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: copd flare/tracheomalacia/bronchomalacia major surgical or invasive procedure: bronchoscopy on rigit bronchoscopy and stenting on history of present illness: 51 f with history significant for copd with multiple admissions to who was again admitted there on for copd exacerbation. she underwent a flexible bronchoscopy today which reported evidence of 50% tracheomalacia. it was also notable for r bronhcial tree and the bronchus intermedius showed evidence of bronchomalacia up to 90%. her pulmonlogist dr. refered her to for evaluation by the interventional pulmonology team for possible intervention for dynamic tracheobronchomalacia that may be contributing to her frequent exacerbations. past medical history: copd on home o2 (3l) and bipap 14/6. multiple admissions to for copd. multiple pulmonary rehabs at without significant improvement in sx. chronic hypercapnic respiratory failure. pfts : fvc 0.7, fev1 0.52, fev1/fvc 54%. ? obstructive sleep apnea type ii dm hyperlipidemia hypertriglycidemia depression anxiety obesity anemia osteoporosis chronic steroids social history: habits: tobacco - quit 6 years ago; 90 pack year hx etoh: none drugs: none living: lives w/ husband at home. occupational: retired sauderer. h/o dust/ fume exposure. spiritual: jehovah's witness/ refuses blood transfusions. family history: mother deceased emphysema physical exam: vs: tm 97.8, tc 96.4, hr 80 (80-100), bp 147/82 (130-147/60-82), rr 24, o2 sats 97% 3l nc, fs 328 and 104 gen: obese, middle aged female, lying in bed, on left side. bipap on. heent: ncat, sclera anicteric. pupils asymmetric in shape, but are rxtive to light equally bilaterally. neck: supple. could not assess lad, jvd or thyroid due to body habitus. cv: heart sounds are distant, but regular. could not appreciate any murmurs. lungs: decreased breath sounds with poor air movement throughout. on bipap. no crackles, rhonchi, or wheezing appreciated. abd: soft, obese abdomen. ntnd. + bs. extr: no c/c. 1+ pitting edema bilaterally, up to mid-shin. ext warm, 2+ pt pulses, radial pulses bilaterally. r arm with large ecchymosis from blood draw. neuro: aaox3. cn ii-xii intact. pertinent results: labs on admission : wbc 16.7, hct 37.9, mcv 83, plt 305 (diff neuts 89.1, lymphs 6.9, monos 3.8, eos 0.1, baso 0.1) pt 13.1, ptt 24.5, inr 1.2 na 144, k 4.0, cl 93, hco3 42, bun 19, cr 0.6, glu 96, mg 2.2 fe 109, tibc 361, ferritin 40, trf 278 theophy 4.3 . rads: : flexible bronchoscopy - patient with significant tracheobronchial malacia in trachea, right main stem and left main stem bronchus. . : ct trachea - 1. severe tracheobronchomalacia. 2. severe emphysema. 3. 5-mm diameter right middle lobe lung nodule and tiny bilateral apical micronodules. recommend a followup chest ct in three months duration to document stability of these small nodules in order to exclude the possibility of early lung neoplasm. . : pfts - spirometry 1:56p pre drug post drug actual pred %pred actual %pred %chg fvc 1.26 2.60 48 fev1 0.68 1.95 35 mmf 0.32 2.50 13 fev1/fvc 54 75 72 brief hospital course: 1) tracheobronchomalacia: repeat bronchoscopy was repeated here and confirmed severe tracheobronchomalacia, with 80-90% collapse of trachea, right and left mainstem bronchi. it was decided that mrs. needed a y stent, but it was decided to wait until her copd was optimized. she was continued on oral prednisone of 60mg daily. pt had persistent hypercarbic respiratory failure following y-stent placement, required intubation. after she was weaned off ventilator and extubated, she was found to have an abg showing 7.07/128/116/39 and was reintubated and ventilated; once she had improved, she was re-extubated but again ineffectively ventilated and was re-intubated. patient was then once again weaned, extubated and this time did well. pt's hypercarbic respiratory failure was believed to be due to a combination of severe copd, tracheobronchomalacia, auto-peeping, and anxiety. after extubation, pt's respiratory status was believed to be at baseline, pfts were done on the day of discharge to determine the amount of benefit from the stent placement. pt had a small amount of hemoptysis following the numerous intubations, however this seemed to be improving and was attributed to the trauma from the intubations. . 2) copd exacerbation: she was continued on oral prednisone 60mg qd, accolate (zafirlukast), theophylline and inhalers/nebs around the clock (fluticasone/salmeterol, alb nebs, ipratroprium nebs). she continued on bipap at night. she was also given levaquin for possible bronchitis, and also received a course of vancomycin after sputum cultures showed mssa. theophylline levels were checked regularly to insure that they did not become toxic while she was taking levaquin. pt wil need to weane her prednisone, although her goal dose is not clear as she has chronically required some steroids. . 