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: histamine h2 inhibitors / codeine / sulfa (sulfonamide antibiotics) / proton pump inhibitors / penicillins / demerol attending: chief complaint: hypoxia major surgical or invasive procedure: none history of present illness: ms. is a year-old woman with a history of parkinson's, cad, dilated cm (ef 30%), chronic mesenteric ischemic s/p stents, recent fall complicated by humeral fracture, aspiration pneumonia. please see admission note for full details of history. briefly, she was admitted to osh with aspiration pneumonia. she was treated with broad spectrum antibiotics but decomepensated, with , demand ischemia, concern for new mesenteric ischemia. she was transferred from osh icu to icu on . . in the icu, she was hemodynamically stable, without oxygen requirement. vancomycin and levofloxacin (needs 6 more days to complete 10 day course) were started. picc was placed. aspiration was thought to be in part secondary to compromised mental status from polypharmacy. zyprexa was given because patient was moaning, resulting in bp drop to the 80s. ekg showed lateral tw changes, thought to be secondary to demand. plavix was held. past medical history: * cardiac risk factors: (-)diabetes, (+)dyslipidemia, (+) * hypertension * cardiac history: nstemi * percutaneous coronary intervention today showed anatomy as follows: lmca ostial 60-70%, distal 40-50% lad origin 60-70% lcx mild diffuse rca 95% proximal, mid diffuse 70%, distal 70% left main and severe two vessel cad, rca felt to be culprit. successful ptca and bms x2 to rca. recommending aspirin 325mg daily x1 month then 162mg daily. plavix 75mg daily x1-12 months. gentle hydration of 1.5 l after contrast load. * no pacemaker/icd. . other past history: - coronary artery disease - non q-wave mi in - chronic angina - peripheral vascular disease - mesenteric ischemia s/p multiple pcis of mesenteric vasculature (sma, celiac artery etc.) - hypertension - gout - parkinson's: lower half - chronic anemia: pernicious - hyperlipidemia - osteopenia: formerly treated with calcium and fosamax - cataracts - hemorrhoids - colonic polyps s/p polypectomies - cholecystectomy - direct brachial artery repair - retinal surgery social history: widowed, lives alone; is retired school principal. has a driver and paid visiting nurse/housekeeper who comes to patient's home three hours a day. has two children in the area. patient does not smoke (remote tobacco use history), drink alcohol and denies illicit drug use. she has 24 hour help at home. family history: hypertension, alzheimer's disease. no family history of sudden cardiac death. physical exam: vitals: t:96.7 bp: 112/50, hr:88 20 97%ra general: lays in bed vocalizing sound, delirious heent: edentulous, ngt in place neck: supple, jvp not elevated, no lad lungs: unable to fully assess lungs due to pt constant vocalizing cv: regular, no murmurs abdomen: mildly distended, non-tender, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: le edema l>r especially on knee, skin tears on lower arm skin: stage 2-3 decub ulcer on coccyx, deep tissue injury to heels bilaterally pertinent results: 06:14am blood wbc-9.1 rbc-3.62* hgb-10.6* hct-32.7* mcv-90 mch-29.4 mchc-32.5 rdw-17.3* plt ct-382 06:18am blood wbc-7.5 rbc-3.21* hgb-9.6* hct-28.9* mcv-90 mch-29.8 mchc-33.1 rdw-17.3* plt ct-286 05:35am blood wbc-9.9# rbc-3.57* hgb-10.3* hct-32.6* mcv-91 mch-28.9 mchc-31.7 rdw-17.3* plt ct-385 06:30am blood wbc-6.5 rbc-3.15* hgb-9.3* hct-29.1* mcv-92 mch-29.5 mchc-32.0 rdw-17.3* plt ct-343 07:40am blood wbc-8.1 rbc-3.25* hgb-9.7* hct-30.3* mcv-93 mch-29.9 mchc-32.0 rdw-17.2* plt ct-345 08:21am blood wbc-8.8# rbc-3.35* hgb-10.0* hct-29.6* mcv-88# mch-29.8 mchc-33.7 rdw-17.3* plt ct-360# 06:14am blood plt ct-382 06:14am blood pt-12.1 ptt-27.9 inr(pt)-1.0 06:14am blood glucose-97 urean-44* creat-1.4* na-138 k-4.7 cl-108 hco3-19* angap-16 08:21am blood ck(cpk)-42 06:14am blood calcium-8.6 phos-3.1 mg-1.9 brief hospital course: ms. was transferred here from osh with concerns of suspected aspiration pna, osh cxr reports look like recurrent aspiration pna w/ new infiltrates every day and possible sepsis on , would be c/w known delerium and pd and high doses of dilaudid/ativan/oxazepam/haldol. she had sputum cx at osh which was + for yeast only on so was continued on levofloxacin and vanc. in the micu she was found to be afebrile, hd stable and not 02 dependent so she was transferred to the floor. on the floor she continued to be delirious with waxing and alertness, as well as agitation. # goals of care: on admission the patient was very agitated and delirious. the family at the time agreed to make the patient dnr but continued potential for intubation. goals during the first week of admission were to support the patient and continue medication with the hopes of allowing the patient to improve her mental status and clarity. while the patient did improve to some degree, demonstrating the ability to speak a few words and respond to questions, her status waxed and waned significantly. at baseline the patient would lay in bed screaming or vocalizing sound without a clear source of pain or agitation. she continued tube feeds with an ng tube and medications for underlying conditions. after a week of admission, a family meeting was held where it was felt that care should be transitioned to comfort measures only. the ng-tube was pulled and po meds were dced. the patient was continued on iv morphine for pain, sublingual zyprexa for agitation. palliative care was consulting. . #pna: suspected to be secondary to aspiration, with possible contribution from ams secondary to polypharmacy. s&s evaluation done, and the patient failed, so she was npo, no meds, no ice chips. she did a course of vancomycin and