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: bactrim ds / hurricaine / zosyn / glipizide / aztreonam / penicillins / vancomycin attending: chief complaint: respiratory failure major surgical or invasive procedure: intubation history of present illness: ms. is a 63 year old diabetic woman with chronic and progressive hypoxemia over the course of several years felt to be secondary to cep and ipf who was transferred from rehab after she was found to confused and hypoxic this morning. she was found to have spo2 of 55%, down from baseline spo2 in the 70's-80's. per their transfer note, she has had a dry, non-productive cough and no recent fevers or chills. attempt to contact hcp regarding her code status was unsuccessful, and she was transported to . . upon arrival to ed, hr 105, bp 160/101, rr 20, spo2 74% on 6l nc. spo2 improved to 90% on 40% ventimask. she was reported to be drowsy and confused but arousable and oriented x 3. abg on arrival was 7.38/59/34. she confirmed her code status to be full code, and she was subsequently sedated with etomidate/succ and intubated. a propofol gtt was started and bp dropped to 78/44 after bolus for agitation. bp's improved with 1.5 l ivf bolus. she received decadron 10 mg iv, metronidazole 500 mg iv, and levofloxacin 750 mg iv. cxr and cta were performed. past medical history: 1) ephysema: pft's with fev1 of 2.69 liters (106% predicted) and an fvc of 3.5 liters (101% predicted). her fev1/fvc ratio is 76.80 (105% predicted). these data are within the normal range but with a progressive decline since her most recent study from . 2) ipf 3) chronic eosinophilic pneumonia, diagnosed based on hypoxia, peripheral infiltrates, peripheral eosinophilia as pt declined bronch) 4) severe osa, intermittently compliant with bipap. cpap best at pressures of cm and bipap at 13/9 with 2 liters of o2. 5) diabetes mellitus, type ii 6) osteomyelitis/l foot ulcer/charcot foot s/p exostectomy plantar tarsal bone, left foot and hardware removal left foot in , s/p mrsa wound infection treated with daptomycin 7) chronic renal insufficiency 8) acute methemoglobunemia hurricaine spray 9) htn 10) hyperlipidemia 11) diastolic chf echo ; lvef>55% 12) h/o lung nodules (7 mm spiculated lul nodules, 6mm rul nodule) 13) psoriasis 14) hypothyroidism 15) h/o positive ppd 16) h/o compression fractures 17) breast cancer, dx in , s/p partial r mastectomy 18) peripheral neuropathy 19) depression, previous h/o hospitalization 20) urge incontinence social history: charcot foot mod rad mastectomy r breast age 37 due to cancer 2 hernia repairs as a child family history: noncontributory physical exam: vs: t 99, hr 97, bp 145/89, rr, spo2 97% on fio2 100% gen: elderly wf, intubated, awake, attempting to communicate with hand motions heent: intubated, dry mucous membranes, perrl, sclerae anicteric cv: rrr, nl s1 and s2, distant heart sounds, no appreciable murmur resp: diminished breath sounds, prolonged expiratory phase, no expiratory wheezes, no rales or rhonchi abdomen: obese, soft, non-tender, non-distended extrem: wwp, left charcot foot/ankle with loss of plantar arch, contracted toes; bilateral lower extremity erythema, 1+ lower extremity edema to mid shins pertinent results: . ekg: sinus rhythm, rate 75, normal intervals, normal axis; twi in i, avl, v2-v6; twave flattening in ii; 1mm st elevation in avr . imaging: cxr : mild cardiomegaly is stable. et tube is 4 cm above the level of the carina. a nasogastric tube tip extends to the stomach, however the sidehole remains above the ge junction. the right lateral chest wall is excluded from the radiograph. dense retrocardiac opacity is noted likely due to atelectasis, however, a focal infectious process cannot be completely excluded. there is marked prominence of the pulmonary interstitium, likely acute pulmonary edema superimposed on emphysema. no sizable left pleural effusion is seen. there is no pneumothorax. impression: 1. satisfactory position of the endotracheal tube. ng tube needs advancement by at least 8 cm. 2. acute pulmonary edema, likely cardiogenic in etiology. 