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: the patient is a 47-year-old female, with a history of copd and asthma, schizoaffective disorder, hypertension, hypercholesterolemia, hypothyroidism, etoh and benzodiazepine abuse, who was admitted , status post fall prior, with some associated resulting leg weakness, found to have a t8 radiculopathy and mild myelopathy secondary to retropulsion and cord compression. ct scan of the spine showed t8 retropulsion with possible cord compression. hospital course: the patient underwent a t8 vertebrectomy and t7-9 stabilization that was done by neurosurgery, with no complications. the patient was continued on a solu-medrol drip postoperatively, and changed to hydrocortisone on . the patient was sent to the surgical intensive care unit postoperatively and was extubated on . on , she was also noted to have bright red blood per rectum with no associated nausea, vomiting, or any abdominal pain, tachycardic to 120s, with hypotension, blood pressures 160-100. the patient received, at that time, 4 units of packed red blood cells, as well as 4 units of ffp. hematocrit noted to drop from 34-24 after the bleed, but then increased back to 34 with transfusion during that time. the patient had a gi consult, with a colonoscopy that was recommended, but deferred given the patient's recent stabilization of bleeding and recent postoperative neurosurgery. the patient progressed reasonably well until , when the patient was transferred to a regular medical floor, 98% on nasal cannula. on , in the morning the patient had an increasing episode of respiratory distress with o2 saturations noted to be 90-92% on 3 liters nasal cannula, in spite of receiving albuterol and aggressive chest physical therapy. noted was thick green sputum that was suctioned. the patient was started on po levaquin. a cta that was done was negative for pulmonary embolism. a chest x-ray, as well as the cta, noted a left lower lobe consolidation consistent with pneumonia, as well as bilateral ground glass opacities. the patient was still coughing up green sputum with saturations 88-92% on liters nasal cannula. on , the patient received some lasix 20 mg iv for respiratory distress with no change in respiratory status. on , a pulmonary consult was recommended. the consult was done. recommendations included a change for broader antibiotic coverage to include gram-positive rods, as well as gram-negative rods, and anaerobes. therefore, zosyn and vancomycin iv were started, and levaquin was dc'd during that time. later that afternoon, the patient had another episode of respiratory distress with tachypnea and o2 saturations in the 80s. therefore, it was decided that the patient would be transferred to the medical intensive care unit at that time. physical exam: vitals - 98.8, blood pressure 169/90, respirations between 22-30, pulse 100-112, satting 92% on o2 nonrebreather. the patient is an obese female in moderate respiratory distress, speaks words before pause. pupils are equal and reactive to light and accommodation. extraocular movements intact. oropharynx clear. neck - no jvd. respiratory - is wheezing bilaterally with coarse breath sounds, symmetrical. heart - regular rate and rhythm, s1, s2 noted, ii/vi systolic ejection murmur. abdomen is nontender and nondistended, positive bowel sounds. extremities - no cyanosis, clubbing, or edema. neurological exam - alert and oriented, moving all extremities. laboratories: white count 24.2, hematocrit 32.4, platelets 169, sodium 140, potassium 4.0, chloride 99, bicarbonate 27, bun 23, creatinine 0.7, glucose 101, calcium 9.1, pt 24.9, ptt 28.8, inr 4.1. abg - ph 7.45, pco2 47, po2 57, bicarbonate 34. chest x-ray showed bilateral consolidation, done on the . the ct angiogram of the chest showed no evidence of pulmonary embolism, with left lower lobe consolidation, and bilateral ground glass opacities. a stool cultures were negative for clostridium difficile. a sputum was negative. for respiratory distress, the patient received albuterol and atrovent nebulizers as needed. hydrocortisone 100 mg iv q 8 h was started, as well as aggressive chest pt, suctioning, and elevation of head of bed with aspiration precautions. etiology of respiratory distress likely due to pneumonia, possible hospital acquired. therefore, the patient was started on zosyn and vancomycin. sputum cultures would be checked serially. because of the recent lower gi bleed, serial hematocrits were checked. protonix was given. if decreasing hematocrits noted, then a bleeding scan would be needed. the patient was started npo and given intravenous fluids of d5 normal saline started. hypotension was treated with patient's hydralazine 10 mg q 6 h as needed. over the course of the hospital stay, results of sputum cultures showed gram-positive cocci in pairs and clusters, with noted moderate oropharyngeal flora and presence of yeast. urine cultures done serially all showed negative results. hematocrits during the rest of the hospital stay to time of discharge were