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: patient recorded as having no known allergies to drugs attending: chief complaint: hypoxia, sob major surgical or invasive procedure: none history of present illness: y/o f with pmhx of copd on home o2 (baseline 90% on 2lnc), afib and diastolic chf who was noted to at nursing home resident who was found today at nh sob and desat 84% on 4lnc. she was transferred to . . in the ed, initial vs were: t 100.5 p 98 bp 137/78 r28 80%ra, 92% nrb. patient was given ceftriaxone, azithro, solumedrol 125 iv x1, and nebs in ed. she was started on nasal bipap with sats in 95% . on arrival to icus she is c/o mild non-productive cough, but denies pain, fever, chills, chest discomfort, palpitatiosn, muscle aches. past medical history: diastolic heart failure atrial fibrillation on coumadin remote h/o tias copd on home o2 (2l at baseline) scoliosis osteoarthritis l hip/r pelvis fx managed nonoperatively recent lle cellulitis social history: was coming from rehab macu. normally ambulates with walker. a&ox3 and functional at baseline. on oxygen 2l. past smoker, quit >30years ago. no etoh or illicits. son/daughter are nearby and involved. dnr/dni. family history: +htn, dm. overall non contributory to currently illness and given her age. physical exam: pe on admission: vitals: t: 98.7 bp: 147/84 p: 89 r: 95%bipap o2: general: alert, oriented to person, tremulous, tolerating nasal mask heent: sclera anicteric, mm dry, oropharynx clear neck: supple, jvp not elevated, no lad lungs: ronchi throughout with some scarce wheeses l>r, no crackles cv: irregular, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: 11:30am blood wbc-6.4 rbc-3.79* hgb-12.2 hct-37.2 mcv-98 mch-32.1* mchc-32.8 rdw-14.4 plt ct-230 05:20pm blood wbc-2.7* rbc-3.33* hgb-10.5* hct-31.9* mcv-96 mch-31.5 mchc-32.9 rdw-14.6 plt ct-190 03:30am blood wbc-4.8 rbc-3.33* hgb-10.3* hct-32.1* mcv-96 mch-30.9 mchc-32.1 rdw-14.2 plt ct-194 04:12am blood wbc-7.0# rbc-3.63* hgb-11.6* hct-33.6* mcv-93 mch-31.8 mchc-34.4 rdw-14.3 plt ct-189 11:30am blood glucose-112* urean-24* creat-1.2* na-143 k-3.7 cl-99 hco3-33* angap-15 04:00am blood glucose-149* urean-37* creat-1.2* na-145 k-4.6 cl-105 hco3-33* angap-12 03:57pm blood glucose-173* urean-49* creat-1.4* na-146* k-4.6 cl-101 hco3-42* angap-8 04:29pm blood glucose-245* urean-30* creat-1.0 na-136 k-3.8 cl-82* hco3-44* angap-14 06:12am blood k-3.7 06:33am blood probnp-5511* 03:25am blood calcium-8.4 phos-4.6* mg-2.0 03:57pm blood calcium-9.2 phos-3.2 mg-2.2 04:12am blood calcium-8.7 phos-2.9 mg-2.2 11:30am blood digoxin-0.3* 07:12pm blood type-art po2-139* pco2-70* ph-7.21* caltco2-30 base xs--1 11:01am blood type-art po2-60* pco2-65* ph-7.29* caltco2-33* base xs-2 01:33pm blood type- po2-163* pco2-86* ph-7.23* caltco2-38* base xs-5 comment-green top 03:42am blood type- temp-36.5 rates-/28 fio2-40 po2-52* pco2-83* ph-7.32* caltco2-45* base xs-12 intubat-not intuba vent-spontaneou 07:40pm blood lactate-2.6* 03:42am blood lactate-1.8 imaging: findings: a small right pleural effusion is seen which has decreased in size since the prior study. patchy opacities at the right lung base are likely atelectasis, although infection cannot be excluded. linear density near the left lung base is likely atelectasis. no other areas of focal consolidation are noted. there is no pulmonary edema. the cardiomediastinal silhouette is difficult to assess due to severe scoliosis; however, cardiomegaly is stable and the mediastinal silhouette is unchanged. there is calcification of the aorta. visualized osseous structures appear intact. impression: decrease in size of small right pleural effusion. most likely atelectasis in the right lower lobe, although infection cannot be excluded. stable cardiomegaly. brief hospital course: y/o f with pmhx of copd on home o2, diastolic chf who presents with sob and hypoxia likely due to copd exacerbation unable to wean from bipap. the big picture is that she has multifactorial severe resp failure including: - severe copd - chronic diastolic heart failure, ph from that as well as cor pulmonale, afib - restrictive ventilatory defect from severe kyphoscoliosis, large hiatal hernia, pleural effusions, which also contributes to atelectasis she has not had a robust response to medical therapy. i am concerned that though she is critically ill with high oxygen requirement, this is probably her baseline and she may not improve to the point of requiring less supplemental o2. . # hypoxia: likely secondary to copd exaccerbation with or without an underlying pneumonia. treated for copd exaccerbation with steroids and azithromycin. also started on ceftriaxone for ? cap and vanco for ? hap considering she was a nursing home resident. the first two days of her hospitalization