levofloxacin (last day ); picc placed. patient remained stable on room air. . # altered mental status: likely secondary to delirium from multiple infections and pain from recent humerus fracture. baseline dementia, parkinson's are also contributing. per family & primary neurologist, her mental status was significantly better than this prior to this hospitalization. over the course of admission the patient had some increased alertness but waxing and . no haldol was given bc of interaction with sinemet. prior to beind made cmo, no zyprexa was given bc of past hypotensive event. hydromorphone for pain. . #cad: known 3vd, recent des. plavix held in icu while stabilizing patient. troponin elevations were likely secondary to demand in the setting of sepsis rather than secondary to plaque rupture. currently downtrending from osh (0.63-->0.52). restarted plavix, then dced as inconsistent with goals of care. metoprolol given until ng tube pulled. . # cki: creatinine currently at baseline 1.3. pt given small fluid boluses to maintain urine output while keeping low ef in consideration. . #hx of mesenteric ischemia: no evidence of active ischemia during this admission. . #shoulder fx: pt given prn dilaudid, standing tylenol. . #pd: likely contributing to swallowing difficulties. patient was on home sinemet until po meds dced. if pt seems to be suffering from pd related problems at the nursing home, can be given sublingial sinemet. . #gout. home allopurinol was continued during the admission but could not be administered without ng tube. can restart if patient able to tolerate crushed in applesauce or pureed po feeds. . #anemia: baseline hct around 31, hx of pernicious anemia. b12 qmonth. . # fen: tf initially per ngtube, did not tolerate full feeds. ultimately held given goals of care. replete electrolytes, regular diet # prophylaxis: subcutaneous heparin # access: picc medications on admission: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 4. valsartan 160 mg tablet sig: two (2) tablet po daily (daily). 5. amlodipine 5 mg tablet sig: one (1) tablet po bid (2 times a day). 6. naphazoline-pheniramine 0.025-0.3 % drops sig: one (1) drop ophthalmic qid (4 times a day) as needed for itchy eyes. 7. fluocinonide 0.05 % cream sig: one (1) appl topical (2 times a day): to legs. 8. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 9. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: 1-2 drops ophthalmic prn (as needed) as needed for dry eyes. 10. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). 11. carbidopa-levodopa 25-100 mg tablet sig: one (1) tablet po qid (4 times a day). 12. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 13. multivitamin tablet sig: one (1) tablet po daily (daily). 14. polyethylene glycol 3350 17 gram/dose powder sig: one (1) packet po daily (daily) as needed for constipation. 15. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 16. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). 17. allopurinol 100 mg tablet sig: one (1) tablet po once a day. 18. isosorbide mononitrate 20 mg tablet sig: 1.5 tablets po twice a day. 19. oxazepam 15 mg capsule sig: one (1) capsule po once (once). vancomycin 500mg iv q24 -> . discharge medications: 1. polyvinyl alcohol 1.4 % drops sig: 1-2 drops ophthalmic prn (as needed) as needed for dry eyes. 2. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: two (2) puffs inhalation q4h (every 4 hours) as needed for sob. 3. brimonidine 0.15 % drops sig: one (1) drop ophthalmic q 12h (every 12 hours). 4. timolol maleate 0.5 % drops sig: one (1) drop ophthalmic (2 times a day). 5. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 6. lidocaine hcl 2 % solution sig: one (1) ml mucous membrane tid (3 times a day) as needed for pain. 7. phenol 1.4 % aerosol, spray sig: one (1) spray mucous membrane prn (as needed) as needed for sore throat. 8. olanzapine 5 mg tablet, rapid dissolve sig: 0.5 tablet, rapid dissolve po tid (3 times a day) as needed for agitation. 9. acetaminophen 650 mg suppository sig: one (1) suppository rectal q6h (every 6 hours). 10. morphine concentrate 20 mg/ml solution sig: 3-6 mg po q3h as needed for pain: 0.15-0.3ml . 11. allopurinol 300 mg tablet sig: one (1) tablet po once a day: can give crushed in applesauce or pudding if patient is tolerating po feeds. discharge disposition: extended care facility: nursing & rehabilitation center - discharge diagnosis: aspiration pneumonia discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable. activity status: bedbound. discharge instructions: you were transferred to from another hospital icu after aspiration event. over the course of your admission you became stable on room air but continued to be delirious and deconditioned. in discussion with your family it was decided to make you comfort measures only. you will continue to receive medications to treat pain and agitation but will not receive unnecessary measures to prolong life. followup instructions: none procedure: enteral infusion of concentrated nutritional substances central venous catheter placement with guidance diagnoses: other primary cardiomyopathies coronary atherosclerosis of native coronary artery congestive heart failure, unspecified acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified peripheral vascular disease, unspecified other and unspecified hyperlipidemia paralysis agitans chronic kidney disease, stage iii (moderate) pneumonitis due to inhalation of food or vomitus old myocardial infarction chronic systolic heart failure pressure ulcer, lower back encounter for palliative care delirium due to conditions classified elsewhere disorder of bone and cartilage, unspecified long-term (current) use of aspirin pernicious anemia pressure ulcer, stage iii 

Answer: The patient is high likely exposed to