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: no known allergies / adverse drug reactions attending: chief complaint: altered mental status major surgical or invasive procedure: endotracheal intubation at osh prior to arrival, extubated at temporary dobhoff tube placement for tubefeeds history of present illness: 36 y.o female with pmhx of cva , dm type 1, found to be unresponsive with a serum glucose of 28. she developed seizure like activity and hypoxemia at where she was intubated, with return of secretions from ett. the seizure like activity improved with ativan. neurology consulted for continued twitches, eeg ordered, loaded with dilantin in ed. recieved total 6mg ativan with control of sz-like activity. given empiric abx: vanc/unasyn initially, now vanc/zosyn. has had klebs utis resistant only to ampicillin in their system.cultures are currently pending and has left sided infiltrate on imaging. . of note the patient was hypothermic initially, now normothermic with wbc 11.5, bmp wnl, bun 21, cr 1.4, abg 7.35/35/170, trop neg. (dm1) no lp was done. she just came in this morning at 7am; family requested transfer to . . per osh notes: in field given 2 amps of dextrose and repeat was 76 from 28, rectal temp on field was 94.5 given warming blanket and temp rose to 96.2. cxr revealed large left infiltrate, possible aspiration. she was just d/c'd from . was intubated per above. head ct revealed no acute changes. ekg nsr. on arrival to the micu, the patient is intubated and not following directions. propofol drip was started to sedate and ej placed without complications. review of systems: cannot be obtained given intubated (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: diabetes mellitus type 1 (dx at age 3), hx of hypoglycemic episodes cva (hemorrhagic) at 27 with residual aphasia and right hemiparesis, tracheostomy post cva now recannulated during recent admission blindness in one eye history of aspiration pneumonia depression hyperthyroidism anemia (bl hct 22-25) htn gastroparesis lv dysfunction c. diff social history: remote smoking history in her teens, lived in ca previously, currently living at hospital. family history: healthy brother/sister. maternal family history of dm. physical exam: admission exam: vitals: t:100.2 bp: 125/73 p: 105 r: 14 18 o2:100% intubated cmv general: eye closed, opens eyes and tried to move arms to audible stmimuli, does not follow commands , intubated. heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: insp. rhonchi, no wheezes, insp left lower/middle lobe rales, abdomen: soft, non-tender, distended,hypoactive bowel sounds, no organomegaly gu: foley with yellow urine ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: does not cooperate with neuro exam, spontaneously moves left arm and b/l legs, opens right eye,right pupil 3mm, reactive to light,left pupil grey and unreactive discharge exam: vitals: t:98.6 bp: 128-151/58-89 p:95 r:20 o2:99% ra general: nad, slightly diaphoretic but states that this is baseline, move arms to audible stimulus, follow commands, answer yes/no questions heent: anicteric, mmm, perrl, l eye partly closed neck: supple, no lad. cv: rrr, no m/g/r lungs: ctab, no wheezes/crackles/rhonchi. abdomen: soft, +bs, nd, nt gu: foley in place with yellow urine extremities: wwp, 2+ pulses, no edema/cyanosis neuro: spontaneously moves extremities, hemiparesis of r side, aphasia pertinent results: admission labs: 03:45pm blood wbc-11.3*# rbc-3.58* hgb-10.7* hct-32.0* mcv-89 mch-29.9 mchc-33.5 rdw-13.3 plt ct-209 12:50pm blood neuts-80.3* lymphs-14.0* monos-2.9 eos-2.4 baso-0.4 12:50pm blood pt-13.1* ptt-34.5 inr(pt)-1.2* 03:45pm blood glucose-174* urean-23* creat-1.3* na-139 k-4.4 cl-107 hco3-21* angap-15 03:45pm blood alt-14 ast-21 ld(ldh)-255* alkphos-53 totbili-0.3 04:24am blood lipase-7 03:45pm blood albumin-3.6 calcium-8.4 phos-2.6* mg-2.0 03:45pm blood tsh-1.7 04:53pm blood type-art po2-104 pco2-40 ph-7.38 caltco2-25 base xs-0 intubat-intubated 04:53pm blood lactate-1.6 04:53pm blood o2 sat-97 discharge labs 06:00am blood glucose-240* urean-8 creat-1.3* na-141 