she required intermittent bipap treatment to maintain o2 sats with goal btw 88-92. then she started to maintain good o2 saturations in the above mentioned goal on 60% face mask, which is the amount of oxygen she was wearing in rehab before readmission. she was mentating well and not complaining of sob with this mask. she was switched to levofloxacin after the first doses of antibiotics mentioned above, and treated with a course of this which was stopped on . she completed a course of azithromycin. initially for steroids she was on iv 125 mg solumedrol, then switched to 40 mg iv bid dosing and then transitioned to po 40 steroids. and we recommend 3 more days of prednisone 40 mg daily, then 2 days of 20 mg daily, then 2 days of 10 mg daily, then 2 days of 5 mg daily, then stopping. . # diastolic heart failure: continued toprol at home dose initially. diuresed over the course of her hospitalization and then started to appear clinically dry and develop a contraction alkalosis. we are continuing to hold her lasix and acetazolamide. it should be restarted based on her clinical fluid status and resolution of her alkalosis. . # atrial fibrillation: was rate controlled and anticoagulated with coumadin. went into afib with rvr during hospitalization on . control with po and iv metoprolol failed and dilt gtt was started. she was weaned off the diltiazem gtt on and transitioned to po diltiazem of 30 mg qid. her dose was increased to 60 mg qid with good control and rates in the 80s-90s. we did not restart her metoprolol. it could be restarted as needed for rate control. . # arf: had increase in her creatinine to 1.4, likey due to dehydration from over diuresis. with holding of her diuretics, it returned to her baseline around 1.0 or 0.9. she made appropriate urine throughout her hospitalization. . # fen: repleted electrolytes prn . # prophylaxis: subcutaneous heparin . # access: pivs . # code: dnr/dni . # communication: patient daughter: ; medications on admission: albuterol sulfate q4hrs ascorbic acid 500 mg buspirone 10 mg qdinner multivitamin daily docusate sodium 100 mg prn omeprazole 20 mg daily lorazepam 0.5 mg qam citalopram 40 mg daily ipratropium bromide q4hr furosemide 120 mg calcium 500+d 500 digoxin 125 mcg tablet tablet per day warfarin 2 mg daily metoprolol succinate 50 mg daily acetazolamide 250 mg discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 3. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). 4. buspirone 10 mg tablet sig: one (1) tablet po dinner (dinner). 5. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 6. citalopram 20 mg tablet sig: two (2) tablet po daily (daily). 7. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). 8. digoxin 125 mcg tablet sig: 0.5 tablet po daily (daily). 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 10. lorazepam 0.5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed. 11. ipratropium bromide 0.02 % solution sig: one (1) treatment inhalation q6h (every 6 hours). 12. warfarin 1 mg tablet sig: one (1) tablet po once daily at 4 pm. 13. diltiazem hcl 60 mg tablet sig: one (1) tablet po qid (4 times a day). 14. prednisone 20 mg tablet sig: two (2) tablet po daily (daily) for 3 days: the complete taper with prednisone 20 mg for 2 days, then 10 mg for 2 days, then 5 mg for 2 days, then stop. discharge disposition: extended care facility: & rehab center - discharge diagnosis: primary diagnosis: 1. copd exaccerbation 2. atrial fibrillation with rapid ventricular response 3. diastolic heart failure secondary diagnosis: 1. hx of tias 2. scoliosis discharge condition: frail, afebrile, on 60% face mask high flow o2 discharge instructions: you were admitted to the hospital for having low oxygen levels at your center. you came to the icu and we treated you with antibiotics, steroids and extra oxygen. the reason for your sob and low oxygen level was likely an exaccerbation of your copd. you will return to where they will continue to use high flow oxygen to help you breath. you will also be able to do more physical therapy while there. if you start feeling more sob, the rehab staff starts noticing fevers, chills, confusion or any other concerns, you should return to the hospital. followup instructions: please continue care with the doctors . follow up with your pcp as needed after rehab. procedure: non-invasive mechanical ventilation arterial catheterization diagnoses: congestive heart failure, unspecified acute kidney failure, unspecified atrial fibrillation obstructive chronic bronchitis with (acute) exacerbation acute respiratory failure alkalosis long-term (current) use of anticoagulants combined systolic and diastolic heart failure, unspecified other dependence on machines, supplemental oxygen 

Answer: The patient is high likely exposed to