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 / ace inhibitors attending: chief complaint: ankle fracture, hypoxia major surgical or invasive procedure: endotracheal intubation central line placement history of present illness: 52f (limited history per chart from ems and ed) w/ hx chf, copd p/w l ankle pain s/p fall while getting oob, found on floor, no other traumatic injuries noted. she complained of left ankle pain. when the ems arrive, she was found to have initial blood sugar 30 on sulonfylurea, she received 1amp d50 and was continue on d5 1/2 ns. however, as the below ed course will show that she became hypoxic and then hypercarbic over the next several hours. she eventually was intubated for hypercarbic respiratory distress. . of note, patient was recently discharged on and was hospitalized for mental status changes, hyperkalemia in setting of acute renal failure and hyponatremia. . ed course: initial vs t 97.6 p 63 bp 161/44 rr 16 o2 75 on ra (1pm)-> nrb(2:20pm) -> 97% on nrb,-> abg 3:30pm 7.19/84/66-> abg 4pm 7.16/90/82-> but patient became more somnolent at (4:30pm). bipap was initiated-> pt was yelling out and trying to get oob (5:30pm). pt was intubated at 5:35pm. alb/atrovent d50 1amp-> fs solumedrol 125 mg iv levaquin 500 iv 1l d5 1/2 ns 325 asa intubated w/ vecuronium and etomidate and propofol for sedation past medical history: - copd/asthma on home o2 (2.5l/min) - restrictive lung disease - htn - chf (diastolic, ef 55% in ) - moderate mental retardation - ckd, baseline cr 1.8 - dm2 - h/o hyponatremia - chronic le edema - dementia - iga nephropathy - hearing loss - tobacco use - chronic constipation - hyperlipidemia social history: tobacco - 1ppd x many years alcohol - none illicit drugs - none occupation - not employed; currently living in group home family history: fh: one older sister, does not know her health status. mother died when she was young, does not know what her father died of. physical exam: vitals: p 70s bp 150/40 rr 14 o2 95% on ps peep 5 fio2 40% tv 250s (spontaneous), peak pressure 20s weight 162.3 lbs (up 3 lbs from baseline) gen: petite female, intubate and arousable heent: ncat, sclerae anicteric/noninjected, eomi, perrl, op clear, uvula midline, mm dry. dentures in place. neck: no jvd, no lad, no carotid bruits. cv: rr, nl s1/s2, no m/r/g noted. lungs: coarese breath sounds bilaterally ab: soft, ntnd,+ bs, no hsm by percussion, no rebound or guarding. extrem: no c/c/e. + wwp. 2+ radial, pt pulses bilaterally. no point tenderness along her spine. no reproducible neck pain. lle in cast neuro: aaox3, cn ii-xii grossly intact. skin: no rashes. + scc on scalp. . pertinent results: at admission: 01:25pm glucose-44* urea n-63* creat-3.0* sodium-124* potassium-5.2* chloride-89* total co2-30 anion gap-10 01:25pm alt(sgpt)-68* ast(sgot)-100* ld(ldh)-200 ck(cpk)-1774* alk phos-190* amylase-24 tot bili-0.3 01:25pm ck-mb-46* mb indx-2.6 ctropnt-0.06* probnp-* 01:25pm wbc-6.3 rbc-3.20* hgb-10.5* hct-30.9* mcv-96 mch-32.7* mchc-33.9 rdw-16.6* 01:25pm plt count-232 03:50pm (pre-intubation) type-art po2-82* pco2-90* ph-7.16* total co2-34* base xs-0 . : ankle xray: there is a displaced comminuted overriding distal fibular (lateral malleolus) fracture. there is also a comminuted fracture of the medial and posterior malleolus (tibial) with likely intra- articular involvement. there is surrounding soft tissue swelling. the ankle mortise appears symmetric. . : tte: 1. the left atrium is mildly dilated. 2. there is mild symmetric left ventricular hypertrophy with normal cavity size and systolic function (lvef>55%). regional left ventricular wall motion is normal. 3. the right ventricular cavity is mildly dilated. right ventricular systolic function appears depressed. 4. the aortic valve leaflets (3) are mildly thickened. mild (1+) aortic regurgitation is seen. 5. the mitral valve leaflets are mildly thickened. there is severe mitral annular calcification. mild (1+) mitral regurgitation is seen. 6. there is a trivial/physiologic pericardial effusion. 7. compared with the report of the prior study (images unavailable for review) of , there is probably no significant change. . : ct chest (w/o contrast): 1. multiple small discrete peripheral pulmonay opacities. the appearance is nonspecific but could be secondary to pulmonary infarctions from multiple pulmonary emboli. this could be further evaluated with a chest cta. the mediastinal and right hilar adenopathy could also be better evaluated with intravenous contrast. 2. mild interstitial edema. 