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: nitroglycerin / plavix attending: chief complaint: respiratory arrest s/p foreign body obstruction major surgical or invasive procedure: intubation, extubation ngt placement history of present illness: 87 year old woman with pmhx of coronary artery disease (s/p bms to rca in ), hypothyroidism, gerd/peptic ulcer disease, chronic renal insufficiency, anemia, recurrent utis who was in her usual state of health at her nursing home today, baseline a&o x3, who presents with respiratory arrest after choking on lunch. she was eating lunch when she started choking, unclear if witnessed or heard by healthcare personnel who was at her side shortly thereafter. heimlich maneuver was started on the patient, without success. the fire department arrived at the scene first and performed heimlich maneuver, which expelled a fair amount of food. the patient subsequently lost consciousness when ems arrived, o2 sat 90% with spontaneous shallow respirations. using laryngoscope, ems did not see anything in the oropharynx and started bagging the patient until arrival at ed. en route, the patient did not regain consciousness but maintained shallow spontaneous respirations and o2 sats >90%; she never lost cardiac circulation. . on arrival to the ed, initial vs were t96.0, hr120, bp123/67, rr18, o2 sat 100% (ambu bag). the patient remained unresponsive but agitated, not following commands, so she was intubated for airway protection w/ etomidate and succinate; the ed resident reports not seeing any food around the vocal cords etc. the patient's initial abg before intubation showed 7.26/36/175/17 with a lactate 5.7. subsequent abg was 7.22/43/513/19 with lactate improved slightly to 4.8. the patient was initially sedated with propofol but remained agitated, moving all four extremities and still not following commands although would turn her head to voice. she was switched to fentanyl/versed with some improvement in agitation. ct head and cxr within normal limits (no signs of aspiration). utox negative. two large bore ivs and ngt were placed and the patient volume resuscitated with 2l ivf. labs were otherwise remarkable for creatinine 1.6, mildly positive ua (trace leuks, 2 wbc, few bacteria, <1 epi). the patient's daughter was updated by phone and she subsequently came to the ed, was at the patient's bedside by 4pm. . upon arrival to the micu, patient is intubated and on sedating medications but following commands. respiratory therapy trialed her on pressure support but rr ~6, too sedated from fentanyl boluses. daughter and son-in-law at bedside. . ros: patient awake, mildly agitated but able to be calmed by family. denies any pain but endorses discomfort from ett and strongly wishes to be extubated soon. . . <h3> a pgy1 daily progress note, , </h3> . <h3>accept note</h3> . <b>brief hpi:</b> i have received verbal signout from the micu resident, reviewed pertinent notes and data, and seen and examined the patient; please see micu admission note for details of the h&p. . briefly, this is an 87 nursing home resident who was admitted to the icu 1 day ago for respiratory failure after choking on a corned beef and subsequently losing consciousness but who never had cardiopulmonary arrest; her pertinent comorbidities include cad, first degree av block, hypothyroid, gerd/pud, hiatal hernia, recurrent utis, cri. after successful heimlich in the field, she was maintaining sats of 90%, was bagged, brought to ed, intubated for airway protection, and found to be in metabolic acidosis 7.26/36/175/17 with a lactate 5.7. present cxr and ct-head were wnl. she is a non-smoker. . icu course: * suctioned out chunks of corned beef * extubated less than 24h after admission * repeat ua -> large leuk, wbc 44, many bact, no yeast -> cipro . denies dysuria; endorses frequency. . <b>ros:</b> notes chronic tension headaches and heartburn, otherwise no cp, palpitations, wheezesm, cough, abdominal pain, leg swelling, rashes. past medical history: * coronary artery disease (s/p bms to rca in ) * first degree av block * hypertension with labile blood pressures * hyperlipidemia * myocardial infarction * hypothyroidism * orthostatic hypotension * osteoporosis * primary hyperparathyroidism * vertigo * anxiety/depression with psychotic variant * gerd/peptic ulcer disease s/p gib (?upper) in * hiatal hernia * chronic renal disease * recurrent utis * iron deficiency anemia * tension headaches * hard of hearing . social history: currently resident (), formerly facility resident (, , ma). retired clerical worker. lifelong non-smoker. no alcohol or illicits. daughter involved in her care. family history: mother died in her 70s from pneumonia. father died in his 80s from unclear . otherwise, no family history of sudden cardiac death, malignancies. physical exam: vs: temp: 95.0 --> 99.0 bp: 184/80 --> 134/78 hr: 71 rr: 16 o2sat 100% gen: pleasant, nad, cooperative, interactive heent: perrl w/ cataracts, eomi, anicteric, mmm, op without lesions, poor dentition, no lymphadenopathy resp: cta b/l with good air movement throughout, no wheezing/rhonchi/rales cv: rrr, s1 and s2 wnl, no murmurs/gallops/rubs abd: nontender, nondistended, soft, no masses, surgical incision site well-healed ext: no cyanosis, ecchymosis or edema skin: no rashes/lesions neuro: aaox3. cn ii-xii intact. strength and sensation grossly intact, moving all extremities purposefully . discharge exam: vitals: 99.0 af 85 108/85 18 95 ra x/x 700/700+br . physical exam: unchanged other than** gen: pale wdwn elderly woman in nad heent: ncat, perrl, eomi, mmms, op clear neck: supple, no lad; no elevated jvp pulm: improved expiratory wheezes and airmovement; otherwise no rh/r cv: rrr nml s1/2 no r/g; new s3 ab: +bs soft ntnd no organomegaly ext: no edema no lesions neuro: grossly unchanged and non-focal pertinent results: 10:18pm type-art temp-37.0 po2-133* pco2-33* ph-7.42 total co2-22 base xs--1 intubated-intubated 07:41pm type-art temp-36.4 po2-63* pco2-45 ph-7.29* total co2-23 base xs--4 intubated-intubated 07:41pm lactate-0.7 06:03pm lactate-1.3 05:45pm glucose-131* urea n-39* creat-1.2* sodium-140 potassium-4.9 chloride-108 total co2-22 anion gap-15 05:45pm calcium-10.2 phosphate-2.8 magnesium-1.9 05:45pm wbc-9.7 rbc-3.57* hgb-11.3* hct-34.2* mcv-96 mch-31.8 mchc-33.1 rdw-13.1 05:45pm plt count-171 05:45pm pt-12.7 ptt-20.2* inr(pt)-1.1 01:30pm urine blood-neg nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-tr 01:00pm type-art tidal vol-450 peep-5 o2-100 po2-512* pco2-43 ph-7.22* total co2-19* base xs--9 aado2-179 req o2-38 -assist/con intubated-intubated 01:00pm lactate-4.8* 12:53pm type- po2-175* pco2-36 ph-7.26* total co2-17* base xs--9 comments-green top 12:53pm glucose-179* lactate-5.7* na+-139 k+-5.3 cl--105 12:40pm lipase-47 12:40pm ctropnt-<0.01 12:40pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 12:40pm wbc-10.3 rbc-3.74* hgb-12.0 hct-36.9 mcv-99* mch-32.1* mchc-32.5 rdw-13.3 12:40pm pt-12.5 ptt-21.8* inr(pt)-1.0 . ct head - no acute intracranial pathological process. large amount of secretions in entire nasopharynx and imaged portion of the oropharynx. particular matter in incompletely imaged esophagus is also noted. these findings may be compatible with the reported history of recent heimlich maneuver. s/p attending review: i do not believe the esophagus is imaged on this study, which proceeds only as far caudally as the oropharynx. if acute brain ischemia is a clinical consideration, mri is more sensitive. . presenting cxr: et tube terminating 4.2 cm above carina. gastric tube terminating within distal stomach/first portion of duodenum. . cxr : pa and lateral chest views were obtained with patient in upright position. there is moderate cardiac enlargement. high-positioned diaphragms are consistent with poor inspirational effort or reduced pulmonary compliance in this elderly patient. there are some basal linear densities consistent with plate atelectasis, but no conclusive evidence for acute pulmonary infiltrates is present. the lateral view discloses a markedly increased depth diameter of the chest related to an accentuated kyphotic curvature and osteopenic appearance of the skeletal structures with multiple mildly wedge deformed vertebral bodies, but no true acute vertebral body fracture. bilaterally, small amounts of pleural effusion have accumulated in the posterior pleural sinuses. when comparison is made with previous chest examinations dated , the heart size has moderately increased and the pulmonary vasculature and the pleural effusions suggest a mild degree of chronic chf. . discharge labs: . 