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: tetracyclines attending: chief complaint: respiratory failure major surgical or invasive procedure: intubation history of present illness: 61 yo f with a history of cad and copd with multiple prior intubations for copd flares admitted with respiratory failure requiring intubation. the patient's visiting nurse called her pcp with reports of increasing cough and dyspnea for several days. note was made of yellow-green sputum. she was afebrile, bp 160/100 with diffuse inspiratory and expiratory wheezes. she had moderate labored breathing. the patient refused to come to the ed at that time. she was started on pulse dose prednisone 50mg daily and azithromycin. on presentation to the ed, the patient was using accessory muscles for breathing, speaking in word sentences. ed vitals hr 140-150, bp 152/84, rr 36-40 86% nrb improved after combivent neb to 100% nrb. she was febrile to 101. the patient received levofloxacin 750mg iv, ceftriaxone 2g, methylprednisolone 125mg iv, acetaminophen and pantoprazole as well as 2.5l ns. the patient was noted on og lavage in the ed to have some coffee-ground return and brown guaiac-positive stool. past medical history: - copd, last pfts with fvc 1.72, fev1 0.82, fev1/fvc 66% (61% and 40% predicted respectively); intubated several times in the past. on 2l home o2. - iga deficiency, was on iv gamma globulin with dr. . - cad s/p mis in (flu symptoms), (jaw pain), nstemi in (chest pain with left arm discomfort). cath in with ptca/stent to lcx. cath in with stent placement to rca and lcx. - hypertension - hyperlipidemia - gastritis, on ppi - osteoporosis, with history of multiple compression and rib fractures from coughing - history of thrush/ esophagitis steroid therapy - depression - tremor social history: she lives with her daughter, , son-in-law and 3 grand-children. she is a widow. she is an ex-smoker, with about a 30-pack-year smoking history, quit in . no etoh. uses a cane and walker to ambulate. family history: mother with dm, father with pancreatic cancer. physical exam: admission physical exam: gen: intubated and sedated. cv: rrr. normal s1 and s2. no m/r/g. pulm: rhoncorous upper airway breath sounds heard bilaterally. abd: mildly distended. soft, nontender. ext: no edema. neuro: unresponsive. pinpoint pupils, minimally reactive. pertinent results: na 142, k 4.2, cl 93, bun/cr 24/0.9, glucose 106, wbc 26.4, hct 43.0, platelets 511, inr 1.0, 88. . lactate 1.6 . 7.25/81/48 -> 7.23/80/141 ac vt 400, fio2 60 -> 7.29/64/121 ac vt 400, fio2 50 . ua rbc, wbc, tr leuk, neg nit, 30 prot . ekg: rhythm strip from the field reveals normal sinus rhtyhm at a rate of approximately 140. sinus tachycardia at 116. normal axis and intervals. large voltage across the precordium. likely left atrial enlargement. upsloping <1mm st elevations in v3-6. no acute st or t wave changes. no prior available for comparison. . micro: blood culture (): ngtd urine culture (; ): ngtd sputum culture (): streptococcus pneumoniae ceftriaxone----------- 1 s erythromycin---------- =>1 r levofloxacin---------- <=0.5 s tetracycline---------- =>16 r trimethoprim/sulfa---- 8 r vancomycin------------ <=1 s . imaging: cxr (): 1. lines and tubes are in adequate position. 2. ill-defined bibasilar opacities, nonspecific, yet may represent a component of aspiration. 3. heart size upper limits of normal without acute pulmonary edema. . tte: the left atrium is mildly dilated. no atrial septal defect is seen by 2d or color doppler. the estimated right atrial pressure is 10-20mmhg. there is mild regional left ventricular systolic dysfunction with hypokinesis/akinesis of the basal to mid inferolateral wall. the right ventricular cavity is mildly dilated with normal free wall contractility. the number of aortic valve leaflets cannot be determined. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. moderate (2+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. there is an anterior space which most likely represents a fat pad. impression: mild focal left ventricular systolic dysfunction. mildly dilated right ventricle with preserved systolic function. at least moderate mitral regurgitation. moderate pulmonary artery systolic hypertension. brief hospital course: hypercarbic respiratory failure, acute copd exacerbation: ms. is a 61 yo female with a history of multiple prior intubations for copd. on arrival to the ed on , she was febrile, tachycardic, tachypneic and satting only in the mid-80's on a non-rebreather. she was in respiratory distress using accessory muscles and speaking in short sentences. abg showed a respiratory acidosis, and she was intubated in the ed. chest x-ray showed bibasilar opacities and she was started