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: ceftriaxone / propofol attending: chief complaint: shortness of breath. major surgical or invasive procedure: endotracheal intubation. bronchoscopy on bronchoscopy on central line placement (rij) central line pull out and tip culture history of present illness: pt is a 75f h/o osa with multiple intubations secondary to tracheobronchomalacia s/p recent stenting in by dr. who presented today with subjective feeling of sob, although sats initially at baseline (98-99 2l). she was also noted to have have yellow sputum and increased facial edema. . in the ed, initial vs were: 98.8 80 145/90 20 100 4l. she was initially thought by ed to have a mild copd exacerbation and received nebs, solumedrol 125 x 1, and levaquin 750 x 1. she did not receive ivfs. she was about to be moved to a floor bed when her respirations became more labored, rr increased to 45, and hr increased to sinus tachycardia in 130's. she was evaluated by ip in ed, had a trial of bipap with minimal improvement. cxr unchanged from prior. she also received 2mg iv ativan for anxiety. she was intubated in ed, ip bronched her and saw no mucous plug, clear and patent stent, and distal airways. . she arrived to icu intubated and sedated with propofol. of note, her last spirometry showed no obstructive pattern. no clear etiology for resp decline. review of sytems: not possible as patient intubated and sedated. past medical history: # panick attacks with respiratory compromise # tracheobronchomalacia s/p recent y silicone stenting # obesity # diabetes mellitus type 2 # hypertension # obstructive sleep apnea # anxiety disorder social history: patient originally form conecticcut, used to live with his daughter who is the priamry care taker. she was at rehab ( ) due to her respiratory therapy and streght as well as frequent pulmonologist visits. she denies any current or prior history of smoking or alcohol. she denies any illegal drug use. family history: denies any history of premature coronary artery disease, dm, htn. physical exam: vital signs - temp 98.6 f, bp 135/78 mmhg, hr 84 bpm, rr 16 x', o2-sat 98% ra <br> general - well-appearing womman in nad, appropriate, speaking in short sentences sob, but comfortably at baseline. heent - nc/at, perrla, eomi, sclerae anicteric, mmm, op clear neck - supple, no thyromegaly, no jvd, no carotid bruits lungs - bilateral ronchi without any appreciable wheezes, good air movement, resp unlabored, no accessory muscle use heart - pmi non-displaced, rrr, no mrg, nl s1-s2 abdomen - nabs, soft/nt/nd, no masses or hsm, no rebound/guarding extremities - wwp, no c/c/e, 2+ peripheral pulses (radials, dps) skin - no rashes or lesions lymph - no cervical, axillary, or inguinal lad neuro - awake, a&ox3, cns ii-xii grossly intact, muscle strength throughout, sensation grossly intact throughout, dtrs 2+ and symmetric, cerebellar exam intact, steady gait. pertinent results: on admission: 10:40am wbc-4.0 rbc-3.38* hgb-10.6* hct-32.4* mcv-96 mch-31.4 mchc-32.8# rdw-13.8 10:40am neuts-57.2 lymphs-32.0 monos-4.8 eos-5.7* basos-0.3 10:40am plt count-319# 10:40am glucose-153* urea n-6 creat-0.7 sodium-140 potassium-3.5 chloride-103 total co2-30 anion gap-11 10:40am pt-12.8 ptt-28.6 inr(pt)-1.1 10:40am ck-mb-6 10:40am ctropnt-0.03* 10:40am ck(cpk)-130 10:57am lactate-1.3 02:30pm urine color-yellow appear-clear sp -1.018 02:30pm urine blood-neg nitrite-neg protein-tr glucose-neg ketone-10 bilirubin-neg urobilngn-neg ph-6.0 leuk-neg 02:30pm urine rbc-1 wbc-3 bacteria-few yeast-none epi-10 . cta : impression: 1. no evidence of central or segmental pulmonary embolism. the subsegmental branches are not fully evaluated due to contrast bolus timing and respiratory motion artifact. 2. no focal pulmonary consolidation to suggest pneumonia. aerosolized secretions are noted within the indwelling tracheal y stent in the proximal right and left main stem bronchus in conjunction with bronchial wall thickening and regions of bronchiectasis within the right lower lobe which may suggest superimposed infectious bronchitis. 3. bilateral pulmonary nodules as described above. based on guidelines, if patient is at low risk, a dedicated one-year followup ct would be recommended, if high risk, a dedicated followup in months would be recommended. if the patient has outside ct imaging, comparison should be made to assess for stability. 4. atherosclerotic disease involving the aorta and coronary circulation. 5. bilateral pleural effusions with regions of adjacent compression atelectasis. 