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: keflex attending: chief complaint: shortness of breath major surgical or invasive procedure: intubation history of present illness: yo f with h/o cad, dchf, symptomatic bradycardia s/p ppm, severe pulmonary hypertension admitted from rehab with cough, sob and hypotension today. per records and signout from rehab patient initially had st and cough on . was afebrile and treated with robutussin . then overnight on noted to be hypotensive (89/59 ->80/50) with )2sat 70% on ra->88% on 2lnc. patient was placed on nrb and bp dropped precipitously to 69/30 so she was given 500ml bolus at rehab but was not responsive (bp 70/37, hr 77 rr 24, 100% nrb) and was subjectively more sob so sent to ed. in the ed, initial vs were: t 98.6 85 120/34 28 100 on nrb. then had fever to 100.8. cxr showed rll pna and patient was given vanc and levoquin as well as 1l ns however bp continued to "dwindle" and patient was more and more dyspneic so she was given succinylcoline, etomidate, versed, and fentanyl and then intubated and a cvl was placed in left ij. ekg was reportedly with inferior std thought demand from increased work of breathing. started on levophed drip for persistent hypotension and thoguht sepsis vs chf. . review of systems: unable as intubated/sedated past medical history: - severe pulmonary htn, severe tr, rv dysfunction and normal lv function - symptomatic bradycardia s/p pacemaker implantation - htn - renal insufficiency - chronic venous stasis - recurrent leg cellulitis - gout - morbid obesity - s/p tahbso - oa social history: lives at rehab. demented but reportedly a+ox 3 in ed last night. wheelchair to ambulate. unmarried. denies tobacco or etoh use. family history: there is no family history of premature coronary artery disease or sudden death physical exam: vitals: t: 98.7 bp:108/38 p:89 r: 18 o2:100 on tv 400 x 14 fio2 60 peep 8 general: intubated/sedated heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp to earlobe lungs: crackles bilateral bases cv: regular rate and rhythm, normal s1 + s2 abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: foley ext: warm, well perfused, 2+ edema pertinent results: labs on admission: 03:30am blood wbc-20.4*# rbc-3.66* hgb-10.5* hct-32.8* mcv-90 mch-28.8 mchc-32.2 rdw-17.7* plt ct-178# 03:30am blood neuts-92.5* lymphs-4.2* monos-3.0 eos-0.1 baso-0.2 03:30am blood plt ct-178# 03:30am blood pt-15.0* ptt-32.1 inr(pt)-1.3* 03:30am blood glucose-128* urean-46* creat-1.5* na-143 k-3.6 cl-101 hco3-29 angap-17 11:42am blood ck(cpk)-23* 03:30am blood probnp-4886* 03:30am blood ctropnt-0.06* 11:42am blood ck-mb-4 ctropnt-0.08* 03:28am blood ck-mb-3 ctropnt-0.06* 05:59pm blood calcium-8.1* phos-3.5 mg-2.0 03:35am blood lactate-3.1* 03:45am blood lactate-0.9 10:42am blood freeca-1.04* 10:56am blood type-art temp-36.6 po2-62* pco2-39 ph-7.47* caltco2-29 base xs-4 intubat-not intuba . labs on discharge: wbc rbc hgb hct mcv mch mchc rdw plt 07:00 10.0 3.76* 10.9* 32.8* 87 28.8 33.0 17.3* 173 glu urean creat na k cl hco3 angap 07:00 97 32* 1.2* 144 3.2* 100 34* 13 07:00 ca: 8.4 phos: 3.0 mg: 1.8 microbiology: urine culture pending : ua negative sputum gram stain-final; respiratory culture-final {streptococcus pneumoniae} inpatient blood culture blood culture negative urine legionella urinary antigen -negative urine urine culture-negative mrsa screen mrsa screen-final {staph aureus coag +} inpatient blood culture blood culture, routine-negative **** tte: the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). the right ventricular free wall is hypertrophied. the right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. the aortic valve leaflets are mildly thickened (?#). there is no aortic valve stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a very small pericardial effusion. compared with the prior study (images reviewed) of , the estimated pulmonary artery pressures are lower. the severity of tricuspid regurgitation is reduced (although image quality on current study is very limited). a very small pericardial effusion is seen. . ecg: sinus rhythm with atrial premature beat. left atrial abnormality. modest st-t wave changes with prolonged qtc interval are non-specific but cannot exclude possible drug/electrolyte/metabolic effect. clinical correlation is suggested. since the previous tracing of same date there is no signficant change. . cxr: 1. worsening right pleural effusion with adjacent atelectasis with or without coexisting infection. 2. improved left pleural effusion. . cxr: no evidence of vascular congestion or acute focal pneumonia. . cxr: bilateral pleural effusions, right great than left. brief hospital course: yo f with h/o d chf, htn, dementia here with cough/fever/hypoxia requiring intubation and hypotension requiring levophed likely sepsis from pna although may also have component chf. admitted to the micu on , transferred to the floor on and discharged on . # shock: when pt was admitted, hypotension was thought sepsis vs. chf. an echo was done which showed improved heart function when compared to an echo from . ivf boluses were used for her hypotension as sepsis was thought to be the likely cause of her hypotension. the pt was originally on levophed, however this was d/c'd soon after her admission (within 12 hrs). an mi was also r/o with cardiac enzymes and serial ekgs. the pt was originally started on vanc/zosyn, however we narrowed to levoquin once further sputum culture speciation showed pneumococcus. she continued her course of iv levofloxacin on the floor and was sent with a prescription to continue it po as an outpatient for at total of 10 day course. . # hypoxic respiratory failure: likely multifactorial and includes baseline compromised respiratory