empirically on levofloxacin and ceftriaxone. she was also given solumedrol and nebulizers for a copd exacerbation. she was admitted to the icu for further care and continued on levofloxacin for a cap. on , her steroids were changed to prednisone 30 mg qd and she was continued on a taper (she was discharged on prednisone 10 mg qd). on she was extubated; she required intermittent bipap over the following 36 hours for hypercarbia, but was eventually able to be weaned to 2l nc after administration of iv lasix. gastritis: ms. was noted on og lavage in the ed to have some coffee-ground return and brown guaiac-positive stool. she has a known history of gastritis. she was continued on a ppi and hct remained stable throughout. chronic diastolic heart failure, mitral regurgitation: an echocardiogram was obtained this admission which showed an ef of 55% and moderate mr. she was started diltiazem and lisinopril for afterload reduction. medications on admission: senna 8.6 mg twice daily as needed simvastatin 20 mg daily clopidogrel 75 mg daily fentanyl 25 mcg/hr patch every 72 hours montelukast 10 mg daily hexavitamin paroxetine hcl 10 mg daily fluticasone 50 mcg two sprays nasal daily calcium carbonate 500 mg 3 times a day with meals cholecalciferol (vitamin d3) 400 unit twice daily pantoprazole 40 mg daily docusate sodium 100 mg twice daily oxycodone-acetaminophen 5-325 mg every 4 hours as needed olanzapine 5 mg 2 times a day levalbuterol hcl 0.63 mg/3 ml 1ml inh q2h lidocaine 5 %(700 mg/patch) adhesive patch daily prednisone 10 mg daily tiotropium bromide 18 mcg capsule daily insulin lispro sliding scale discharge medications: 1. simvastatin 10 mg tablet : two (2) tablet po daily (daily). 2. clopidogrel 75 mg tablet : one (1) tablet po daily (daily). 3. montelukast 10 mg tablet : one (1) tablet po daily (daily). 4. calcium carbonate 500 mg tablet, chewable : one (1) tablet, chewable po tid w/meals (3 times a day with meals). 5. cholecalciferol (vitamin d3) 400 unit tablet : one (1) tablet po twice daily (). 6. olanzapine 5 mg tablet : one (1) tablet po bid (2 times a day). 7. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 8. fluticasone 110 mcg/actuation aerosol : two (2) puff inhalation (2 times a day). 9. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed for constipation. 10. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 11. acetaminophen 325 mg tablet : 1-2 tablets po q6h (every 6 hours) as needed for pain. 12. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day) as needed for constipation. 13. lisinopril 20 mg tablet : two (2) tablet po daily (daily). 14. prednisone 10 mg tablet : one (1) tablet po daily (daily). 15. albuterol 90 mcg/actuation aerosol : 1-2 puffs inhalation q4h (every 4 hours) as needed for soa. 16. oxycodone-acetaminophen 5-325 mg tablet : one (1) tablet po q6h (every 6 hours) as needed for pain. 17. ipratropium bromide 17 mcg/actuation aerosol : two (2) puff inhalation qid (4 times a day). 18. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : one (1) neb inhalation q4h (every 4 hours) as needed for sob/wheezing. 19. diltiazem hcl 240 mg capsule, sust. release 24 hr : one (1) capsule, sust. release 24 hr po once a day. discharge disposition: extended care facility: discharge diagnosis: primary diagnoses: (1) acute copd exacerbation (2) pneumonia (3) heart failure - chronic diastolic secondary diagnoses: (1) gastritis (2) depression (3) osteoporosis discharge condition: stable-- on 2l nc; mental status good -- seems to be back to baseline. discharge instructions: you were admitted with a copd exacerbation requiring intubation. you were also treated for a pneumonia. please call your doctor if you develop a fever or feel short of breath. if you cannot reach your doctor or if you feel severely short of breath, please return to the emergency department for further evaluation. followup instructions: you will be followed by the physicians at your rehab facility while you are there. md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube diagnoses: pneumonia, organism unspecified anemia, unspecified coronary atherosclerosis of native coronary artery mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension unspecified protein-calorie malnutrition obstructive chronic bronchitis with (acute) exacerbation personal history of tobacco use depressive disorder, not elsewhere classified percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia acute and chronic respiratory failure osteoporosis, unspecified old myocardial infarction paralytic ileus unspecified gastritis and gastroduodenitis, without mention of hemorrhage chronic diastolic heart failure abnormal involuntary movements 

Answer: The patient is high likely exposed to