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: s/p fall major surgical or invasive procedure: : traction pin placement : orif left distal femur fracture with removal of traction pin. history of present illness: ms. is a yo f with a hx of asthma, paroxysmal af who is being transferred from the t-sicu/orthopedics to the medicine floor s/p a mechanical fall with l femur fracture and aspiration pneumonitis. pt experienced a mechanical fall on and broke her left femur. pt went to or on and is currently 7 days s/p l distal femoral orif. she had a pre-operative cxr on which showed a large midline hernia with stomach and transverse colon within it, which appeared to have not been followed up. she reportedly did well intially post-operatively on the surgical floor, although was noted to have an increased oxygen requirement to 3 l 2 days post-operatively and was noted to be having difficulty tolerating pos post-operatively. pt was being followed by speech and swallow who stated on that the patient had "atypical symptoms of aspiration" and recommended a video swallow, which demonstrated ues dysfunction. further gi work-up was recommended, and gi was consulted on , who recommended a ct chest/abdomen and barium swallow. on , patient triggered for respiratory distress on floor and was hypoxic to 53%, and transferred back to the icu. this occurred while she was being fed, but there were no witnessed aspiration events. she had a cta which was negative for pe, but confirmed the presence of transverse colon herniating into the thorax. during her micu course, her o2 sats have been normal on oxygen. she has a known hematoma in her l thigh.hematoma on left thigh which is following. overnight while in the icu, she had a slight decrease in hct overnight and was hypotensive in setting of sleeping (low 80s). bps improved with 500 ccs ns. patient is currently dnr/dni with no escalation of care. . past medical history: paroxysmal atrial fibrillation asthma htn dementia social history: lives with daughter. denies etoh, tobacco, illicit drug use. states she used to live in "" family history: parents died at ages of 89 and 97 physical exam: physical exam: vs: 98 89 17 99/56 96% on 2 l nc ga: elderly f lying in bed aox2 to person and place "medical", does not know date, nad although intermittently moans heent: perrla. mm dry. no lad. no jvd. neck supple. cards: pmi palpable at 5/6th ic space. no rvh. rrr s1/s2 heard. no murmurs/gallops/rubs. pulm: +expiratory wheezes and rhonchorus bs throughout all lung fields. decreased bs at middle and lower lung fields on l>r. abd: soft, nt, +bs. no g/rt. neg hsm. neg sign. extremities: wwp, no edema. dps, pts 2+ bl. skin: no rashes. neuro/psych: cns ii-xii intact. 5/5 strength in upper extremities, in lower extremities. dtrs 2+ bl (biceps, achilles, patellar). gross sensation intact. cerebellar fxn intact (ftn, hts). gait deferred. pertinent results: head ct - - no acute ic process 08:05am glucose-149* urea n-18 creat-0.9 sodium-143 potassium-3.5 chloride-105 total co2-31 anion gap-11 08:05am calcium-9.2 phosphate-3.4 magnesium-2.0 08:05am wbc-7.3 rbc-4.08* hgb-13.4 hct-39.7 mcv-97 mch-33.0* mchc-33.9 rdw-14.0 08:05am neuts-80.5* lymphs-15.0* monos-3.8 eos-0.4 basos-0.3 08:05am plt count-227 08:05am pt-13.3 ptt-25.0 inr(pt)-1.1 08:05am urine color-yellow appear-clear sp -1.009 08:05am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg brief hospital course: a/p: f h/o htn, paroxysmal atrial fibrillation, dementia and asthma presented fall and l femoral fracture s/p open reduction internal fixation, complicated by acute hypoxic respiratory distress and aspiration due to hiatal hernia, herniated transverse colon into the thoracic cavity, and upper esophageal sphincter stricture. brief hospital course by problem: # l femur fracture: ms. presented to the on via transfer from hospital. she was evaluated by the orthopaedic service and found to have a left distal femur fracture. a traction pin was placed in the emergency department and she was admitted, consented, and prepped for surgery. the medical service was consulted for help with preoperative clearance and medical management. she was taken to the operating room on . she underwent an orif of his left distal femur fracture with plate. she tolerated the procedure well, was extubated,transferred to the recovery room, and then to the floor. # hypoxia: likely due to aspiration pneumonitis as a result of hiatal hernia and transverse colon in thorax. patient was noted to have difficulty tolerating pos 2 days after surgery with an increased oxygen requirement. she triggered for hypoxia down to the 50s requiring icu re-admission, and recovered her saturations with nasal oxygen. she was ruled out for an mi and had a cta showing no evidence of pe. no antibiotics