07:22am blood wbc-6.0 rbc-2.93* hgb-9.3* hct-28.3* mcv-97 mch-31.7 mchc-32.8 rdw-13.6 plt ct-194 07:22am blood neuts-64.8 lymphs-24.8 monos-5.4 eos-4.4* baso-0.5 07:22am blood glucose-92 urean-33* creat-1.4* na-141 k-3.9 cl-106 hco3-23 angap-16 01:15pm blood glucose-109* urean-35* creat-1.4* na-140 k-4.3 cl-104 hco3-24 angap-16 01:15pm blood calcium-10.3 phos-2.9 mg-1.8 brief hospital course: 87 nursing home resident who was admitted to the icu for respiratory failure after choking on a corned beef and subsequently losing consciousness but who never had cardiopulmonary arrest; her pertinent comorbidities include cad, first degree av block, hypothyroid, gerd/pud, hiatal hernia, recurrent utis, cri. . icu course: . # respiratory arrest: known choking event at her facility. although foreign body aspiration events are not uncommon in the elderly population, patient's course has been complicated by loss of consciousness and inability to follow commands. she was subsequently intubated for airway protection. can not rule out mental status changes to precipitate the event although daughter states she has had previous partial choking and food stuck in her esophagus in the past. reportedly significant food output during heimlich maneuvers and no more food seen during rapid sequence intubation. more food (chunks of roast beef) suctioned out during deep suctioning overnight, extubated the night of admission. no bronch overnight, slight risk of chronic inflammation with residual oily foods if left over in airway, but pt doing well clinically and given age, wouldn't sedate her again for bronch. speech and swallow evaluation said one time event, can eat ground diet, thin liquids. . floor course: . active issues: . # pre-renal : cr elevated to 1.4 the day of discharge from 1.1; received 1l of ns prior to discharge and repeat cr was stable at 1.4. discharge planning included provisions to re-check cr the day after discharge and to give fluids if still elevated. . # aspiration pneumonitis: transferred to the floor with o2 requirement of 3l above baseline of no o2. cxr and history pointed to aspiration pneumonitis; pna was considered but thought unlikely in the absence of clinical sequallae. o2 was weaned to ra. follow-up cxr showed small pleural effusions, no infiltrate. . # complicated uti: ua from foley was positive; culture was positive for e.coli > 100k. treated for a complicated uti with cipro and discharged on this antibiotic to complete a total course of 7 days. . inactive issues: . # anemia: previously diagnosed with iron deficiency although also on vitamin b12. currently normocytic. baseline hct 32-34 and patient currently is close to this. - continued home ferrous sulfate - continued home vitamin b12 . # cri: @ baseline 1.0 . # coronary artery disease: s/p bms to rca in , gib in . - continued home lipitor, atenolol - continued home losartan, nifedipine . # hypothyroidism: - continued home levothyroxine . # anxiety/depression: with psychotic variant, reportedly. stable. - continued home seroquel, venlafaxine, clonazepam . # gerd/peptic ulcer disease: s/p gib in although unclear source at the time. the patient also has known hiatal hernia. - continued home pantoprazole - continued home ranitidine . # osteoporosis: - continued home vitamin d, calcium and multivitamin . # seasonal allergies: - therapeutic exchange from loratadine to fenafexadine in-house; discharged on loratadine. . transitional issues: # code: patient admitted to icu unconsious; daughter requested the patient be made dnr but ok to intubate after already intubated. when patient transferred to the floor, she expressed wanting to be full code (was ao x 3 and able to manipulate the facts) and so was made such after conferring with the daughter. discharged full code with her pcp ( ) aware; further discussions will need to be had in the future to clarify this matter. # : cr will be checked after discharge and will be overseen by . # elevated eosinophils: last cbcd showed elevated eosinophils; this should be rechecked on follow-up with primary care physician. medications on admission: * acetaminophen 1 gram three times daily * acidophilus 10mg three times daily * atenolol 50mg daily * clonazepam 0.5mg (take vs. half tablet) twice daily * docusate 100mg qhs * ferrous sulfate 325mg daily * fiber laxative one tablet twice daily * levothyroxine 75mcg daily * lidoderm 5% patch to