3. left retrocardiac density as above. likely atelectasis, however pneumonia cannot be excluded. . cta chest : there are no filling defects in the main segmental pulmonary arteries to suggest bilateral pulmonary embolism. the evaluation of distal segmental branches, especially to lower lobes is limited. pulmonary artery remains significantly enlarged. the heart size remains enlarged. again noted is a calcified and non-calcified plaque in the aorta. some of the noncalcified plaque is ulcerated. there is no pericardial or pleural effusion. coronary calcification involves lad, rca, and circumflex. diffuse bilateral septal thickening has developed in the interval, when compared to the prior study. there is severe extensive emphysema, involving the entire lungs, more pronounced in the upper lobes, right greater than left. the airways are patent to the segmental levels bilaterally. limited evaluation of upper abdominal organs is unremarkable. the patient is post right mastectomy. several mediastinal lymph nodes are present, measuring up to 14 mm in the prevascular and lower paratracheal station. there is a left hilar node, measuring 13 mm in short axis diameter. enlarged right hilar nodes are also present. bone windows: demonstrate no concerning lytic or sclerotic lesions. the compression fracture of t8 vertebral body is unchanged in extent. extensive degenerative changes of the right glenohumeral joints are again noted. impression: 1. interval development of diffuse bilateral septal thickening, most likely secondary to cardiogenic edema, given acute presentation. however, in a patient with apparent history of breast carcinoma (not provided but surmised from images), septal thickening may also be due to lymphangitic tumor spread. 2. mediastinal lymphadenopathy. 01:29pm type-art po2-34* pco2-59* ph-7.38 total co2-36* base xs-7 01:30pm neuts-84* bands-0 lymphs-7* monos-7 eos-1 basos-0 atyps-1* metas-0 myelos-0 01:30pm wbc-10.7# rbc-4.84 hgb-15.0 hct-44.6 mcv-92 mch-31.0 mchc-33.6 rdw-17.0* 01:30pm ctropnt-<0.01 01:30pm glucose-125* urea n-15 creat-1.2* sodium-133 potassium-4.6 chloride-95* total co2-30 anion gap-13 04:30pm urine blood-tr nitrite-pos protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.0 leuk-neg 09:11pm glucose-148* urea n-14 creat-1.0 sodium-133 potassium-4.4 chloride-97 total co2-31 anion gap-9 09:20pm type-art temp-37.2 po2-62* pco2-63* ph-7.34* total co2-35* base xs-5 09:20pm lactate-0.7 . 2:01 am sputum source: endotracheal. gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 3+ (5-10 per 1000x field): gram positive cocci. in pairs and clusters. respiratory culture (final ): oropharyngeal flora absent. staph aureus coag +. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | clindamycin----------- =>8 r erythromycin---------- =>8 r gentamicin------------ <=0.5 s levofloxacin---------- =>8 r oxacillin------------- =>4 r penicillin g---------- =>0.5 r rifampin-------------- <=0.5 s tetracycline---------- 2 s trimethoprim/sulfa---- <=0.5 s vancomycin------------ <=1 s fungal culture (preliminary): yeast. brief hospital course: # hypoxemia: the patient was noted to be hypoxemic in the 50's at the outside facility. she was intubated for airway protection and oxygenation. upon admission she was started on levofloxacin and metronidzole for empiric treatment of aspiration pneumonia. she was also continued on her home regimen of nebulizers and prednisone. serial cardiac enzymes were negative for an mi. urine legionella and staining for pcp were negative. in addition she had a bronchoalveolar lavage that showed no white cells, no rbcs and 8% eos. the patient's respiratory status improved and she was extubated; she was back on her baseline oxygen requirement and saturation upon discharge. her respiratory culture was positive for mrsa. however as the patient demonstrated rapid clinical improvement while receiving levofloxacin only, collective clincal decision was decided to treat the mrsa as a colonizer rather than a pathogen. the metronidazole was discontinued at discharge. she was discharged with prescriptions to complete a 7 day empiric course of levofloxacin. # obstructive sleep apnea: patient maintained on non-invasive ventilation at night. # diabetes: the patient was continued on her regular insulin sliding scale. # hypothyroidism: continued home synthroid. # depression: continue home effexor, depakote, trazodone. # chronic renal insufficiency: monitored, at baseline. # gerd: patient continued on home ppi. # uti: patient had >100,000 gnrs on urine culture, treating with levofloxacin medications on admission: prednisone 30 mg daily atovaquone 750 mg oxycodone 2.5 mg q8h prn oxycodone 10 mg q 12h vitamin d 1000 units daily aledronate 70 mg qweek bisacodyl 10 mg pr prn colace 250 mg daily levothyroxine 75 mcg daily venlafaxine xr 150 mg daily omeprazole 20 mg daily baclofen 20 mg qid gabapentin 400, 400, 600 mg daily tums 650 mg ditropan-xl 10 mg depakote ec 500 mg lidocaine td daily salmeterol 1 puff tiotropium 18 mcg daily trazodone 75 mcg qhs sorbitol 70% solution 15 ml daily prn vitamin c 500 mg daily albuterol discharge medications: 1. prednisone 10 mg tablet sig: three (3) tablet po daily (daily). 2. venlafaxine 150 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po once a day. 3. atovaquone 750 mg/5 ml suspension sig: one (1) po bid (2 times a day). 4. lidoderm 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) patch topical 12 hours daily. 5. divalproex 500 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. 6. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 7. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 8. cholecalciferol (vitamin d3) 400 unit tablet sig: 2.5 tablets po daily (daily). 9. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) inhalation inhalation once a day. 10. calcium carbonate 650 (1,625) mg tablet sig: one (1) tablet po once a day. 11. vitamin c 500 mg tablet sig: one (1) tablet po twice a day. 12. albuterol 90 mcg/actuation aerosol sig: one (1) treatment inhalation every 4-6 hours as needed for shortness of breath or wheezing. 13. fosamax 70 mg tablet sig: one (1) tablet po once a week. 14. prilosec 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 15. baclofen 10 mg tablet sig: two (2) tablet po qid (4 times a day). 16. oxycodone 10 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po twice a day. 17. gabapentin 400 mg capsule sig: one (1) capsule po bid (2 times a day). 18. gabapentin 300 mg capsule sig: two (2) capsule po hs (at bedtime). 19. ditropan xl 10 mg tab,sust rel osmotic push 24hr sig: one (1) tab,sust rel osmotic push 24hr po once a day. 20. serevent diskus 50 mcg/dose disk with device sig: one (1) inhalation inhalation twice a day. 21. trazodone 150 mg tablet sig: .5 tablet po once a day. 22. levofloxacin 750 mg tablet sig: one (1) tablet po every other day for 4 days. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: hypoxemic respiratory failure emphysema interstitial pulmonary fibrosis chronic eosinophilic pneumonia obstructive sleep apnea diabetes type ii hypertension hyperlipidemia chronic diastolic congestive heart failure with ef > 55 peripheral neuropathy urge incontinence urinary tract infection discharge condition: stable, oxygenation at baseline. discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: 2 liters daily. you were admitted to the hospital with shortness of breath and low blood oxygen levels. your breathing deteriorated to the point that your required intubation. we treated you with antibiotics and your breathing improved, allowing us to remove the breathing tube. please continue to take your medications as prescribed. you are on your old medications in addition to two antibiotics. please follow up with your physicians as listed below. if you have worsening shortness of breath, fever, or any other concerning symptoms please contact a physician . followup instructions: provider: , dpm phone: date/time: 2:30 provider: phone: date/time: 3:15 please follow up with your primary care physician . () in one week. md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube enteral infusion of concentrated nutritional substances closed [endoscopic] biopsy of bronchus diagnoses: obstructive sleep apnea (adult)(pediatric) esophageal reflux urinary tract infection, site not specified congestive heart failure, unspecified unspecified acquired hypothyroidism personal history of malignant neoplasm of breast diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes acute respiratory failure postinflammatory pulmonary fibrosis other emphysema pulmonary eosinophilia chronic diastolic heart failure 

Answer: The patient is high likely exposed to