceed 4g/day order date: @ 0814 25. niacin 250 mg po bid po/ng. order date: @ 0814 7. albuterol inhaler 4 puff ih q6h:prn wheezing while intubated order date: @ 1232 26. norepinephrine 0.03-0.25 mcg/kg/min iv drip titrate to map of 55 order date: @ 1455 8. aspirin 325 mg po/ng daily order date: @ 0814 27. nystatin oral suspension 5 ml po qid po/ng order date: @ 0814 9. carvedilol 25 mg po/ng hold for sbp<100 or hr<60 order date: @ 0814 28. pneumococcal vac polyvalent 0.5 ml im asdir order date: @ 0005 10. chlorhexidine gluconate 0.12% oral rinse 15 ml oral tid order date: @ 1232 29. prednisone 40 mg po bid duration: 5 days order date: @ 1329 11. famotidine 20 mg po/ng q12h order date: @ 0814 30. prednisone 40 mg po daily duration: 5 days start: order date: @ 1329 12. fentanyl citrate 25-100 mcg/hr iv drip infusion order date: @ 1236 31. prednisone 20 mg po daily duration: 11 days start: order date: @ 1329 13. fluoxetine 20 mg po/ng order date: @ 0814 32. simvastatin 40 mg po/ng daily order date: @ 0814 14. furosemide 60 mg iv bid hold for sbp<100 order date: @ 2319 33. sodium chloride 0.9% flush 3 ml iv q8h:prn line flush peripheral line: flush with 3 ml normal saline every 8 hours and prn. order date: @ 1232 15. furosemide 60 mg iv once duration: 1 doses order date: @ 1613 34. sodium chloride 0.9% flush 3 ml iv q8h:prn line flush peripheral line: flush with 3 ml normal saline every 8 hours and prn. order date: @ 1232 16. heparin 5000 unit sc tid order date: @ 1735 35. sodium chloride 0.9% flush 10 ml iv prn line flush temporary central access-icu: flush with 10ml normal saline daily and prn. order date: @ 2214 17. insulin sc (per insulin flowsheet) sliding scale & fixed dose order date: @ 1813 36. sodium chloride 0.9% flush 10 ml iv prn line flush temporary central access-icu: flush with 10ml normal saline daily and prn. order date: @ 1618 18. ipratropium bromide mdi 6 puff ih q6h while intubated order date: @ 1232 37. sulfameth/trimethoprim 325 mg iv q8h day 1 order date: @ 1329 19. levetiracetam solution 1500 mg ng po/ng order date: @ 1255 38. vancomycin 1250 mg iv q 24h start: in am order date: @ 2216 discharge medications: n/a discharge disposition: expired discharge diagnosis: cardiopulmonary collapse hypoxemic respiratory failure acute respiratory distress syndrome ventilator-associated pneumonia intracranial hypertension septic shock pneumomediastinum discharge condition: expired discharge instructions: n/a followup instructions: n/a procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances intravascular imaging of intrathoracic vessels intravascular imaging of intrathoracic vessels closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus diagnoses: anemia, unspecified obstructive hydrocephalus congestive heart failure, unspecified toxic encephalopathy friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia hyposmolality and/or hyponatremia severe sepsis aortocoronary bypass status other chronic pulmonary heart diseases motor vehicle traffic accident involving collision with pedestrian injuring pedestrian other late effects of cerebrovascular disease septic shock methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site abdominal aneurysm without mention of rupture ventilator associated pneumonia acute on chronic systolic heart failure traumatic subcutaneous emphysema gastrostomy status tracheostomy status aftercare for healing traumatic fracture of other bone other disorders of muscle, ligament, and fascia dependence on respirator, status subarachnoid hemorrhage following injury without mention of open intracranial wound, unspecified state of consciousness 

Answer: The patient is high likely exposed to