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: patient recorded as having no known allergies to drugs attending: chief complaint: hip fracture and subsegmental pe major surgical or invasive procedure: l hip orif history of present illness: year old female with h/o hypothyroidism, anemia, osteoporosis, multiple falls including and , who presents s/p fall on left hip. per ambulance report, pt was behind her apartment door with walker, when her physical therapist opened the door which hit her, causing her to fall. she landed on left hip. she denies loc, dizziness, palpitations and confusion. x-ray confirmed l hip fracture. . pt taken to or for l orif. intraoperatively she dropped her o2 sats from 100 to 90 and was noted to have an elevated a-a gradient. hip procedure went well without complications. post-operatively, the pt left ventilated on simv and ortho requested transfer to micu for further evaluation and treatment. past medical history: frequent falls , gerd hypothyroidism hearing loss on left b12-deficiency, iron deficiency, anemia osteoporosis t3 compression fracture uti anxiety echo ef>55%, with 1+ ar, normal lv wall motion. social history: social history: - lives in own apartment on - walks with walker - has lifeline - has very actively involved family (niece/hcp) in the area who helps with . she has strong feelings as to how her aunt should be taken care of. - remote tobacco use, no etoh - nok/hcp is patient's niece (is a social worker) - (#1 daughter's room), (#2 cell phone). does not want to work with , rn cm. - pcp is . family history: nc physical exam: vitals: t 99.2 bp 142/65 hr 84 r 26 sat 91% 5lnc * pe: g: elderly female, nad heent: dry mm neck: supple, no jvd lungs: bs bl, diffuse rhonchi cardiac: rr, nl rate. nl s1s2. no murmurs abd: soft, nt, nd. nl bs. no hsm. ext: no edema. neuro: alert, but thinks she's on a ride ("when does this ride stop?") * pertinent results: admission labs: 07:02pm urine color-yellow appear-clear sp -1.017 07:02pm urine blood-tr nitrite-neg protein-neg glucose-neg ketone-15 bilirubin-neg urobilngn-neg ph-7.0 leuk-neg 07:02pm urine rbc-* wbc-0-2 bacteria-few yeast-none epi-0-2 05:40pm glucose-101 urea n-34* creat-1.2* sodium-142 potassium-4.7 chloride-105 total co2-26 anion gap-16 05:40pm calcium-8.8 phosphate-3.8 magnesium-2.0 05:40pm wbc-6.8 rbc-4.26 hgb-12.1 hct-35.6* mcv-84 mch-28.5 mchc-34.1 rdw-13.3 05:40pm neuts-75.1* lymphs-20.4 monos-2.8 eos-1.1 basos-0.6 05:40pm plt count-300 05:40pm pt-12.0 ptt-24.1 inr(pt)-0.9 imaging: admission hip film (): impression: proximal left femoral fracture. admission cxr (): impression: no acute pulmonary process. low lung volumes with right basilar atelectasis. previously identified right retrocardiac nodular density, not clearly visualized in this study. gross path on l hip fx: clinical: fracture left hip. the specimen is received fresh labeled with " " and "left femoral head" and consists of a femoral head measuring 6.5 x 4.5 x 3.8 cm. the additional separate fragment of bone measuring 2.3 x 1.5 x 1.3 cm. the shape of the femoral head is unremarkable, however, there is extensive eburnation across most of the surface. there is mild, focal osteophytic growth on the edge. it is sectioned to reveal large area of hemorrhage measuring up to 3 cm, and the inferior surface of the femoral head is jagged and hemorrhagic. the bone trabecula are firm and no tumors or other mass lesions are noted on sectioning. representative sections are submitted in a-b following decalcification. cta chest (post-op) : impression: 1. single pe visualized in the apical segment of the right lower lobe. 2. small bilateral pleural effusions. associated atelectasis. no other areas of consolidation are visualized. 3. mild/early chf. ct abd/pelvis (): impression: 1. patient is status post orif of the left proximal femur. there is marked streak artifact from this within the pelvis, however, no definite hematomas are identified. 2. bilateral small pleural effusions with associated atelectasis. 3. the gallbladder appears full, and contains sludge. if there is clinical concern for acute cholecystitis, evaluation with ultrasound is recommended. us liver/gb (): impression: gallbladder sludge and pericholecystic fluid. no gallbladder wall edema or other evidence to suggest acute cholecystitis. given the presence of hypoalbuminemia, normal lfts, and the absence of a white count, the gallbladder sludge and gallbladder distention likely reflect a fasting state. cxr : impression: improvement of pulmonary edema. unchanged right pleural effusion. brief hospital course: year old female with h/o hypothyroidism, anemia, osteoporosis, multiple falls including and , who presented s/p mechanical fall with subsequent l hip fx. she was taken to or for l orif. intraoperatively she dropped her o2 sats from 100 to 90 and was noted to have an elevated a-a gradient. hip procedure went well without complications. post-operatively, the pt left ventilated on simv and ortho requested transfer to micu for further evaluation and treatment. in the icu, she was found to have a subsegmental pe and bl pleural effusions. she developed a fever to 101.9, and was treated empirically for hospital-acquired pna with ctz/flagyl (plan for 10 days). she was also started on heparin, and was noted to have had a hct drop of 10 points on , which was stable after transfusion. no obvious source was found and her hct was stable following. during this time (), she was also empirically started on vancomycin for the fevers, but it was d/c'd on . no other etiology for the fevers was found, including negative ruq u/s and ct a/p. once extubated, the patient failed speech and swallow evaluation, but refused ngt placement. a picc line was placed for temporary nutrition via tpn. . 