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: penicillins / tetracycline / sulfa (sulfonamides) / morphine / codeine attending: chief complaint: severe diffuse tracheobronchomalacia. major surgical or invasive procedure: : right thoracotomy and tracheoplasty with mesh, right main stem bronchus/bronchus intermedius bronchoplasty with mesh, left main stem bronchus bronchoplasty with mesh, bronchoscopy with bronchoalveolar lavage. : flexible bronchoscopy : trach changed to 6.0 portex trach cuff deflated history of present illness: mrs. is a 57 y/o, female with severe tbm with previous silicone-y-stent and tracheostomny tube that resulted in symptomatic improvement but the patient was hesitant to undergo a tbp at that time. she developed another episode of respiratory failure with septic shock 2 months ago in the setting of pneumonia which required another silicone-y-stent and tracheostomy tube and then later on, had the silicone-y-stent removed secondary to granulation tissue. the patient was discharged to rehab where she was weaned off mechanical ventilation and has been tolerating continuous red capping for the last few weeks. she has been participating in physical therapy and reports being "active" while she denies any dyspnea, chest pain, neck pain, cough, hemoptysis, wheezing, feve, chills, night sweats. she has been tolerating oral feeding and denies any dysphagia. she is being admitted following her trachealplasty. past medical history: # tracheobronchial malacia: s/p stent placement in then removal in due to persistent secretions # obesity # gerd # avascular necrosis of the l hip s/p l hip replacement in # alcohol abuse # rue dvt in # copd # granulomas in l lung # s/p tah # s/p appendectomy social history: ms. had been a regional manager at insurance company. she lived with boyfriend > 10 years. she had not been in contact with her brother in ~1 year, however, brother has visited her frequently while in the hospital and he is from area and lives at a distance. patient has history of significant alcoholism. former smoker family history: noncontributory physical exam: vs: t 96.5 hr: 93 sr bp: 110/70 sats: 93% tm 50% general: 57 year-old sitting in chair in no apparent distress heent: mucus membranes moist neck: trach in place. site clean card: rrr resp; decreased breath sounds with scattered crackles gi: benign. peg in place extr: warm no edema incision: right thoracotomy site clean, margins well approximated neuro: awake, alert, responds appropriately pertinent results: wbc-6.4 rbc-3.17* hgb-8.3* hct-26.5 plt ct-303 wbc-8.2 rbc-3.11* hgb-8.1* hct-26.3 plt ct-238 glucose-111* urean-19 creat-0.7 na-146* k-4.2 cl-105 hco3-35 glucose-105* urean-18 creat-0.8 na-145 k-4.0 cl-105 hco3-33 glucose-135* urean-11 creat-1.1 na-145 k-4.0 cl-105 hco3-34 glucose-200* urean-19 creat-0.8 na-143 k-3.8 cl-108 hco3-27 cultures: sputum endotracheal. gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 3+ (5-10 per 1000x field): multiple organisms consistent with oropharyngeal flora. respiratory culture (final ): moderate growth commensal respiratory flora. gram negative rod(s). sparse growth of two colonial morphologies. cxr: findings: the tracheostomy tip is 4 cm above the carina. the heart size is at the upper limits of normal. the mediastinal contours appear mildly widened but unchanged from prior study. the lung volumes are low. bibasilar opacities may represent atelectasis, although underlying infectious process cannot be ruled out. blunting of the costophrenic angles bilaterally is consistent with small pleural effusions. a coiled tube projecting over the epigastrium is most consistent with a percutaneous feeding tube. the osseous structures demonstrate mild scoliosis. : continued low lung volumes with some elevation of the right hemidiaphragmatic contour. although bibasilar opacifications persist, there appears to be some increased aeration on the left. this most likely represents some effusion and atelectasis, though superimposed pneumonia must be considered if there are appropriate clinical symptoms. : : in comparison with the study of , there are continued low lung volumes in a patient with tracheostomy tube. bibasilar opacification is consistent with atelectasis and effusions. in the appropriate clinical setting, the possibility of supervening pneumonia could not be excluded. : right basal chest tube is in place. there is no evident pneumothorax. there are low lung volumes. bibasilar opacities are likely atelectases, right greater than left. there is mild right subcutaneous emphysema. tracheostomy tube is in standard position. cardiac silhouette is obscured by lung abnormality. catheter projects over the upper abdomen. brief hospital course: ms. was admitted to the thoracic surgery service at on after she was taken to the operating room on for tracheoplasty by dr. . please see operative report for full details. she remained ventilated with trach mask trials until when she tolerated trach mask x 24 hours with oxygen saturations stable at 93-95% on 50% humidified oxygen. neuro: awake alert with episodes of anxiety which responded to seroquel. pulmonary: the patient required aggressive pulmonary toilet, mucolytic nebs, chest pt and ambulation. she continued to do well on trach collar. her trach was downsized to a 6.0 portex w/o inner cannula, cuff (deflated) from #7 . she tolerated this well. oxygen saturations with 50% humidified air were 93-95%. cv: the patient was maintained on tid diltiazem in sr 80-90. hemodynamic stable with blood pressures 110-140. gi: her bowel function returned with bowel regime in place. nutrition: she was seen by nutrition who recommended replete with fiber to a goal of 70 ml/hr. strict npo. sit upright when receiving tube feeds. speech: she was seen by speech for pmv evaluation initially but was unable to tolerate edema. repeat swallow evaluation on her oxygen saturations decreased. vocal quality is strained likely irritation and swelling, but she can wear it for trials throughout the day. her vocal quality is improved with cues to "have an easy onset" to speech.she was taken for a video-swallow on which showed aspiration. she should remain npo including all medications. initiate swallow therapy to improve oral and pharyngeal strength. renal: renal function within normal range with good urine output. electrolytes were replete as needed. id: bronchoscopy x 2 for mucus plug with bal gnr consistent with normal flora. she completed a 7 day course of levofloxacin. heme: hct stable at baseline 26.0-30. anticoagulation was not restarted since she completed her treatment for right cephalic thrombus. endocrine: blood sugars were 88-140's requiring occasional insulin sliding scale coverage immediately postoperatively. pain: epidural bupivacaine and dilaudid was managed by the acute pain service, once removed she was converted to po pain medications via peg, and lidocaine patch placed on either side of the right thoracotomy site. disposition: she was followed by physical therapy. she continue to make steady progress but continued need for aggressive physical and speech therapy is required. she was discharged to in . medications on admission: polyethylene glycol senna docusate sodium folic acid sucralfate 1 g. po qid tiotropium bromide one inhalation daily diltiazem hcl 360 mg po daily artificial tears miconazole acetaminophen albuterol sulfate nebulized solution q6hrs. prn ipratropium bromide nebulized solution q6hrs. prn magnesium hydroxide discharge medications: 1. heparin (porcine) 5,000 unit/ml solution : one (1) injection (2 times a day). 2. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : three (3) ml inhalation q6h (every 6 hours) as needed for sob. 3. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed for constipation. 4. diltiazem hcl 60 mg tablet : one (1) tablet po tid (3 times a day): give via peg. 5. quetiapine 50 mg tablet : one (1) tablet po tid (3 times a day): give via peg. 6. lidocaine 5 %(700 mg/patch) adhesive patch, medicated : one (1) adhesive patch, medicated topical daily (daily): cut in on either side of right thorocotomy incision. 7. acetylcysteine 20 % (200 mg/ml) solution : three (3) ml miscellaneous q12h (every 12 hours) as needed for thick secretions: mix with albuterol to prevent bronchospasm. 8. oxycodone-acetaminophen 5-325 mg/5 ml solution : ml po every 4-6 hours as needed for pain: via peg. 9. prevacid solutab 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr once a day. 10. acetaminophen 325 mg/10.15 ml suspension : ten (10) ml po every six (6) hours as needed for pain. 11. docusate sodium 50 mg/5 ml liquid : ten (10) ml po twice a day. discharge disposition: extended care facility: tcu - discharge diagnosis: -tracheobronchomalacia s/p tracheoplasty -atrial fibrillation- new controlled with diltiazem -tbm -avascular necrosis of the l hip s/p l hip replacement in -alcohol abuse -r cephalic dvt in -copd -granulomas in l lung -s/p tah -s/p appendectomy discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: call dr. office if you experience: -fever > 101 or chills -increased shortness of breath, cough or sputum production -trach concerns. -incision develops drainage -you may shower. no tub bathing or swimming -strict npo followup instructions: follow up with dr. date/time: 9:30 in the building chest disease center i chest x-ray clinical center radiology 30 minutes prior your appointment procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances other bronchoscopy other lavage of bronchus and trachea closed [endoscopic] biopsy of bronchus other repair and plastic operations on trachea other repair and plastic operations on bronchus bronchoscopy through artificial stoma diagnoses: chronic airway obstruction, not elsewhere classified atrial fibrillation pulmonary collapse personal history of venous thrombosis and embolism gastrostomy status foreign body accidentally entering other orifice chronic respiratory failure hip joint replacement other diseases of trachea and bronchus attention to tracheostomy foreign body in respiratory tree, unspecified 

Answer: The patient is high likely exposed to