k-3.6 cl-108 hco3-24 angap-13 05:45am blood wbc-7.9 rbc-3.03* hgb-8.8* hct-27.0* mcv-89 mch-29.1 mchc-32.7 rdw-13.6 plt ct-232 images: video swallow : oropharyngeal swallowing videofluoroscopy was performed in conjunction with the speech and swallow division. multiple consistencies of barium were administered. findings: there was aspiration with thin and nectar consistencies. for details please refer to speech and swallow division note in omr. impression: aspiration with thins and nectar consistency. cxr : 1. endotracheal tube is positioned too low. suggest withdrawing the tube by 2-3 cm. 2. bilateral patchy areas of opacification could represent pneumonia or asymmetric pulmonary edema. cxr : 1. low position of endotracheal tube, which could be withdrawn a few centimeters for standard positioning. this finding has been communicated by telephone with dr. on at 7:45 a.m. at the time of discovery. 2. worsening asymmetrical perihilar and basilar opacities, which may be due to asymmetrical pulmonary edema. given history of seizures, aspiration pneumonia is an additional consideration. 3. new small left pleural effusion. brief hospital course: 36 y.o female with pmhx of cva , dm type 1, found to be unresponsive with hypoglycemia, hypoxemia, altered mental status/seizure like activity found to have infiltrate on cxr concerning for aspiration pneumonia. #seizure like activity: likely related to hypoglycemia in the field in setting of infectious pulmonary process causing metabolic derangements. patient phenytoin loaded at the osh. ct head showed no acute changes at osh. low pre-test probability for meningitis on admission to micu, though she was intubated and thus lumbar puncture not done. held phenytoin with plan to restart if seizure like activity recurred. her mental status improved over her micu stay and was confirmed to be back to baseline by her brother. seizure like activity noted. mostly slept, responsive to verbal stimuli, will not follow commands and nods no when asked if has pain. #hypoxemia/pna: intubated for altered mental status and hypoxemia at osh. could have aspirated during hypoglycemic/seizure like episode causing a aspiration pneumonitis. could also have hap given recent hospitilizations. cxr consistent with pna and in lower lobes so could also be aspiration pna. pt started on broad spectrum abx at osh which were continued on admission to micu. no signs of pe/ards. pt extubated the morning after admission to micu and tolerated it well, satting well on nasal cannula hd #2. sputum cx and blood cx from osh showed no growth to date. cultures from showed no growth. vanc/zosyn continued and narrowed to levofloxacin. she has completed 7/8 days of treatment. #hypoglycemia/dm i: likely due to underlying dm and insulin usage vs infectious trigger. resolved at the time of arrival to micu. restarted lantus at 12 units qhs trend fingersticks. consulted and followed in house. pt very sensitive to standard sliding scale, becoming mildly hypoglycemic in unit while npo. doboff was placed and tubefeeds started with q6 sliding scale. on , patient pulled out doboff tube. she had a video swallow which showed risk for aspiration. family meeting was held on (with patient, brother, mother, father over the phone, and health care proxy) and decision was made to take the risk of aspiration and to continue on a regular diet. she was switched to a ground, diabetic diet with nectar prethickened liquids and crushed meds. patient is overly sensitive to insulin and thus at risk of developing seizures/hypoglycemia. her sugars were monitored while she began eating again and insulin dosages were adjusted daily by . she is discharged with lantus 5u in the morning and 10u at night and sliding scale. she will be given bedtime sliding scale if not eating. attending will contact facility this weekend to check on glucose levels. #htn: normotensive on admission to micu. she was continued on her home labetolol and lisinopril and amlodipine were held. when transferred to the floor, her pressures were in the 140s-150s and her amlodipine was restarted at a lower dose (10mg as opposed to 20mg). #s/p cva: continued home baclofen, baby asa, simvastatin. #constipation: continued home docusate, senna and bisacodyl. #anemia: baseline from 22-25, continued home iron #depression: continued home sertraline and restarted home ativan. trazodone held. medications on admission: preadmissions medications listed are incomplete and require futher investigation. information was obtained from webomr records from nursing facility. 