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: history of present illness: this is a 54-year-old woman with a past medical history significant for 20 years of low back pain managed with heavy-dose narcotics at home with several recent admissions in the past year for hypercarbic respiratory failure (reportedly, all these episodes have occurred since she changed her opiate regimen last spring). she had a recent admission approximately 10 days ago at an outside hospital for hypercarbic respiratory failure with increased troponins at that time. on that admission, she was extubated one day after admission and discharged to home. on the day of admission she was found to be somnolent by emergency medical service with a respiratory rate of 8, and a fingerstick in the 250s. she was brought to where an arterial blood gas showed 7.19/73/32. she was intubated with rapid improvement in her arterial blood gas, but her systolic blood pressure subsequently dropped into the 50s and she was started on a dopamine drip. she was transferred to with her dopamine drip partially weaned, and her systolic blood pressure in the 120s. she was seen in the emergency department at by the cardiology consultation service secondary to her increase in troponin. increased troponins were thought to be secondary to hypotension causing demand ischemia and a troponin lead. her chest x-ray in the emergency department showed bibasilar consolidations. a ct angiogram showed bibasilar atelectasis/consolidation with air bronchograms and numerous mediastinal lymph nodes. there was no evidence of pulmonary embolus. given the results of the ct angiogram and the fact that the patient subsequently spiked to a temperature of 103, she was started on vancomycin, ceftriaxone, and metronidazole. her troponin came back at 26.2. she had no acute changes on her electrocardiogram, but a heparin drip was started due to concerns of a possible acute coronary syndrome. she maintained her blood pressure, overnight on the night after admission, as the dopamine drip was weaned off. the dopamine drip was stopped entirely on the morning after admission. she remained stable on a mechanical ventilator overnight, and on the day after admission she was extubated without difficulty. while in the intensive care unit, she was seen by the pain consultation service who recommended stopping all of her outpatient pain medications and staring a morphine patient-controlled analgesia to evaluate her daily opiate needs prior to starting a new pain control regimen. review of systems: on review of systems in the intensive care unit she reported cough productive of scant sputum, though she has always had a chronic cough secondary to smoking. per her report, she was feeling fine at home prior to admission other than feeling a bit sleepy on the date of admission. she went to sleep and was later found unresponsive. at home she denied any fevers, chills, shortness of breath, or chest pain. the patient and family adamantly deny that the patient was overusing her narcotics at home. past medical history: 1. coronary artery disease, status post coronary artery bypass graft in , status post myocardial infarction. cardiac catheterization showed a patent left internal mammary artery to left anterior descending artery, and occluded saphenous vein graft to right coronary artery, a 40% stenosis in the right internal mammary artery to right coronary artery, and left ventricular ejection fraction of 63%, left ventricular end-diastolic pressure of 26, and occluded left main coronary artery, a proximally occluded right coronary artery, 50% mid stenosis of the circumflex, and a 100% stenosis of the mid left anterior descending artery. 2. hypertension. 3. hypercholesterolemia. 4. chronic low back pain, status post laminectomy times two in the past. she is maintained on chronic narcotics at home. 5. gastroesophageal reflux disease. 6. question chronic obstructive pulmonary disease. 7. question liver disease. 8. depression. medications on admission: medications at home included robaxin 750 mg 2 tablets q.4h., 150 mg p.o. q.d., oxycodone 5 mg 6 to 8 tablets p.o. q.d., neurontin 300 mg p.o. t.i.d., lipitor 80 mg p.o. q.d., aspirin, prilosec 20 mg p.o. q.d., xanax 1.5 mg p.o. q.i.d., gemfibrozil 600 mg p.o. q.d., vioxx 25 mg p.o. q.d., atenolol 25 mg p.o. q.d., nitroglycerin p.r.n. allergies: nitroglycerin causes significant decreased blood pressure. she has taken sublingual nitroglycerin in the past without difficulty. she is also allergic to tape and bee stings. social history: she lives at home with her family. she has been on disability for the last 20 years secondary to low back pain. she smokes approximately one pack per day for about a 50-pack-year history. physical examination on presentation: at the time of the examination in the intensive care unit she was afebrile. her blood pressure and heart rate were stable and within normal limits, off cardiac medications except for the atenolol. she was awake, alert, and pleasant, and cooperative. she was interviewed with her daughter and husband in the room. pupils were equal, round, and reactive to light. extraocular movements were intact without nystagmus. anicteric. the oropharynx was benign. neck was supple. jugular venous distention