1. pe: the patient was anticoagulated initially with heparin gtt then switched to lovenox. once a peg was placed, the patient was transitioned over to coumadin with lovenox bridge. last inr was 2.1 on , stopped lovenox, discharged on coumadin 3mg po qd, please check inr in 2 days and adjust dose of coumadin as needed. at time of discharge, her sao2 ranged from 92-95 on ra. . 2. id: the patient was treated empirically with ctz and flagyl for a nosocomial/aspiration pna and remained afebrile while on the floor. however, pt's wbc elevated so vanco was added to regimen for a 7 day course. a sputum cx from grew sparse yeast. the foley was changed and a urine sent for culture; the initial sample was contaminated and grew yeast; the second urine cx grew enterococcus resistant to vanco 10,000-100,000 colonies. a repeat urine was sent and the foley was removed; cx grew only yeast. she remained afebrile, with a normal wbc, throughout the remainder of her hospitalization. a pcxr on showed a question of a new l medical base infiltrate; however, in absence of fever and stable wbc, did not treat with abx, followed clinically. there was a concern that the patient may have experienced an aspiration event; however she did not worsen clinically so no further treatment provided other than measures to reduce aspiration risk. . 3. l hip fracture, s/p orif: the patient was followed by orthopedics and did well, cleared for wbat and work with pt/ot; will need pt/ot at rehab when physically able. the patient will f/u with dr. 2 weeks from discharge date (number in discharge paperwork). . 4. delirium/dementia: the patient had a waxing/ mental status. at one point the patient pulled her iv lines including her picc line, occasionally requiring the use of soft restraints for her safety. olanzapine was used on a prn basis for agitation. frequent reorientation was used. pt has periods of apparent lucidity and makes insightful comments and conversation. . 5. fen: the patient failed multiple speech & swallow evaluations. the patient was initially on tpn via the picc line for nutrition. extensive discussions were had with the healthcare proxy regarding options for enteral nutrition. an albumin was 2.7. a peg was placed on and tube feeds were begun and the patient achieved her tf goal. electrolytes were stable. there was concern on that the patient was aspirating some of her tf reflux, despite no residuals when checked; a cxr was unchanged. a day later a repeat cxr showed a question of a new l medial base infiltrate (poor quality film). reglan was started, and tf were restarted at a slower rate. a ppi was also administered. hob kept elevated >30-45 degrees at all times. the patient was followed on a sliding scale insulin regimen with good effect. . 6. hypothyroidism: the patient was initially treated with iv levoxyl since she was npo; a tsh was checked: 8.5, difficult to interpret in an ill, hospitalized patient. a free t4 was wnl, so pt was maintained on same dose of levoxyl. once peg in place, po levoxyl started at same dosing per pharmacy recs. . 7. anemia: stable during remainder of hospitalization. baseline hct appears to be in the low to mid 30s. . . medications on admission: meds on transfer: propofol gtt multivitamins 1 cap po daily olanzapine prn oxycodone 5 mg po q4-6h:prn pain acetaminophen 650 mg po/pr q6h pantoprazole 40 mg po q24h calcium carbonate 500 mg po tid cefazolin 1 gm iv q8h duration: 6 doses docusate sodium 100 mg po bid:prn enoxaparin sodium 40 mg sc q24h levothyroxine sodium 88 mcg po daily senna 1 tab po bid metoprolol 5 mg iv q6h morphine sulfate 1-2 mg iv q4-6h:prn vitamin d 400 unit po daily . allergies: nkda discharge medications: 1. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po bid (2 times a day) as needed for agitation. 2. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 3. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 4. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 5. coumadin 3 mg tablet sig: one (1) tablet po once a day: via peg. tablet(s) 6. lansoprazole 15 mg susp,delayed release for recon sig: one (1) po daily (daily): via peg. 7. metoclopramide 10 mg tablet sig: one (1) tablet po q6h (every 6 hours): via peg. 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day): via peg, fold for hr<60, sbp<115. 9. outpatient lab work please check inr in 2 days and adjust coumadin level as needed for goal inr . 10. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day). 11. warfarin 1 mg tablet sig: three (3) tablet po daily (daily) as needed for pe. discharge disposition: extended care facility: at discharge diagnosis: 1. l hip fracture s/p orif 2. pe 3. dementia/delirium 4. pneumonia (resolved) 5. anemia (stable) 6. hypothyroidism discharge condition: fair discharge instructions: -take medications as prescribed -work with physical therapy as able -tube feeds via peg (nothing by mouth until re-evaluation by speech/swallow) -notify your doctor or return to the er for: * fever>101.4 * chest pain, shortness of breath, abdominal pain * other concerns followup instructions: - provider: , md date/time: 1:30 - orthopedics dr. -- call to schedule appointment at a time conveneient for you 2 weeks from your discharge date. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] partial hip replacement open reduction of fracture with internal fixation, femur diagnoses: pneumonia, organism unspecified anemia, unspecified esophageal reflux acute kidney failure, unspecified unspecified protein-calorie malnutrition unspecified acquired hypothyroidism unspecified fall pneumonitis due to inhalation of food or vomitus iatrogenic pulmonary embolism and infarction other closed transcervical fracture of neck of femur 

Answer: The patient is high likely exposed to