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: sulfa (sulfonamide antibiotics) / penicillins / decongestant sinus / potassium sorbate attending: chief complaint: dyspnea major surgical or invasive procedure: none history of present illness: 79 yo female with a history of metastatic thymic cancer s/p palliative chemo, stage i nonsmall cell lung cancer s/p cyberknife therapy, asthma, htn, insulin resistance presents with dyspnea. patient was originally admitted to ccu, but is now transferred to micu for management of suspected septic shock. per the patient's record, the patient felt acute dyspnea yesterday evening. this episode was followed by acute chest discomfort located in the substernal region and was brought in by her son. of note, the patient has had a recent admission for asthma/bronchiectasis and possible radiation pneumonitis. at that time she was on aztreonam and azithromycin (given penicillin allergy for coverage of pseudomonas) . in the ed, initial vs were hr 135 bp 155/92 o2 82% on ra. her physical exam was consistent with pulmonary edema. ekg revealed tachycardia with aberancy (left bundle pattern) new compared to prior. cardiology was consulted. labs revealed elevated bnp at 1381 (prior 792), trop 0.16, wbc of 13.8, normal ua. cxr revealed bilateral fluffly infiltrates, more dense infiltrates in the right upper lobe, bilateral effusions. she was given nitro drip, lasix, aspirin, morphine, eventually cefepime, vanco, methylprednisone. she was placed on cpap however her symptoms did not improve. the decision was made to intubate. . the ed resident had a difficult time intubating, with copious frothy bloody fluid from the et tube. she had an episode of hypoxia while attempting to replace et tube down to the 60s. eventually the patient was successfully intubated by anesthesia by a fiberoptic. she was given propofol during intubation and then sedated with fentanyl/midaz following. initial abg following intubation revealed respiratory acidosis (7.17 pco2 65 po2 117 hco3 25), however after increasing tidal volume and rate, ventilatory efforts have improved (ph 7.34 pco2 32 po2 68 hco3 18 with a lactate of 5.3). . there was concern for lbbb on ekg initially, but cardiology fellow felt this was more consistent with sinus rhythm w/ aberrancy. cardiology fellow performed bedside echo which demonstrated globally decreased function with questionable wall motion abnormality of anterior and septal walls with trivial pericardial effusion and no impairment of the rv, new compared to normal echo in . cardiology recommended heparin, however the patient has not had head imaging recently so heparin was held until head ct could be performed. prior to leaving for ct scanner the patient's blood pressure dropped. despite pulmonary edema, the patient was given 2l ivf and started on levophed. a central femoral line was placed. the patient was also sent for chest ct prior to arrival in the ccu. . in ccu, patient started on vanc/cefepime/flagyl for pneumonia. she was started on vasopressin after maximal levophed. she is transferred to micu for further management of shock. . review of systems unable to be performed. past medical history: 1. metastatic thymic carcinoma: s/p excision, xrt, pleurodesis for recurrent right-sided pleural effusion , and 5 cycles of palliative chemotherapy with carboplatin and etoposide. was her oncologist. 2. nsclc: stage 1 (t1n0m0) disease; treated with cyberknife radiosurgery, last treatment 4/. 3. asthma diagnosed at age 50, treated at , previously hospitalized, never intubated. 4. post nasal drip 5. impaired glucose tolerance. exacerbated by recent steroids. has been on metformin in the past but did not tolerate gi side effects. 6. hypertension 7. gerd 8. histoy of c diff infection social history: lives alone in . dresses and for herself. no history of tobacco, alcohol, or iv drug use, but notes 50-year exposure to secondhand smoke from husband. ambulates with assistance of cane. daughter lives in family history: no known family history of cancer. family history of asthma - one daughter and grandchildren affected. physical exam: exam on admission: general: intubated and sedated, : ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: unable to assess jvp, dilated vessels on anterior chest. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: coarse sounds bilaterally, rhonchi bilaterally. abdomen: distended, obese, soft, extremities: cool extremities, no c/c/e. skin: multiple bruises on abdomen, arms, no stasis dermatitis, ulcers, scars, or xanthomas. pulses: 1+/dopplerable pulses in lower extremies and upper extremities pertinent results: labs on admission: 01:15am blood wbc-13.8* rbc-4.70 hgb-13.7 hct-42.5 mcv-91 mch-29.1 mchc-32.2 rdw-16.5* plt ct-237 01:15am blood neuts-75.6* lymphs-22.3 monos-1.5* eos-0.2 baso-0.4 08:53pm blood hypochr-1+ anisocy-1+ poiklo-3+ macrocy-1+ microcy-normal polychr-normal ovalocy-1+ burr-3+ tear dr 01:15am blood pt-10.8 ptt-17.8* inr(pt)-0.9 01:15am blood glucose-333* urean-37* creat-1.3* na-134 k-5.3* cl-93* hco3-25 angap-21* 01:15am blood alt-57* ast-92* ld(ldh)-471* ck(cpk)-79 alkphos-68 totbili-0.4 01:15am blood ck-mb-4 ctropnt-0.16* probnp-1381* 01:15am blood albumin-4.0 calcium-9.1 phos-5.1*# mg-2.1 02:09am blood type-art rates-/40 tidal v-500 peep-8 fio2-100 po2-180* pco2-37 ph-7.35 caltco2-21 base xs--4 aado2-527 req o2-84 intubat-not intuba vent-spontaneous 01:21am blood k-4.8 . cxr: - there are bilateral pleural effusions, right greater than left. additionally, there is increased opacification within the right upper lobe, which is new since , as well as in bilateral lung bases which likely represent pneumonia. there is mild cardiomegaly and pulmonary edema. sternotomy wires are midline and intact. . cta chest: 1. no central pulmonary embolism. 