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 attending: chief complaint: fever, sob, cough major surgical or invasive procedure: endotrachial intubation bronchoscopy foley catheter placement left subclavian line placement history of present illness: 67 y/o f with a h/o htn, t2dm, and hyperlipidemia who presented to the ed with a 4 day h/o cough, sob, and fever. of note, the patient recently returned from a trip to to visit relatives. the patient had been living in for several years and recently moved to the area. she flew back from this past friday and began to feel unwell on the following saturday. she had a productive cough of pink, frothy sputum. she also had a fever at home (no exact measurement). she also reported myalgias and decreased po intake. she presented to the ed for further evaluation of her symptoms. past medical history: 1. t2dm 2. htn 3. hyperlipidemia social history: no tobacco or ethanol use family history: nc physical exam: on transfer from micu: vitals: t 98.4 hr 81 bp 115/44 rr 22 94-100% on 2l nc general: 67 f in nad heent: nc/at. mm moist. op clear. neck: no jvd. cv: regular rhythm. nl s1, s2; no m/r/g. pulm: ctab, mildly decreased bs rul. abd: soft, non-distended, non-tender, with normoactive bs. ext: feet cool. 2+ dp's bilaterally. 2+ edema around ankles bilaterally, 1+ edema in ues around wrists. skin: no rash. neuro: a/o x 3. strength and sensation intact throughout. access: left subclavian in place pertinent results: initial labs (): wbc 17.5 hb 13.6 hct 39.8 plt 233 diff - 66n + dohle bodies, 21 bands, 10 lymphs na 135 chloride 96 bun 41 glucose 224 k 4.1 bicarb 26 cr 2.1 lactate 3.0 ck 1297 ck mb 7 trop t < 0.01 abg 7.29/53/83 21:07 abg 7.26/63/70 06:00 mixed venous 7.43/55/169 fe studies: iron 81 ug/dl 30 - 160 iron binding capacity, total 252* ug/dl 260 - 470 ferritin 513* ng/ml 13 - 150 transferrin 194* mg/dl 200 - 360 micro: bronchoalveolar lavage gram stain-final; respiratory culture-final; legionella culture-final; fungal culture-preliminary; acid fast smear-final; acid fast culture-pending cmv, ebv negative legionella negative mycoplasma igg, igm negative multiple blood culture, urine culture, respiratory culture negative imaging: pa and lateral: chest, two views: there is dense opacification of the right upper lung with associated air bronchograms. there is thickening of the right minor fissure likely due to a small amount of fluid in the fissure. the right posterior costophrenic sulcus is blunted consistent with a small pleural effusion. the left lung is clear. the heart size is normal. the aorta is tortuous. impression: dense opacification of the right upper lobe, likely representing a lobar pneumonia. an endobronchial obstructing lesion cannot be excluded on these radiographs. followup imaging after treatment is suggested. echo conclusions: the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: mild symmetric left ventricular hypertrophy with preserved left ventricular systolic function. mild valvular thickening with no signifcant stenosis or regurgitation. pa and lateral chest compared to through : a small amount of volume loss persists in the right upper lobe. there is no good evidence of recurrent pneumonia. mild cardiomegaly is stable. mediastinal vascular engorgement has improved. there is an unusual configuration to gas shadows in the upper abdominal midline, probably unusual displacement of the gastric antrum. if patient has referable symptoms to abdominal pathology i would reevaluate with routine abdominal radiographs. tip of the left subclavian line projects over the upper svc. no pneumothorax. medical student and dr. were both paged to report these findings at the time of dictation. brief hospital course: in the ed, her vital signs were t 99.9 hr 120 bp 114/50 rr 32 95%nrb. a chest x-ray da rul pneumonia, and ecg showed afib with rvr. her lactate was 3.0 and creatinine 2.1. she was pan-cultured, given a dose of antibiotics, and transferred to the micu for presumed septic shock. . # respiratory failure/septic shock: in the micu she quickly went into severe hypoxic hypercarbic failure (7.26/59/63 on nrb) requiring intubation. she became hypotensive, requiring transient pressors and a total of 13 liters net volume resuscitation. culture data including ebv, cmv, and tuberculosis were consistently negative, even after bronchoscopy. she completed a ten day course of ceftriaxone and azithromycin, but was also on vancomycin. by chest x-ray, her consolidation resolved quickly after 5 days (post-bronchoscopy for cultures), suggesting increased secretions were a major component of her pulmonary dysfunction. she had a prolonged intubation () with hypoxia during spontaneous breathing trials for many days. she was extubated on with steadily decreasing secretions and o2 requirements. she had an o2 requirement for 1-2 days on the floor that improved with incentive spirometry and walking with pt. . # rhabdomyolysis upon presentation in the micu, her ck was 1297 with large blood and few rbcs in the urine suspicious for rhabdomyolysis. her troponins wer negative. her cpks peaked at on along with transaminases in the 300's. she was treated by aggressive volume resuscitation and lasix to achieve uo > 100cc/hr. she never had any bump in her creatinine. her