6. left hepatic cyst with calcification . cxr : there is moderate cardiomegaly, unchanged. small bilateral pleural effusions and bibasilar atelectasis are noted. there is no definite consolidation or pneumothorax identified. tracheal stent is not clearly seen on this limited view. extensive calcifications of the aortic arch are noted.impression: tiny bilateral pleural effusions and bibasilar atelectasis. no definite consolidation identified. . on discharge : 05:59am blood wbc-8.2 rbc-3.27* hgb-10.5* hct-30.5* mcv-93 mch-32.0 mchc-34.4 rdw-13.0 plt ct-315 05:59am blood plt ct-315 05:59am blood urean-8 creat-0.6 na-145 k-3.3 hco3-35* . spirometry : 1:43 pm pre drug post drug actual pred %pred actual %pred %chg fvc 1.42 2.01 71 fev1 1.41 1.37 102 mmf 1.41 1.96 72 fev1/fvc 99 68 145 lung volumes 1:43 pm pre drug post drug actual pred %pred actual %pred tlc 3.18 3.48 91 frc 1.75 2.05 85 rv 1.73 1.47 118 vc 1.45 2.01 72 ic 1.43 1.43 100 erv 0.01 0.58 2 rv/tlc 54 42 129 he mix time 3.00 notes: dx: copd spirometry: fair test quality and reproducibility, results are a composite of 2 different efforts. lung volumes: only one reportable effort, good test quality. dlco: unable to get reportable results due to pt. difficulty performing test. bmi: 41.9 mechanics: the fvc is mildly reduced. the fev1 is normal. the fev1/fvc ratio is elevated. flow-volume loop: mild restrictive pattern with an early termination of exhalation. lung volumes: the tlc, frc and rv are normal. the rv/tlc ratio is elevated. impression: normal lung volumes with probably normal spirometry. the fvc may be underestimated due to early termination of exhalation. there are no prior studies available for comparison. echocardiogram : the left atrium is mildly dilated. no atrial septal defect is seen by 2d or color doppler. the estimated right atrial pressure is 10-20mmhg. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef 60-70%). right ventricular chamber size and free wall motion are normal. the ascending aorta is moderately dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: elevated right atrial pressure with normal left and right ventricular contractile function brief hospital course: this is a 75 y/o f with tacheobronchomalacia s/p stenting, osa, who now presents with sob. . # sob: based on history, she may have initially presented with reactive airway disease / asthma exacerbation with no compromise of her oxygenation. unfortunately we do not have abgs. patient's lungs were without crackles. patient's nt-probnp was 679 and she had a normal echocardiogram 3 weeks prior to presentation. off note, she had normal pfts at that time as well (see reports section). she suddenly decompensated in the er with increased labor breathing and respiratory distress and had a bronchoscopy looking for mucus plug and/or stent obstruction. however, the bronchoscopy showed patent stent and no mucus. nothing was sent to microbiology. patient was emergently intubated had a pe-ct that showed normal lung parenchyma and no evidence of pulmonary embolus. pt was transferred to the icu and the first abg on 12/500/40/12 was 7.35/58/179. she was started on methylprednisolone 60 mg daily and slowly weaned off the vent. on she was extubated and started with respiratory distress afterwards with spo2 of 100% on 4 l nc. she underwent a bronchoscopy and there was paradoxical movement of the vocal cords with edematous cords and with patent airways and stent and distal malacia without any evidence of secretions or mucus plug. patient received racemic epinephrin and salbutamol nebs and improved within an hour. she was transferred to the medicine floor, where she was weaned off the oxygen slowly until she was breathing comfortably in room air. she was able to go upstairs with an spo2 of 92-99% on ra. in the medical floor there was no clear precipitant of the crisis, so viral panel was sent and negative. patient was afebrile and without a white count. steroids started to be tappered and nebs were continued. the most likely diagnosis after extensive work up was panic attack with paradoxical vocal cord movement. ent was consulted in house and patient refused examination. they recommended video swallow that showed mild delay without other abnormalities. patient can have full liquids and soft solids, but stated that she prefered thickened fluids. benzodiazepines were not recommended since she will need very high-dose in case of the repeating episode and will need very close monitor. she was arranged for follow up with ent for vocal cord training to avoid another episode. she has follow up arranged with pfts with dr. in 3 weeks. . # volume status - pt had low urine output first day of admission, fena consistent with volume depletion and prerenal state. patient was hydrated and urine output improved. . # hypertension - patient is diabetic and currently bp not on started according to jnc-7 guidelines. she will benefit of acei, but did not start them in the setting of respiratory distress in case she were to get cough as an adverese reaction. she was started on nifedipine, which was titrated up to 90 mg daily. she will need further titration as outpatient and may be able to switch to an acei once breathing stable. . # dm - patient was given iss. she is being discharge on lantus plus sliding scale. . # anemia ?????? stable hematocrit of ~30 with guaiac negative stools and mcv 93, mch 32, mchc 34.4 and normal plt count. will need outpatient work up. . # anxiety - patient with low threshold for anxiety with medical issues and family situation. she was reassured and explained her diagnoses. no role of benzodiazepines at this time (see above). . # mental stauts - patient showed signs of poor