3) iddm: she was continued on her outpatient insulin regimen (nph + regular qam and qpm) and was covered with a humalog sliding scale. despite these measures, her glucose was widely variable and difficult to control, partially due to the oral prednisone but also due to the fact that the patient would not comply with a diabetic diet and ate frequently. nutrition was consulted. . 4) hyperlipidemia/hypertriglycidemia: she was continued on her outpatient dose of pravachol. . 5) htn: she was continued on her outpatient antihypertensive regimen of verapamil, and lisinopril. . 6) oral thrush: she had a history of oral thrush, but on admission it seemed to have resolved. she was given nystatin and fluconazole while she was on a steroid taper. . 7) fen: she was given a diabetic, low sodium diet, but had poor compliance with her diet. her electrolytes were checked daily and repleted as needed. . 8) ppx: she was given protonix for gi prophylaxis given her chronic steroid usage. for osteoporosis prophylaxis, she was given calcium carbonate, vitamin d, and aledronate. for constipation prophylaxis, she was given colace, senna, and lactulose. for dvt prophylaxis, she was given heparin sq. . 9) access: she had peripheral ivs. . 10) code: full medications on admission: fosamax 70 mg po q monday nystatin mouth wash qid insulin sliding scale humulin n 47 u q am and 17 u q evening humulin r 17 u q am and qhs tylenol prn robitussin ac 10 cc po qid tums 500 mg tid protonix 40 mg qd advair 500/50 1 puff colace 100 mg po bid verapamil sr 120 mg daily uniphyl (theophylline) 600 mg daily paxil 20 mg daily pravachol 20 mg qhs zestril 10 mg daily accolate (zarfilukast) 20 mg po bid prednisone taper started 60 mg x 3 d, 40 mg x 3 d, 20 qd diflucan 100 mg x 5 d to start discharge medications: 1. alendronate 70 mg tablet sig: one (1) tablet po qmon (every monday). disp:*4 tablet(s)* refills:*0* 2. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 3. pravastatin 20 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*0* 4. captopril 12.5 mg tablet sig: 0.5 tablet po tid (3 times a day). disp:*45 tablet(s)* refills:*0* 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 6. verapamil 120 mg tablet sustained release sig: one (1) tablet sustained release po q24h (every 24 hours). disp:*30 tablet sustained release(s)* refills:*0* 7. albuterol sulfate 0.083 % solution sig: one (1) neb inhalation q6h (every 6 hours). 8. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). 9. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid w/meals (3 times a day with meals). disp:*90 tablet, chewable(s)* refills:*0* 10. theophylline 400 mg tablet sustained release sig: 1.5 tablet sustained releases po daily (daily). disp:*45 tablet sustained release(s)* refills:*0* 11. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 12. zafirlukast 20 mg tablet sig: one (1) tablet po bid (). disp:*60 tablet(s)* refills:*0* 13. prednisone 20 mg tablet sig: three (3) tablet po daily (daily). disp:*90 tablet(s)* refills:*0* discharge disposition: home with service facility: care discharge diagnosis: tracheobronchomalacia copd diabetes type ii obstructive sleep apnea discharge condition: fair discharge instructions: please follow-up with you primary care physician as scheduled. please schedule an appointment with your pulmonary doctor in the next 2 weeks. take your medications as prescribed. please check you blood sugar frequently (preferably four times a day) and take your insulin as prescribed, please call your doctor if your blood sugars are low or very high. please call if you develop difficulty breathing, increase in cough, fever, chills, or any other questions or concerns. followup instructions: dr. - monday, 1:30 pm tel number procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified fiber-optic bronchoscopy non-invasive mechanical ventilation other intubation of respiratory tract infusion of vasopressor agent diagnoses: unspecified essential hypertension long-term (current) use of steroids adrenal cortical steroids causing adverse effects in therapeutic use acute kidney failure, unspecified obstructive chronic bronchitis with (acute) exacerbation hypopotassemia constipation, unspecified anxiety state, unspecified acute respiratory failure long-term (current) use of insulin other diseases of pharynx, not elsewhere classified unspecified sleep apnea obesity, unspecified other osteoporosis diabetes with unspecified complication, type ii or unspecified type, uncontrolled 

Answer: The patient is high likely exposed to