last ck was 3000, and she continued to have a stable creatinine until discharge. . # atrial fibrillation the patient's micu course was also complicated by atrial fibrillation for 3-4 days not properly rate controlled on metoprolol or diltiazem. echocardiography showed a normal heart with lvh and preserved ef (>55%). she was therefore begun on an amiodarone drip, leading to documented conversion on , after which the drip was d/ced. she was anticoagulated for a total of 5 days. in discussions with the cardiology consult service, it was felt that the transient risk factor for atrial fibrillation (septic shock) had resolved and that long-term anticoagulation would not be warranted. she remained in sinus rhythm for 9 days on telemetry after her cardioversion, after which telemetry was discontinued. she reported no palpitations at any point in her stay. . # weakness ms. was initially weak while recovering from her extesnive micu course. she improved rapidly with hospital pt, however, and was felt safe for discharge with home pt services to aid her recovery. . # anemia she had a labile hematocrit during this admission, likely consistent with a dilutional effect from high volume resuscitation. on discharge, she has borderline macrocytic anemia with near-appropriate reticulocyte production and fe studies consistent with anemia of chronic disease. she was guaiac negative. further w/u as an outpt may be clinically indicated. . # hypertension her blood pressure was titrated with iv beta-blocker in the micu and switched oiver to po beta-blocker once the patient was taking good pos. ace-i was d/ced out of concern for renal toxicity while rhabdomyolysis resolving. pt discharged on stable regimen of metoprolol 75mg with bps in the 120s -130s except before morning meds. outpt resumption of ace-i can be considered for this hypertensive patient with diabetes mellitus. . # dm2 pt was on humalog sliding scale during the majority of this admission. she was restarted on metformin before discharge, and had fsbg in the 100s without humalog support. pt reports she ahs always had normal blood sugars on metformin, and so she was sent home on her home regimen. . #hyperlipidemia crestor was held durign this admission out of concern for potentially exacerbating rhabdomyolysis. resumption of a statin as an outpatient is likely clinically indicated. . # nasal congestion ms. complained of nasal congestion post-intubation, which was initially treated with afrin x 3 days. she was sent home with ocean nasal spray. . the patient was discharged in good condition on . medications on admission: lisinopril 40 mg po daily tylenol prn ibuprofen prn ambien prn metformin 500 mg po bid crestor 20 mg po daily atenolol 50 mg po daily asa 81 mg po daily discharge medications: 1. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 2. aspirin 81 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 3. metoprolol tartrate 25 mg tablet sig: three (3) tablet po bid (2 times a day). disp:*180 tablet(s)* refills:*0* 4. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 5. ocean nasal 0.65 % spray, non-aerosol sig: two (2) sprays nasal twice a day: each nostril. disp:*1 bottle* refills:*2* discharge disposition: home with service facility: americare at home inc discharge diagnosis: primary: lobar pneumonia hypoxic and hypercarbic respiratory failure septic shock rhabdomyolysis atrial fibrillation critical illness myopathy secondary: hypertension diabetes mellitus type 2 controlled discharge condition: good. tolerating oral medications and nutrition. ambulating without assist on room air. discharge instructions: you have been evaluated and treated for a severe pneumonia. your course was complicated by severe breathing difficutly requiring a breathing machine to temporarily support your breathing. also, there was evidence of temporary muscle breakdown that was resolving by the time of discharge. during the most severe period of your illness, you developed a rapid irregular heartbeat. as this resolved as you recovered, no direct therapy was started for this heartbeat. should you notice a return of your irregular heartbeat, you should contact your doctor as soon as possible. please take the medications as prescribed. some of your medications have been changed. you may want to re-address these medications with your pcp at your next appointment. please attend the recommended follow-up appointments. please continue to practice incentive spirometery at home until your appointment with your pcp. if you develop any new or concerning symptom such as shortness of breath, chest pain, fevers to greater than 101f, or a fast irregular heartbeat; please seek medical attention as soon as possible. followup instructions: primary care physician: . 11:45am friday health center procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances arterial catheterization closed [endoscopic] biopsy of bronchus diagnoses: unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute and subacute necrosis of liver acute kidney failure, unspecified unspecified septicemia severe sepsis atrial fibrillation acute respiratory failure septic shock pneumococcal pneumonia [streptococcus pneumoniae pneumonia] rhabdomyolysis critical illness myopathy 

Answer: The patient is high likely exposed to