3. slight over-distension of the endotracheal tube cuff. . : chest xray: endotracheal tube, central venous catheter, and nasogastric tube remain in standard position. cardiac silhouette is enlarged but stable. there is persistent vascular engorgement and perihilar haziness attributed to congestive heart failure. the peripheral right hemidiaphragm is partially obscured. this may be due to right effusion and/or developing consolidation in the right lower lobe. followup radiographs are suggested to exclude developing infectious pneumonia. . brief hospital course: a/p:52 year old copd, cri, htn, anemia, p/w ankle fracture and now intubated for hypercarbic respiratory distress. . #hypercarbic respiratory distress - this is likely exacerbation of her underlying copd and chf with questionable pna. pcp reports 15 lb weight gain over the last month although no evidence of pulmonary edema on cxr. pna is no evidence on cxr, but there is significant secretion on suctioning as well. patient was treated with lasix in attempt to diurese, levaquin and vancomycin for pna, albuterol, combivent, solumedrol for copd. despite these efforts, patient was extubated unsuccessfully and required reintubation and had an episode of asystole. she then was reintubated for one more week. on extubation, patient was made dnr/dni and comfort measures were started with morphine gtt. patient died the next day respiratory failure. . . #ankle fracture -comminitated fracture-> put in cast. . # ckd- baseline cr 1.7 - 2.4, and planned for starting hd at the end of the year. cr on admission was 4.1 and bun 108. attempted aggressive diuresis. creatinine improved down to high 2s. dialysis never started. . . # cv a)pump: history of chf. patient had pulmonary edema on cxr and had h/o weight gain. attempted diuresis with bumex and metalazone which was difficult given cri. . b) ischemia-elevated ck likely in setting of fall and elevated troponin likely in setting of renal failure. troponin is at baseline. -monitor on telemetry -continue b-blocker and asa . c)rhythmn-nsr w/1 avb. . # htn: elevated over baseline likely in setting of stress -continued labetalol, nifedipine, bumex, imdur, hydralazine -held valsartan given very limited renal status . # dm type ii: fs qid with riss for now. oral glycemic held in setting of sulfonrea-related hypoglycemia. . # anemia: stable and at baseline.will guaiac all stools and monitor hct daily . # depression: continue home regimen of doxepin, carbamazepine and remeron. medications on admission: carbamazepine 800 mg doxepin 150 mg hs mirtazapine 30 mg hs labetalol 200 mg nifedipine 120 mg tablet sustained release daily calcium carbonate 1000 mg daily as needed cholecalciferol (vitamin d3) 800 unit daily atorvastatin 20 mg daily multivitamin daily montelukast 10 mg daily pantoprazole 40 mg q24 tiotropium bromide 18 mcg capsule daily fluticasone-salmeterol 250-50 mcg/dose disk polysaccharide iron complex 150 mg daily albuterol sulfate q6 prn atrovent q6 prn ammonium lactate 12 % lotion bumetanide 1.5 mg tid aspirin 325 mg daily colace polyethylene glycol 3350 17 g (100%) daily calcitriol 0.25 mcg po twice a week. glipizide 10 mg q am. glipizide 5 mg qhs melatonin 1 mg qhs. prilosec 20 mg capsule daily metamucil 0.52 g daily discharge medications: none discharge disposition: expired discharge diagnosis: deceased s/p respiratory failure discharge condition: deceased discharge instructions: none followup instructions: none md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances application of splint diagnoses: anemia in chronic kidney disease nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere tobacco use disorder congestive heart failure, unspecified acute kidney failure, unspecified hyposmolality and/or hyponatremia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified chronic kidney disease, unspecified constipation, unspecified other and unspecified hyperlipidemia anxiety state, unspecified acute respiratory failure cardiac arrest diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled unspecified hearing loss other and unspecified special symptoms or syndromes, not elsewhere classified encounter for palliative care chronic obstructive asthma, unspecified accidental fall from bed diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled moderate intellectual disabilities nephritis and nephropathy, not specified as acute or chronic, with unspecified pathological lesion in kidney trimalleolar fracture, closed 

Answer: The patient is high likely exposed to