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: a.c.e inhibitors / gemfibrozil attending: chief complaint: ruq abdominal pain reason for micu admission: respiratory failure major surgical or invasive procedure: fiberoptic intubation with anesthesia picc line placement arterial line placement ij central venous catheter placement history of present illness: this is a 70yo female, with dm, htn, and asthma, who presented to the ed with ruq abdominal pain, and was admitted to the icu for respiratory failure. history was obtained from ed and husband as patient now intubated. per report, she developed shortness of breath over three days and aches throughout her body. pain had some radiation to right shoulder and was generally worse in ruq. no cough or rhinorrhea. she also endorsed subjective fevers and mild shortness of breath with wheezing at home. no sick contacts. presented to pcp today and was noted to be dyspneic in waiting room, with o2 sats in the low 80s on room air. she was given asa 325 mg at clinic. . in the ed, initial cxr showed rll pneumonia. patient was given ceftriaxone, levofloxacin, and 2l ns. ipratropium and albuterol nebs given. refused flu swab but received 75 mg tamiflu. became more short of breath with desaturations and was then 90% on nrb. the patient was a very difficult intubation - at least 5 unsuccessful attempts with glidescope; eventually required stat fiberoptic intubation with anesthesia. got succ x2 doses, 10 mg vecuronium, etomidate, ativan. on transfer, patient satting 94% on fio2 1 with peep 5. . on arrival to micu, patient intubated and sedated with residual effects of paralytics. given solumedrol 125, mag, vanco 1 gram, and albuterol. past medical history: - diabetes type ii - hypertension - asthma: o2 sats at baseline low 90s on ra - hypertriglyceridemia social history: from in . married, lives with husband of 50 years, independent in adls. 5 children. no etoh, no smoking. family history: non-contributory physical exam: on presentation to the ed: 98.2, 128/60, 86, 20, 100% on 10l nrb on arrival to the icu: 96.7, 77, 106/48, 22, 86% on 100% fio2 general: intubated, sedated and paralyzed. heent: perrl, sclera anicteric, mmm, ett and ogt in place. neck: obese, supple, difficult to appreciate jvd elevation. lungs: bilateral wheezes with very poor air entry - improving with albuterol. cv: minimal ability to hear heart sounds beneath lung sounds. abdomen: soft but very distended, tympanic throughout, bowel sounds present. no rebound tenderness or guarding. ext: warm, well perfused, no clubbing, cyanosis or edema neuro: sedated and paralyzed. pertinent results: admission labs: wbc-12.1, hct-30.0, plt ct-250 neuts-77.4, lymphs-15.0, monos-6.2 eos-1.0 baso-0.4 pt-14.2, ptt-20.4, inr(pt)-1.2 glucose-326, urean-30, creat-1.8, na-130, k-4.5, cl-90, hco3-25 alt-19, ast-21, ck(cpk)-214, alkphos-96 totbili-0.6 ck-mb-2 ctropnt-<0.01 calcium-7.1, phos-5.6, mg-1.9 d-dimer-1556 acetone-neg, acetmnp-10.3 lactate-2.3* admission abg, on nrb mask: type-art po2-46* pco2-47* ph-7.39 caltco2-30 base xs-2 intubat-not intuba comment-non-rebrea discharge labs: wbc-5.9, hct-30.3, plt ct-280 neuts-90.6, lymphs-5.5, monos-3.5 eos-0.3 baso-0.2 glucose-64, urean-58, creat-1.6, na-150, k-4.1, cl-108, hco3-30 alt-59, ast-57, ld(ldh)-363, alkphos-74, totbili-0.7 calcium-9.8 phos-4.2 mg-2.5 imaging: admission cxr: 1. right lower lobe and right middle lobe consolidation, atelectasis, and likely right pleural effusion. 2. streaky left basilar retrocardiac opacity may reflect atelectasis and/or consolidation. tte: the left atrium is moderately dilated. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast with maneuvers. left ventricular wall thicknesses and cavity size are normal. left ventricular systolic function is hyperdynamic (ef>75%). the right ventricular cavity is mildly dilated with mild global free wall hypokinesis. the diameters of aorta at the sinus, ascending and arch levels are normal. there are simple atheroma in the aortic root. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. there is no valvular aortic stenosis. the increased transaortic velocity is likely related to high cardiac output. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: mild symmetric lvh with hyperdynamic left ventricular systolic function. mildly dilated/hypokinetic right ventricle. mild mitral regurgitation. moderate pulmonary artery systolic hypertension. no evidence of pfo/asd with agitated saline. compared with the report of the prior study (images unavailable for review) of , lv function appears hyperdynamic and the right ventricle appears mildly dilated/hypokinetic. pulmonary artery systolic pressures could not be determined on the prior study. ct sinus: the patient is intubated. there is mild mucosal thickening of the left maxillary sinus. the right maxillary sinus demonstrates a fluid level. there is opacification of many of the right-sided ethmoid air cells. aerosolized secretions are noted in left-sided ethmoid air cells. there is mild mucosal thickening of the ethmoid air cells bilaterally. there is near opacification of the sphenoid sinus, with only small foci of air. frontal sinuses are absent. the ostiomeatal units are patent bilaterally. there is type ii of the fovea ethmoidalis bilaterally. there may be slight demineralization of the cribiform plate. the sphenoid sinus septum is midline with insertion on the clivus. an impacted canine tooth is noted in the left maxilla. impression: extensive sinus disease as described above with fluid levels and aerosolized secretions. this may represent an acute on chronic sinusitis. ct torso: 1. large right basal effusion and small left basal effusion with atelectasis in the lower lobes bilaterally. the heart is enlarged. scattered ground-glass opacities seen throughout both lungs, the appearances may represent fluid overload versus infection. 2. 5-mm nodular opacity in the right middle lobe should be followed up with a chest ct in three months if the patient is at increased risk or has prior history of malignancy, otherwise followup chest ct in one year is recommended as guidelines. 3. abdominopelvic ascites and fatty liver. 4. no abscess or collection present in the abdomen or pelvis. microbiology: blood cultures: all negative , , , , , , , , urine cultures: : gram negative rods cfu's; not speciated : negative , , , : yeast greater than 100,000; foley changed after each culture returned yeast dfa flu: negative rrp negative for parainfluenza, adenovirus and rsv sputum: , , , : yeast stool: negative brief hospital course: 70f with dm, htn, asthma; presenting to ed with ruq pain with development of hypoxic respiratory failure and ards, possible r pneumonia, had increasing vent requirements, and evolving metabolic lactic and respiratory acidosis and shock picture, with evidence of liver and renal organ damage. had several episodes of pea arrest requiring shocks. currently, she has been more stable for the past several days, was weaned off the vent and been afebrile x 3 days (tm 101.5 ). active issues: # respiratory failure/ards. patient presented with evidence of lobar r-sided pneumonia with rapid progression to severe ards requiring maximal ventilatory support. pt is now s/p 7 pea arrests. we were unable to find a fluid collection amenable to thoracentesis on ultrasound. patient extubated on after long intubated course. has completed levaquin and vancomycin and meropenem and cefepime 15-day antibiotic course for severe pneumonia. asthma management with albuterol mdis; off of systemic steroids. diuresis also helped with respiratory distress. . # persistent fevers: unknown source, possibly r sided pna from admission. not enough fluid on thoraco to tap. nothing seen on abd/pelvis ct done on to suggest a source. ij has been replaced, foley has been replaced multiple times. patient has had blood cultures, sputum, stool, and urine. not sure what other source is possible. could be a drug . will see if afebrile when all antibiotics are stopped. afebrile x 3 days. . #tachycardia and htn: the tachycardia has been responsive to fluid boluses. she was on a significant home regimen of htn meds, which were restarted s/p hypotension. her htn and tachycardia are currently controlled. now taking labetalol 800 tid and amlodipine 10mg, as pt is tolerating pos. could consider continued diuresis as this will also help control blood pressure. . #yeast in urine/vagina: foley catheter replaced . still yeast in urine. now yeast in vagina. s/p 5-day course of fluconazole 200 iv qd. . #anemia: patient hct has been low for length of stay and interval blood transfusions given. patient has been responsive to blood transfusions. cause