1. amlodipine 10 mg po daily 2. aspirin 81 mg po daily 3. baclofen 15 mg po tid 4. bisacodyl 10 mg po daily:prn constipation 5. calcium carbonate 500 mg po daily 6. docusate sodium 100 mg po bid 7. ferrous sulfate 300 mg po bid 8. labetalol 200 mg po bid 9. lorazepam 0.5 mg po bid 10. sertraline 75 mg po daily 11. simvastatin 20 mg po daily 12. trazodone 50 mg po hs 13. lisinopril 5 mg po daily 14. glargine 16 units bedtime 15. oxycodone (immediate release) 5 mg po 1x/week (we) 16. acetaminophen 650 mg po q6h:prn pain or fever 17. milk of magnesia 30 ml po daily:prn constipation 18. artificial tears 1-2 drop both eyes prn dryness 19. aluminum-magnesium hydrox.-simethicone 30 ml po qid:prn gi upset discharge medications: 1. amlodipine 10 mg po daily hold for sbp <100 2. aspirin 81 mg po daily 3. baclofen 15 mg po tid 4. labetalol 200 mg po bid hold for sbp <100, hr <60 5. simvastatin 20 mg po daily 6. sertraline 75 mg po daily 7. acetaminophen 650 mg po q6h:prn pain or fever 8. aluminum-magnesium hydrox.-simethicone 30 ml po qid:prn gi upset 9. artificial tears 1-2 drop both eyes prn dryness 10. bisacodyl 10 mg po daily:prn constipation 11. calcium carbonate 500 mg po daily 12. docusate sodium 100 mg po bid 13. ferrous sulfate 300 mg po bid 14. lisinopril 5 mg po daily hold for sbp <100 15. milk of magnesia 30 ml po daily:prn constipation 16. trazodone 50 mg po hs 17. lorazepam 0.5 mg po bid 18. oxycodone (immediate release) 5 mg po 1x/week (we) rx *oxycodone 5 mg 1 tablet(s) by mouth every wednesday disp #*4 tablet refills:*11 19. glargine 5 units breakfast glargine 10 units bedtime insulin sc sliding scale using hum insulin 20. levofloxacin 750 mg po daily 21. nystatin oral suspension 5 ml po qid:prn thrush discharge disposition: extended care facility: health care center discharge diagnosis: primary diagnosis: hypoglycemia, seizure secondary to hypoglycemia secondary diagnosis: aspiration pneumonia, diabetes mellitus type 1 discharge condition: mental status: baseline, able to answer yes/no questions, follow commands, aphasia level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: dear ms. , it was a great pleasure taking care of you at . you were admitted to the hospital because you were unresponsive and your blood sugars were very low. you also had a seizure, which was likely due to the low blood sugar. you needed a breathing tube and a feeding tube to help support your breathing and nutrition. during your hospitalization, you developed an infection in your lungs and we treated you with antibiotics. your breathing improved and we were able to remove the breathing tube. while you were here, you were closely followed by the team for management of your diabetes and adjusment of your insulin. we made changes to your insulin doses. please continue to take your antibiotics (levofloxicin) for one more day. followup instructions: contact your provider at the clinic early next week to review your blood sugar levels. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours enteral infusion of concentrated nutritional substances diagnoses: anemia, unspecified urinary tract infection, site not specified unspecified essential hypertension other convulsions depressive disorder, not elsewhere classified constipation, unspecified pneumonitis due to inhalation of food or vomitus long-term (current) use of insulin late effects of cerebrovascular disease, hemiplegia affecting unspecified side late effects of cerebrovascular disease, aphasia gastroparesis diabetes with other specified manifestations, type i [juvenile type], not stated as uncontrolled 

Answer: The patient is high likely exposed to