function from severe pulmonary hypertension with likely superimposed pna. pt was weaned to pressure support and extubated after 2 days on the icu. the main thought was pna, so she was treated with abx as above. pt also had pleural effusion, with the thought to do thoracentesis, however she stablized so this was deferred. also, pt was continued on home dose (3x a week) of lasix and metolazone. this regimen was continued on the floor and will be continued as an outpatient. on the floor, she was satting well in the mid-high 90s on 2l nc. . #nutrition: patient failed her bedside s/sw for concern of an aspiration risk. however, her po meds were continued mixed in applesauce, and she was able to take her pills. she was sent for video s/s eval on and they recommended nectar thickened liquids and soft solid diet. # hypertension: pt hypertensive to 180s-190s thought anxiety. returned to normotensive range with ativan in the micu. started on prn zydis for anxiety. once transferred to the floor, she had an episode of hypertension the night of up to 189/76. she was given amlodipine 10mg for this and her pressures responded well. she continued to take this daily throughout her admission, and we have discharged her on this as well. . # cri: baseline creatinine over last year 1.4-1.9. ranged from 1.2-1.5 throughout admission. we monitored her creatinine, renally dosed her meds, and avoided nephrotoxins. . # anemia: appeared to be at her baseline, we monitored her daily and guaiac'd her stools which were negative. . # code status: pt was admitted as a full code, and continues to be a full code at discharge. this was discussed with her niece, who feels that the patient should be making her own decisions, but agreed that code status should be further addressed. we feel that this is something that should be followed up as an outpatient. medications on admission: oxycodone 2.5mg ativan 0.5mg daily at night and q6h prn anxiety apap 650mg daily sorbitol 15ml daily calcium 1300mg daily colace 100mg daily omeprazole 20mg daily nitro 0.3mg prn aspirin 81mg daily metolazone 2.5mg 3 x weekly (m/w/f) allopurinol 100mg qod mag hydroxide 30ml daily prn lasix 40mg m/w/f ergocalciferol 5000units q21days guiafensin prn discharge medications: 1. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 2. furosemide 40 mg tablet sig: one (1) tablet po 3x/week (mo,we,fr). tablet(s) 3. metolazone 2.5 mg tablet sig: one (1) tablet po 3x/week (mo,we,fr). 4. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 5. amlodipine 10 mg tablet sig: one (1) tablet po once a day. 6. levofloxacin 500 mg tablet sig: one (1) tablet po once a day for 4 days. 7. colace 100 mg capsule sig: one (1) capsule po once a day. 8. lorazepam 0.5 mg tablet sig: one (1) tablet po once a day. 9. allopurinol 100 mg tablet sig: one (1) tablet po once a day. 10. ergocalciferol (vitamin d2) 400 unit capsule sig: one (1) capsule po 2 times per week. 11. sorbitol 70 % solution sig: fifteen (15) ml miscellaneous once a day. 12. oxycodone 5 mg tablet sig: 0.5 tablet po twice a day. 13. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed for cough. 14. calcium carbonate 650 mg (1,625 mg) tablet sig: two (2) tablet po once a day. discharge disposition: extended care facility: for the aged - ltc discharge diagnosis: primary: hypotension respiratory distress pneumonia secondary: renal insufficiency hyptertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: ms. , you were admitted to the hosptial from rehab because you had low blood pressures and shortness of breath. at the hospital, you were brought to the icu and had a breathing tube placed as you were having difficulty breathing on your own. after a couple of days, you improved and the tube was removed. you have been breathing well since. you also had a pneumonia which has been treated with antibiotics. you should continue your antibiotics as listed below. while you were here, we had some trouble controlling your high blood pressure, so we started you on an additional blood pressure medicine called amlodipine. please continue to take this according to the instructions below. you should also follow up with your cardiology appointments as instructed below. medication changes: - take levofloxacin 500 mg by mouth each day until your prescription runs out (until ) - take amlodipine 10 mg by mouth each day - continue all other the medications you were taking prior to your hospitalization followup instructions: department: cardiac services when: monday at 10:00 am with: device clinic building: sc clinical ctr campus: east best parking: garage department: cardiac services when: thursday at 8:30 am with: device clinic building: sc clinical ctr campus: east best parking: garage department: cardiac services when: thursday at 9:20 am with: dr. building: campus: east best parking: garage procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube arterial catheterization diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified acute kidney failure, unspecified severe sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified acute on chronic diastolic heart failure other chronic pulmonary heart diseases other persistent mental disorders due to conditions classified elsewhere chronic kidney disease, stage iii (moderate) acute respiratory failure septic shock morbid obesity osteoarthrosis, unspecified whether generalized or localized, site unspecified cardiac pacemaker in situ other postprocedural status pneumococcal septicemia [streptococcus pneumoniae septicemia] pneumococcal pneumonia [streptococcus pneumoniae pneumonia] venous (peripheral) insufficiency, unspecified tricuspid valve disorders, specified as nonrheumatic ulcer of lower limb, unspecified 

Answer: The patient is high likely exposed to