of her low hct is now known, but there does not seem to be a gi bleed per ng tube suctioning and bowel movement examination. loss could be due to being critically ill. . # hyperglycemia. patient takes 180 units of insulin daily at home, and has been difficult to control. adjusted glargine and sliding scale for better blood sugar control while inpatient. . # repeated pea arrests/shock: (ie: and ) patient decompensates precipitously in setting of hypoxia, presumably due to vagal vasodilation. responds well to epinephrine (but very sensitive, does not require large epinephrine doses as they send her too hypertensive). she did have evidence of end-organ damage on labs, with rising cr and transaminitis, then improved. on multiple occasions, spoke to family and she is full code. optimizing respiratory status was key to preventing further pea arrests. . # elevated troponins ?????? almost definitely due to global ischemia rather than acs, as there is widespread evidence of hypoperfusion of multiple organs. her echo did not show any focal wall-motion abnormalities. has stabilized with her improvement. . code: full code, confirmed with family on multiple occasions. okay with trach and peg if necessary. communication: daughter speaks english and understands the situation, has been kept informed and been key family contact. medications on admission: medications (per omr, not verified): - advair 250/50 - albuterol mdi prn - asa 325 mg daily - hydrochlorothiazide 25 mg daily - nifedepine 90 mg daily - metoprolol xl 200 mg daily - valsartan 320 mg daily - simvastatin 10 mg daily - metformin 500 mg - humulin n 100 units qam, 80 units qpm - paroxetine 30 mg daily discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. docusate sodium 50 mg/5 ml liquid sig: po bid (2 times a day). 3. white petrolatum-mineral oil 42.5-56.8 % ointment sig: one (1) appl ophthalmic prn (as needed) as needed for dry eyes. 4. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po q8h (every 8 hours) as needed for constipation. 5. famotidine 20 mg tablet sig: one (1) tablet po q24h (every 24 hours). 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 7. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 8. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 9. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q4h (every 4 hours) as needed for wheezing. 10. labetalol 200 mg tablet sig: four (4) tablet po tid (3 times a day). 11. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 12. miconazole nitrate 2 % cream sig: one (1) appl vaginal hs (at bedtime) for 3 days. 13. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 14. olanzapine 5 mg tablet sig: 1-2 tablets po tid (3 times a day) as needed for agitation. 15. medication insulin per attached sliding scale. discharge disposition: extended care facility: - discharge diagnosis: pneumonia. ards. vaginal and urinary tract yeast infection. discharge condition: stable. afebrile. breathing comfortably. extubated. discharge instructions: weigh yourself every morning, md if weight goes up more than 3 lbs. . take inhalers for wheeze or shortness of breath. . return to the hospital or call your doctor , shortness of breath, lightheadedness, chest or abdominal pain, rash. . 3 days more of cream for vaginal yeast infection. . consider lasix if sob. followup instructions: provider: , dpm phone: date/time: 1:00 . provider: , m.d. phone: date/time: 9:00 procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances other electric countershock of heart arterial catheterization cardiopulmonary resuscitation, not otherwise specified cardiopulmonary resuscitation, not otherwise specified diagnoses: pneumonia, organism unspecified hypocalcemia anemia, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute and subacute necrosis of liver acute kidney failure, unspecified hyposmolality and/or hyponatremia candidiasis of other urogenital sites pure hyperglyceridemia constipation, unspecified acute respiratory failure cardiac arrest other ascites chronic obstructive asthma, unspecified hyperosmolality and/or hypernatremia other nonspecific abnormal serum enzyme levels other chronic nonalcoholic liver disease candidiasis of vulva and vagina mixed acid-base balance disorder abdominal pain, right upper quadrant shock, unspecified 

Answer: The patient is high likely exposed to