stable with no hematocrit ever going below a target value of 30 despite fear of hematocrit measurements. psychiatric issues: the patient was continued on all prehospital psychiatric medications. a psychiatric consult was done on with recommendations that the patient stay on psychiatric medications, and ativan be administered as a standing dose instead of prn. during the first day in the icu, the patient had continuing respiratory distress with hyperventilation, despite being on pressure support with biphasic positive airway pressure. therefore, the decision was made to intubate the patient on . the patient was also started on tube feeds for a question of aspiration on po. noted was continuous suctioning of thick secretions, but changing in consistency to white from a previous color of yellowish-green. the patient was ventilated on assisted control with a tidal volume of 550, rate of 16, peep of 5, and a fio2 of 0.4 on initial settings which she tolerated well per serial abgs. on , the patient was started on a trial of pressure support ventilation from assisted control which she tolerated well. therefore, later on on that day on , the patient was extubated successfully and started on albuterol and atrovent nebulizers standing dose q 3 h, tube feeds were held, and the patient was kept npo due to aspiration precautions. left lower extremity ultrasounds were negative for dvt. also, the patient's vancomycin on was dc'd, since sputum culture showed no evidence of methicillin resistant staphylococcus aureus. serial urinalysis done showed no evidence uti throughout the rest of the hospital stay. on , psychiatry was consulted given patient's multiple episodes of respiratory distress, status post extubation. they noted that the patient's anxiety was a large component of her respiratory distress. psychiatry's recommendations were that the patient would continue with all of her preadmission medications, and that ativan should be considered as a standing dose of 0.5 mg tid. recommendation was also to check a tsh for possible hyperthyroidism as a source of her anxiety. the patient's hydralazine was discontinued, and diltiazem was started at 30 mg po qid, given patient's unresponsiveness to hydralazine and recent clonidine trial of 0.1 mg po. it was thought that hydralazine was causing a reflex tachycardia which would be contributing to the patient's anxiety component. the patient was also switched to an oral steroid dose of prednisone 60 mg po qd during that same time. over the rest of the hospital course, the patient's respiratory status improved remarkably. the patient's high blood pressure was improved slightly. the patient's respirations rate decreased from high-30s, to low-40s, to the 20s. physical therapy tried evaluating the patient on and recommended that the patient would be a good candidate for improvement, but patient did not comply with all physical therapy exercises. today, on , the patient has been stable and has improved throughout hospital stay. therefore, the decision was made to discharge the patient to rehabilitation for continued pt therapy. the patient is to be discharged in stable status. discharge medications: 1) clonazepam 250 mg po q hs, 2) clomipramine 150 mg po qd, 3) nicotine patch 40 mg td qd, 4) thiothixene 20 mg po q am, thiothixene 10 mg po q pm, 5) doxepin 50 mg po qd, 6) combivent inhaler 3 puffs qid, 7) fluticasone inhaler mdi 4 puffs , 8) protonix 40 mg po qd, 9) diltiazem 30 mg po qid, 10) heparin subcu 5,000 u, may dc once patient is able to tolerate physical therapy and is ambulating well, 11) ativan 0.5 mg po tid, 12) zosyn 4.5 gm iv q 8 for 3 days postdischarge. treatments: the patient must have tlso brace on at all times. the only time patient can have off is when patient is lying flat in bed. the patient is started on diabetic diet with aspiration precautions. discharge diagnoses: 1) chronic obstructive pulmonary disease exacerbation with left lower lobe pneumonia. 2) status post t8 vertebrectomy. 3) schizoaffective disorder. 4) hypothyroidism. 5) hypertension. 6) hypercholesterolemia. follow-up with the following physicians: neurosurgeon - , md, follow-up within 2 weeks, (. the patient is to follow-up with primary care doctor, dr. , within 2-3 weeks, (. finally, the patient is to follow-up with , psychiatric np, within 2-3 weeks at (. she should also follow-up with a pulmonologist. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube dorsal and dorsolumbar fusion of the anterior column, anterior technique excision of intervertebral disc total ostectomy, other bones insertion of interbody spinal fusion device diagnoses: pneumonia, organism unspecified pure hypercholesterolemia unspecified essential hypertension unspecified acquired hypothyroidism acute respiratory failure chronic obstructive asthma with (acute) exacerbation hemorrhage of gastrointestinal tract, unspecified schizoaffective disorder, unspecified closed fracture of t7-t12 level with other specified spinal cord injury 

Answer: The patient is high likely exposed to