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: klonopin / morphine attending: chief complaint: shortness of breath major surgical or invasive procedure: multiple bronchoscopies w/ stenting and later stent removal history of present illness: 75 year-old woman with hx of tracheobronchomalacia and copd complicated by vocal chord dysfunction, prolonged history of copd exacerbations, on 3l home o2 at night, s/p y-stent placement a couple of weeks ago by dr. , who presented to osh with increased sob over past 3 days and hypoxia. she was noted to have room air o2 saturation of 85% at , improved to 96% on room air after nebulizers. patient was transferred to for further management by ip. patient reports taking her mucolytics regularly though daughter is concerned about compliance. of note, she was recently hospitalized for copd exacerbation, initially started on broad-spectrum antibiotics, which were narrowed down to levofloxacin to complete course, discharged on prednisone taper. . in the ed, patient was initially 88% on ra. she received duonebs and was started on bipap, after which she improved to 100% o2sat. she was given iv lorazepam as well to help with anxiety on bipap. ekg showed nsr 79 with no changes from prior, and cxr showed persistent left retrocardiac opacity from prior. vitals prior to transfer were as follows: afebrile, 98.4, hr 84 139/72 28 100% bipap 8/5 and 100%fio2. on arrival to the icu, patient still in some respiratory distress, on bipap. past medical history: tracheobroncheomalacia s/p y stenting in , which was removed on given mucous plugging; also s/p stent on - removed on for mucous plugging copd on 3l home oxygen vocal cord dysfunction obesity hypoventilation syndrome chronic diastolic heart failure hypothyroidism irritable bowel syndrome vitamin d deficency coronary artery disease anxiety depression seizure disorder h/o c. diff colitis r colon cancer s/p hemicolectomy in (vs. neuroendocrine tumor per some osh reports) s/p tonsillectomy s/p thyroid lobectomy s/p cholecystectomy s/p appendectomy - for neuroendocrine tumor smoking psychosis with prednisone social history: lives in ma, alone, independent in adls. tobacco - 55yrs of 1ppwk etoh, drugs - denies. family history: mother and father with cad no lung cancer or congenital lung diseases physical exam: physical exam on admission: vitals: t: 96.5 bp: 152/70 p: 95 r: 28 o2: 100% on bipap general: lying supine in mild respiratory distress, tachypneic, answering questions through bipap mask heent: dry mucus membranes, sclera anicteric neck: jvp not elevated lungs: diffuse rhonchi anteriorly and laterally, could not appreciate wheezing cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, no rebound tenderness or guarding gu: no foley ext: warm, well perfused, 1+ peripheral lower extremity edema physical exam on discharge: vitals: t: 98.2 bp: 118/82 p: 99 r: 20 o2:95% on 4l general: sitting upright, tachypneic, conversational heent: moist mucus membranes, sclera anicteric neck: jvp not elevated lungs: mild diffuse rhonchi posteriorly with occassional wheezes cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, no rebound tenderness or guarding, obese gu: no foley ext: warm, well perfused, 1+ peripheral lower extremity edema, picc inplace pertinent results: on admission: 12:45pm pt-11.5 ptt-21.7* inr(pt)-1.0 12:45pm wbc-10.5 rbc-4.47 hgb-11.9* hct-38.2 mcv-86 mch-26.6* mchc-31.1 rdw-15.2 12:45pm calcium-8.4 phosphate-4.5 magnesium-2.2 12:45pm glucose-157* urea n-15 creat-1.0 sodium-138 potassium-4.8 chloride-106 total co2-23 anion gap-14 . cxr: improved bibasilar atelectasis in the setting of increased lung volumes as compared to the study. persistent left retrocardiac opacity remains, reflecting chronic changes. . echo: the left atrium is mildly dilated. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: suboptimal study, pulmonary pressures not obtainable because of technically-inadequate tricuspid regurgitation jet. grossly preserved biventricular systolic function. brief hospital course: 75m with hx of tracheobronchomalacia and copd complicated by vocal chord dysfunction on home o2 who presented to osh with increased sob over past 3 days and hypoxia and transferred to for interventional pulmonology. brief hospital course is as follows: # shortness of breath: patient has history of copd on home o2, recently discharged from hospitalization for copd exacerbation. a large mucus plug was suctioned from y-stent during bronchoscopy on arrival to micu with subsequent improvement in symptoms back to baseline. she received the following meds mucinex 1200mg po bid, inhaled acetylcysteine , prn nebs and her prednisone taper from previous hospitalization was continued. the patient again had a bronchoscopy on icu day #2, which showed thin mucous and stent in place. they recommended bipap to be used as needed for sob. on hd #4, the patient underwent a 3rd bronch as her symptoms had not been improving with the recent stents. the y-stent was removed on out of concern for mucus plugging. she was briefly on bipap for respiratory distress but tolerated the mask for 1.5 hours. the patient's dyspnea had a significant anxiety component and she responded well to ativan. palliative care was consulted and the patient expressed her wishes to be dnr/dni - the patient's daughters were also involved in this discussion. palliative care also recommended improved pain control with oxycodone and prn dilaudid. interventional pulmonology recommended prn bipap and prn mucolytics for her symptoms. she was treated with a course of antibiotics for fever with presumed pulmonary source. her prednisone was tapered. she is being discharged to rehab with one day left of iv antibiotic therapy and 3 days of her steroid taper. she is being set up for an outpatient sleep study to get home cpap setup. . # hx of