were administered given that her event was likely a chemical pneumonitis from gastric reflux (no fevers or leukocytosis). she was transferred back to the floor, kept on nasal canula oxygen, standing albuterol nebulizers every 6 hours, and followed by speech and swallow and gi while in house. she was initially kept npo after these aspiration events, but as her care became focused on comfort, her diet was changed to dysphagia with mouth care, swabs, ice, and comfort tastes. # dysphagia/herniated bowel: patient has a history of chronic dysphagia w/ a history of achalasia and botox injections. she has two contributing abnormalities: a tight upper esophogeal sphincter seen on video swallow (with associated stranding and thickening on ct), and hiatal hernia/bowel into the thorax through a diaphragmatic hernia noted on cxr and ct. gi and s&s followed patient in house. ues dilation and egd were offered to patient and family to further work-up dysphagia. however, patient and family declined procedure and focused on comfort care only. she was continued on a ppi, bowel regimen, and reglan/zofran as needed for nausea. # htn: re-started beta-blocker with good hypertensive control. d/c-ed hydrochlorothiazide and lisinopril. # paf: rate controlled on amiodarone and beta-blocker. chads2 score = 1 (for age), so anticoagulation not required # femur fracture: pain control with iv dilaudid q2h:prn, which was switched to oxycodone liquid and morphine liquid on discharge. . # dementia: frequent reorientation and minimize lines. . # asthma: continued albuterol nebs #code: dnr/dni (confirmed with hcp) . #disposition: hospice medications on admission: albuterol, amiodarone, lisinipril, metoprolol (not taking) discharge medications: 1. dorzolamide-timolol 2-0.5 % drops : two (2) drop ophthalmic qhs (once a day (at bedtime)). 2. latanoprost 0.005 % drops : one (1) drop ophthalmic (2 times a day). 3. morphine concentrate 20 mg/ml solution : 5-10 mg po q1h as needed for shortness of breath, pain. 4. metoclopramide 10 mg tablet : one (1) tablet po qidachs (4 times a day (before meals and at bedtime)). 5. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 6. amiodarone 200 mg tablet : 0.5 tablet po every other day (every other day). 7. metoprolol tartrate 25 mg tablet : one (1) tablet po bid (2 times a day). 8. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : one (1) neb inhalation q6h (every 6 hours): standing nebs. 9. acetaminophen 500 mg tablet : two (2) tablet po q8h (every 8 hours). 10. ondansetron hcl (pf) 4 mg/2 ml solution : four (4) mg injection q8h (every 8 hours) as needed for nausea. 11. oxycodone 5 mg/5 ml solution : 2.5-5 mg po q3h (every 3 hours) as needed. discharge disposition: extended care facility: - discharge diagnosis: left distal femur fracture discharge condition: stable, on comfort tastes and thin liquids on discharge. discharge instructions: you were admitted with a diagnosis of left femur fracture, requiring orthopedic surgery. you were also having difficulty swallowing and had many aspiration events leading to an aspiration pneumonitis and an oxygen requirement. the aspiration is due to herniated bowel and stomach in your chest and a stricture of the upper part of your esophagus. you and your family declined any further procedures to correct either of these abnormalities and you understand you will be unable to eat normally again. you were discharged to an inpatient hospice facility. please take all medications as prescribed. you are not being sent out on lovenox (a blood thinner) because it is not within your goals of care. if you are experiencing any pain or discomfort, please let someone at your hospice facility know. followup instructions: you have the following appointments booked in omr. please make them if you are able, although it is understandable if you cannot. provider: xray (scc 2) phone: date/time: 10:40 provider: , : date/time: 11:00 procedure: open reduction of fracture with internal fixation, femur other skeletal traction diagnoses: other iatrogenic hypotension esophageal reflux urinary tract infection, site not specified atrial fibrillation asthma, unspecified type, unspecified unspecified fall acute respiratory failure pneumonitis due to inhalation of food or vomitus other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation pressure ulcer, buttock accidents occurring in other specified places hypoxemia surgical or other procedure not carried out because of patient's decision streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] accidents occurring in residential institution closed supracondylar fracture of femur pressure ulcer, stage i benign essential hypertension hernia of other specified sites without mention of obstruction or gangrene 

Answer: The patient is high likely exposed to