left buttock/lower back daily (12 hours on, 12 hours off) * lipitor 10mg daily * loratadine 10mg daily * losartan 50mg daily * multivitamin daily * nifedipine er 90mg daily * pantoprazole 40mg daily * ranitidine 150mg daily * seroquel 25mg qhs * venlafaxine er 37.5mg daily * vitamin d 1000 units daily * vitamin b-12 100mcg daily * ketoconazole 2% to breasts twice daily prn * mylanta 15ml three times daily prn heartburn . allergies: plavix, nitroglycerin discharge medications: 1. acetaminophen 500 mg tablet sig: two (2) tablet po three times a day. 2. acidophilus capsule sig: one (1) capsule po three times a day. 3. atenolol 25 mg tablet sig: two (2) tablet po daily (daily). 4. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 5. nifedipine 90 mg tablet extended release sig: one (1) tablet extended release po daily (daily). 6. losartan 50 mg tablet sig: one (1) tablet po daily (daily). 7. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 8. clonazepam 0.25 mg tablet, rapid dissolve sig: to 1 tablet, rapid dissolve po twice a day. 9. quetiapine 25 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 10. venlafaxine 37.5 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po daily (daily). 11. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 12. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 13. mylanta 200-200-20 mg/5 ml suspension sig: fifteen (15) ml po three times a day as needed for heartburn. 14. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). 15. docusate sodium 100 mg capsule sig: one (1) capsule po at bedtime. 16. fiber laxative 500 mg tablet sig: one (1) tablet po twice a day. 17. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily): left buttock/lower back daily (12 hours on, 12 hours off) . 18. loratadine 10 mg tablet sig: one (1) tablet po once a day. 19. multivitamin tablet sig: one (1) tablet po daily (daily). 20. cholecalciferol (vitamin d3) 400 unit tablet sig: 2.5 tablets po daily (daily). 21. cyanocobalamin (vitamin b-12) 100 mcg tablet sig: one (1) tablet po daily (daily). 22. ketoconazole 2 % cream sig: one (1) application topical twice a day as needed for itching: breasts. 23. duoneb 0.5 mg-3 mg(2.5 mg base)/3 ml solution for nebulization sig: one (1) neb inhalation every six (6) hours as needed for shortness of breath or wheezing. 24. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 4 days: d1 , end . 25. outpatient lab work discharge disposition: extended care facility: care & rehab center - discharge diagnosis: primary: -aspiration of food -intubation for airway protection -complicated uti secondary: -none discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: it has been a privilege to take care of you at . . you were hospitalized in the intensive care unit because you inhaled part of your and were temporarliy unconscious. you were intubated with a breathing tube to prevent you from further inhaling oral secretions while you were unconscious. the breathing tube was then removed when you regained consciousness and you were transferred to the regular medical floor where your condition continued to improve. . you were found to have a urinary tract infection and were treated for this with antibiotics; continue the antibiotics after discharge until the prescription is complete. . you were a little dehydrated before discharge; you were given iv fluids to correct this. . no changes were made to your medications, other than as detailed below: start -ciprofloxacin for a urinary tract infection -duonebs for wheeze or shortness of breath . you are to eat a ground solid diet and thin liquids to prevent further inhalation of food. followup instructions: none. your physician at the nursing home will oversee your care after discharge from the hospital. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: acidosis coronary atherosclerosis of native coronary artery esophageal reflux urinary tract infection, site not specified acute kidney failure, unspecified unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified percutaneous transluminal coronary angioplasty status chronic kidney disease, unspecified dysthymic disorder acute respiratory failure pneumonitis due to inhalation of food or vomitus osteoporosis, unspecified old myocardial infarction dehydration respiratory arrest 

Answer: The patient is high likely exposed to