recent memory. she will need close pcp follow up to evaluate for progressive cognitive decline. . # fen: no ivf, replete electrolytes, diet as tolerated. . # prophylaxis: subcutaneous heparin, ppi, colace/senna. . # access: piv. . # code: full code. . # communication: patient, pt's son () and daughter and . medications on admission: colace/senna escitalopram 10 mg daily simvastatin 40 mg daily acetylcysteine 20 % (200 mg/ml) solution , mix w/albuterol. ferrous sulfate 325 mg daily famotidine 20 mg daily sq hep ipratropium albuterol mucinex 1,200 mg tab, multiphasic release po bid saline nebulizers: 3cc saline nebs tid for y stent patency acetaminophen 325 mg as needed for pain. nph 5 subcutaneous qam & hs. hiss discharge medications: 1. escitalopram 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 2. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 3. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 4. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: one (1) puff inhalation every four (4) hours as needed for shortness of breath or wheezing. disp:*1 inhaler* refills:*2* 5. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. disp:*30 capsule, delayed release(e.c.)(s)* refills:*0* 6. nifedipine 90 mg tablet sustained release sig: one (1) tablet sustained release po once a day. disp:*30 tablet sustained release(s)* refills:*0* 7. ipratropium bromide 17 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). disp:*1 inhaler* refills:*2* 8. advair diskus 250-50 mcg/dose disk with device sig: one (1) inhalation inhalation twice a day. disp:*1 disk* refills:*2* 9. prednisone 10 mg tablet sig: one (1) tablet po once a day for 8 days: day 1: 4 tablets, day 2: 4 tablets, day 3: 2 tablets, day 4: 2 tablet, day 5: 1 tablet, day 6: 1 tablet, day 7: tablet, day 8: tablet. disp:*15 tablet(s)* refills:*0* 10. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 11. menthol-cetylpyridinium 3 mg lozenge sig: one (1) lozenge mucous membrane prn (as needed). 12. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q4h (every 4 hours) as needed for cough. 13. insulin glargine 100 unit/ml solution sig: twenty (20) units subcutaneous at bedtime. 14. humagol insulin please resume your prior sliding scale. 15. saline mist 0.65 % aerosol, spray sig: one (1) nasal four times a day. discharge disposition: extended care facility: of discharge diagnosis: primary diagnsosis: anxiety with panic attacks associated with respiratory distress tracheobronchomalacia possible reactive airway disease / asthma . secondary diagnsosis: obesity diabetes mellitus hypertension obstructive sleep apnea discharge condition: stable, breathing comfortably on room air, tolerating diet, walking by herself. discharge instructions: you were seen at the for shortness of breath. the doctors in the thought you were having a copd exacebration and were going to admit you for medical management when you suddenly started with sever shortness of breath and respiratory distress. you had an emergent bronchoscopy to take a look at your airways for the concern of mucus plug in your stent. it was patent and functioning adequately. then, to help you breathe they intubated you. you had a ct scan of your chest that showed normal lungs, patentn stent and no clots in your arteries. you were slowly extubated. immediately after extubation you had another episode of respiratory distress and had another bronchoscopy that was normal again. you received nebulized medication and improved. in the medical floor you were slowly weaned of the oxygen as you were tolerating until you were breathing comfortably on room air. . your medications were changed (see attached sheet). . if you have sudden worsening of your breathing, fever, chills, rigors, production of green sputum or anything else that concerns you please come back to our er. followup instructions: provider: scan phone: date/time: 8:30 provider: ,interpret w/lab no check-in intepretation billing date/time: 9:00 provider: function lab phone: date/time: 9:00 . md: specialty: pulmonology date and time: at 9am location: , 116 phone number: special instructions if applicable: scheduled for a pulmonary function test with 6min walk at 9am, then a follow up with dr at 10:30am and then a brochoscopy at 11:30 which lasts around 90 mins. all in same location. . md: specialty: otolaryngology (ent) date and time: at 3pm location: ,, bldg, floor 6, suite 6e phone number: procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube insertion of endotracheal tube other bronchoscopy non-invasive mechanical ventilation other intubation of respiratory tract diagnoses: obstructive sleep apnea (adult)(pediatric) anemia, unspecified congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled asthma, unspecified type, unspecified depressive disorder, not elsewhere classified acute respiratory failure other postprocedural status obesity, unspecified chronic diastolic heart failure volume depletion, unspecified other diseases of trachea and bronchus other specified disorders of liver panic disorder without agoraphobia memory loss 

Answer: The patient is high likely exposed to