2. post-radiation fibrotic changes within the right lung. additionally, a small right-sided pleural effusion and trace left-sided pleural effusion is noted. adjacent compressive atelectasis in bibasilar lungs is noted; additionally, new foci of consolidative process within bilateral lung bases may represent aspiration/pneumonia. 3. no acute aortic pathology identified. . ct head: no evidence of acute intracranial process. mri would be more sensitive for metastatic disease, if indicated. brief hospital course: 79 yo female with a history of metastatic thymic cancer s/p palliative chemo, stage i nonsmall cell lung cancer s/p cyberknife therapy, asthma, htn, insulin resistance admitted to hypercarbic respiratory failure. . # septic/cardiogenic shock: strongly suspect infectious source of shock, given evidence of multifocal pneumonia on chest ct. however, concern for possible cardiac etiology as well, given depressed ef, though this could alternatively be due to myocardial stunning from sepsis. placed on coverage for hcap with meropenem/vancomycin/levaquin. placed on coverage for pcp pneumonia with bactrim + steroids, and aspergillus with voriconazole given recent positive sputum culture and nodules on ct scan. covered for cdiff with both iv flagyl and po vancomycin given history of cdiff infection and current distended abdomen. the patient was started on levophed and vasopressin, as well as dobutamine for ionotropic effect. cultures of sputum returned after the patient's passing and were (+) for mrsa, which was vancomycin-sensitive. . # hypercarbic/hypoxia respiratory failure: the patient has a history of asthma, however presentation is more consistent with pulmonary edema or infectious process (ct reveals bilateral infiltrates). she is also immunosuppressed as she has been on prednisone, bringing into question possible pcp . patient intubated and started on ards net protocol. . # myocardial ischemia: cardiac enzymes trending up, ef was 15-20% and echo shows global hypofunction. high suspicion for demand ischemia/stunning in the setting of septic shock, now with component of cardiogenic shock as well. . # acute renal failure: acute increase in creatinine from 1.0 to 2.3 with resulting hyperkalemia to 5.8. likely in the setting of tissue hypoperfusion shock. . # anion gap metabolic acidosis: likely secondary to lactic acidosis and renal failure. . # thymic cancer and nsclc: s/p chemo for thymic cancer and cyberknife for stage i nsclc. pet from shows likely metastatic disease in the mediastinum. the patient has had recurrent pleural effusions, s/p pleurodesis. . a discussion was held with patient's family, and the decision was made to withdraw vasopressors and antimicrobial treatment. the patient expired at 17:51. the immediate cause of death was septic shock. the other causes of death included respiratory failure, thymic cancer, and non-small cell lung cancer. family declined autopsy. medications on admission: albuterol sulfate neb ih q3-4hrs as needed ventolin hfa 90 mcg/actuation hfa aerosol inhaler 2 puffs ih every 4-6 hours as needed alendronate 70 mg po once a week. fexofenadine 180 mg po once a day. fluticasone 220 mcg/actuation aerosol sig: 2-3 puffs ih hydrochlorothiazide 25 mg po once a day. lorazepam 1 mg po bid as needed for anxiety/insomnia. montelukast 10 mg po daily omeprazole 20 mg po bid oxycodone-acetaminophen 5-325 mg as needed for pain. prednisone 20 mg taper salmeterol 50 mcg/dose inhalation q12h tiotropium bromide 18 mcg capsule daily valsartan 320 mg po once a day. aspirin 81 mg po once a day. calcium carbonate 600 mg (1,500 mg) po once a day. ergocalciferol (vitamin d2) oral multivitamin ferrous sulfate 325 mg po once a day. omega-3 fish oil oral discharge medications: expired discharge disposition: expired discharge diagnosis: expired discharge condition: expired discharge instructions: expired followup instructions: expired md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube arterial catheterization diagnoses: pneumonia, organism unspecified other primary cardiomyopathies acidosis congestive heart failure, unspecified unspecified essential hypertension acute and subacute necrosis of liver acute kidney failure, unspecified unspecified septicemia severe sepsis asthma, unspecified type, unspecified acute respiratory failure malignant neoplasm of bronchus and lung, unspecified cardiogenic shock septic shock acute systolic heart failure other and unspecified coagulation defects personal history of malignant neoplasm of other respiratory and intrathoracic organs 

Answer: The patient is high likely exposed to