at 14 cm. lungs had bibasilar crackles, dullness to percussion at the bases. no wheezes, no rhonchi, no accessory muscles for respiratory were used. hear was regular in rate and rhythm with normal first and second heart sounds. there was a fourth heart sound present. no murmurs were appreciated. the abdomen was soft. there was mild diffuse tenderness which was not localized. there was trace pitting and pretibial edema bilaterally. neurologic examination was nonfocal. pertinent laboratory data on presentation: on the day of admission white blood cell count was 12.1 (with 79% neutrophils and 16% lymphocytes), hematocrit of 34.9, platelets of 196. electrolytes were within normal limits. pt and ptt were within normal limits. urinalysis showed no evidence of infection. creatine kinases were 2108, 1708, and 1277. ck/mb were 49, 31, and 16. mb index was 2.3, 1.8, and 1.3. troponin i was 26.2 and 21.7. on the day after admission, white blood cell count was 9.5, hematocrit 30.3, platelets 188. electrolytes were within normal limits. ast 117, alt 40, alkaline phosphatase 149, total bilirubin of 0.6, amylase 149, lipase 27, albumin 2.7. calcium 7.7. a post extubation arterial blood gas was 7.35/45/93. sputum culture from the date of admission had greater than 25 neutrophils, less than 10 epithelial cells, with 1+ multiple organisms consistent with oropharyngeal flora. blood cultures times four and urine culture times one showed no growth. radiology/imaging: electrocardiogram showed normal sinus rhythm at 82 beats per minute. there was a normal axis and normal intervals. there were q waves in leads ii, iii, and avf. there were no st depressions or elevations. there was a t wave inversion in lead v1. ct angiogram showed numerous mediastinal lymph nodes, the largest 1.2 cm in diameter, bibasilar consolidations/atelectasis, single bulla in the right lower lobe, some air trapping in the right lower lobe, and degenerative joint disease of the spine. a persantine mibi in showed no reversible or fixed ischemic defects with normal wall motion and an ejection fraction of 70%. hospital course: following transfer out of the intensive care unit, ms. was admitted to the medical floor for further management of her acute medical issues. 1. cardiovascular: she was followed by the cardiology consul service while in the hospital. their opinion was that the increased troponins were due to demand ischemia and not supply ischemia. they recommended increasing the beta blocker as tolerated. she was maintained on her aspirin and lipitor. she had no further episodes of chest pain throughout the remainder of her hospital course. due to a slight increase in peripheral edema during the course of her hospital stay she received several liters of intravenous fluids in the intensive care unit, she was given several low doses of intravenous diuretics. 2. infectious disease: she was started on levofloxacin in the intensive care unit for treatment of likely pneumonia. sputum cultures and blood cultures were all negative. 3. pain: she was seen by the pain consultation service who recommended starting her on a morphine patient-controlled analgesia. after 24 hours on the morphine patient-controlled analgesia they recommended switching her over to ms contin 60 mg p.o. b.i.d. and msir 15 mg p.o. q.6h. p.r.n. she maintained on her neurontin for treatment of neuropathic pain. dr. at (her primary pain specialist) was . thought it was unlikely that she had overdosed on the narcotics. he agreed to follow up with her immediately after discharge. 4. psychiatry: she was seen by the psychiatry consultation service while in the hospital. they thought that she had some mild delirium and would benefit from an outpatient psychiatry followup. this was arranged prior to discharge. condition at discharge: condition on discharge was stable. discharge diagnoses: 1. hypercarbic/hypoxic respiratory failure; question secondary to narcotic overdose. 2. pneumonia. 3. myocardial infarction. 4. coronary artery disease. 5. hypertension. 6. hypercholesterolemia. 7. chronic low back pain. 8. gastroesophageal reflux disease. 9. question chronic obstructive pulmonary disease. 10. question liver disease. 11. depression. medications on discharge: 1. ms contin 60 mg p.o. b.i.d. 2. neurontin 300 mg p.o. t.i.d. 3. lipitor 80 mg p.o. q.d. 4. aspirin 325 mg p.o. q.d. 5. prilosec 20 mg p.o. q.d. 6. xanax 1.5 mg p.o. q.i.d. 7. gemfibrozil 100 mg p.o. q.d. 8. vioxx 25 mg p.o. q.d. 9. atenolol 25 mg p.o. q.d. 10. nitroglycerin p.r.n. discharge followup: she was to follow up in the clinic on with dr. . she was to follow up with her cardiologist, dr. . she was to follow up with her pain specialist, dr. , at on . an outpatient psychiatry appointment was arranged for her on . , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified arteriography of other intrathoracic vessels diagnoses: pneumonia, organism unspecified subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery unspecified essential hypertension chronic airway obstruction, not elsewhere classified acute respiratory failure accidental poisoning by central nervous system stimulants delirium due to conditions classified elsewhere poisoning by opiate antagonists 

Answer: The patient is high likely exposed to