seizure disorder: home lamotrigine was continued . # hypothyroidism: home levothyroxine was continued . # depression: her home venlafaxine was restarted . # dvt prophylaxis was with subcutaneous heparin. . # communication was with daughter (hcp). code status was dnr/dni (confirmed with daughter, hcp). she will accept rehospitalization if necessary, however she refuses to come back to for any reason. she will only accept going to community hospitals near her rehab and her home. she will benefit from pallative care planning from rehab. medications on admission: (per her past d/c summary) 1. lamotrigine 100 mg tablet daily 2. cyanocobalamin (vitamin b-12) 100 mcg daily 3. venlafaxine 150 mg 4. aspirin 81 mg tablet, chewable daily 5. cholecalciferol (vitamin d3) 800u daily 6. nexium 20 mg capsule, delayed release(e.c.) daily 7. levothyroxine 125 mcg tablet daily 8. guaifenesin 600 mg tablet sustained - 2 tabs 9. benzonatate 100 mg capsule po tid 10. acetylcysteine 20 % (200 mg/ml) neb solution 11. tiotropium bromide 18 mcg capsule, daily 12. fluticasone-salmeterol 250-50 mcg/dose disk 13. prednisone 20 mg tablet sig: two (2) tablet po daily (daily): please take 2 tablets for 5 days, then 1 tablet for 5 days, then tablet for 5 days, then stop. disp:*20 tablet(s)* refills:*0* 14. morphine 10 mg/5 ml solution sig: teaspoons po q4h (every 4 hours) as needed for sob. 15. fexofenadine 60 mg tablet po daily *per report - patient noncompliant with many of medications* discharge medications: 1. levothyroxine 125 mcg tablet sig: one (1) tablet po daily (daily). 2. fexofenadine 60 mg tablet sig: one (1) tablet po daily (daily). 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 4. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 5. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 6. benzonatate 100 mg capsule sig: one (1) capsule po tid (3 times a day) as needed for cough. 7. oxycodone 5 mg/5 ml solution sig: one (1) 5mg po q8h (every 8 hours). 8. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 9. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 10. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 11. acetylcysteine 20 % (200 mg/ml) solution sig: one (1) nebulization miscellaneous twice a day. 12. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). 13. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) nebulization inhalation q4h (every 4 hours) as needed for shortness of breath. 14. lorazepam 1 mg tablet sig: one (1) tablet po q4 prn as needed for anxiety, sob. 15. prednisone 10 mg tablet sig: one (1) tablet po once a day for 3 days. 16. vancomycin 1,000 mg recon soln sig: one (1) intravenous every twenty-four(24) hours for 1 days. 17. cefepime 2 gram recon soln sig: one (1) intravenous every twenty-four(24) hours for 1 days. discharge disposition: extended care facility: nursing home - discharge diagnosis: pneumonia, copd exacerbation discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent, however requiring oxygen support. discharge instructions: you were transferred to from hospital for management of your increasing shortness of breath and low oxygen levels. you had a stent in your lungs which was removed as it kept becoming clogged. you were treated for presumed pneumonia, as well as exacerbation of your lung disease. you received steroids, breathing treatments and intravenous antibioitics. it is felt that you would benefit from the use of a breathing machine which could help you when you have lung disease attacks. you will need to have a sleep study performed to get this machine set-up for you. the procedure for having that study set-up is described below. some changes were made to your medications as follows: 1. prednisone: you will need to take 10mg of prednisone, one time a day, for the next 3 days. after that you will not need any more of this medication. 2. ativan: 1mg taken by mouth every 4 hours as needed for anxiety or shortness of breath 3. oxycodone: 2.5mg-5mg taken by mouth every 3 hours as needed for pain or shortness of breath. 4. vancomycin/cefipime: you will get your final intravenous doses of these medications at rehab. please resume all your other home medications as previously ordered. please follow-up with your primary care provider concerning this hospitalization next week. followup instructions: you need to have a sleep study in order to get set-up from a cpap machine for your home. these studies are done outside of the hospital. the study has been ordered, however they will call you with an appointment. please call your primary care provider to set up a follow-up appointment to discuss this hospitalization. procedure: other intubation of respiratory tract other intubation of respiratory tract other intubation of respiratory tract endoscopic excision or destruction of lesion or tissue of bronchus endoscopic removal of bronchial device(s) or substances diagnoses: pneumonia, organism unspecified tobacco use disorder congestive heart failure, unspecified unspecified acquired hypothyroidism obstructive chronic bronchitis with (acute) exacerbation dysthymic disorder personal history of malignant neoplasm of large intestine mechanical complication due to other implant and internal device, not elsewhere classified personal history of noncompliance with medical treatment, presenting hazards to health surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation do not resuscitate status chronic diastolic heart failure foreign body accidentally entering other orifice chronic respiratory failure unspecified vitamin d deficiency epilepsy, unspecified, with intractable epilepsy other diseases of trachea and bronchus other dependence on machines, supplemental oxygen foreign body in respiratory tree, unspecified other diseases of vocal cords obesity hypoventilation syndrome 

Answer: The patient is high likely exposed to