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: codeine / percocet attending: chief complaint: fevers, arthralgias, previous rash major surgical or invasive procedure: picc placement ct-guided thoracentesis history of present illness: ms. is a 49 year old woman with h/o genital herpes who is being transferred from the micu to 7 because of improvement of her hypoxia, but now with resolving nausea and vomiting likely causing metabolic alkalosis. two weeks prior to admission, while driving home after visiting her daughter at , she had sudden aches in her hips, knees, and ankles. she also noticed swelling in her ankles. the following day, she noticed a rash on her left leg that eventually spread throughout her body. per her pcp, rash was diffuse, erythematous, and blanching. it covered her chest, back, arms, and legs, but spared her palms and soles. her pcp instructed her to use hydroxyzine and ibuprofen for relief, but the rash persisted and because purpuric. at the same time, she had fevers, with temperatures to 103.9. she began having worsening dyspnea and cough. she also had body aches and joint swelling. she was seen in rheumatology clinic and, from there, was sent to the ed for further workup. . in the ed, her vital signs were 100.9, 102, 110/69, 22, and 99% on ra. neurology was consulted and an lp was attempted but could not be performed. she received 2 l ns, acetaminophen, albuterol and diazepam. she was then transferred to cc-7 for further management. while on the floor, the patient triggered twice for tachypnea and low oxygen saturation down to 84% on ra. her pulmonary symptoms dramatically progressed and cxr findings were consistent with multilobar pna (especially lll). she was started on ceftriaxone, azithromycin, and doxycycline. she was then transferred to the micu for further work-up of her hypoxia. . in the micu, her vital signs were 98.2 112/58 112 28 93% on 6l. she was continued on vancomycin, zosyn, levofloxacin, and doxycycline. viral serologies were already pending. id was consulted, but urine legionella ag returned positive. repeat cxr showed interval progression of multilobar pneumonia and she underwent thoracentesis of l pleural effusion. she did not require intubation. while in the micu, she began having nausea and vomiting on and off. she was treated with zofran with good improvement, but the nausea and vomiting continued. occasionally, the nausea comes on while eating, but improves with cessation of eating. percocet and anything with codeine seemed to make the nausea worse. over the next few days, her respiratory status improved significantly, pt weaned from nrb to 4l nc. on transfer, she continues to have nausea and vomiting and diffuse jt aches/fatigue. otherwise denying cp/abd pain. past medical history: genital herpes social history: she is married with three children. she has a 20 pack year smoking history and currently smokes one pack per day. she denies alcohol or illicit drugs. family history: non-contributory physical exam: physical exam on admission vs 101.4 112/82 91 18 95%ra gen: well-appearing woman lying in bed heent: clear op, mm slightly dry neck: supple, no lad, no jvd cv: rr, nl rate. nl s1, s2. no murmurs, rubs or lungs: cta, bs bl, no w/r/c abd: soft, nt, nd. nl bs. no hsm ext: no edema. 2+ dp pulses bl skin: no lesions neuro: a&ox3. appropriate. cn 2-12 grossly intact. preserved sensation throughout. 5/5 strength throughout when pushed to do things. + reflexes, equal bl. normal coordination. gait assessment deferred joints: no joints with effusions or surrounding erythema. pain much worse with active motion rather than passive motion. physical exam on transfer to the micu vst 98.2 bp 112/58 ar 112 rr 28 o2 sat 93% on 6l gen: appears in acute respiratory distress heent: mmm, anicteric sclera heart: sinus tachycardia, no audible m,r,g lungs: poor air movement (l>r), bronchial breath sounds, +egophany abdomen: soft, nt/nd, +bs extremities: no edema, 2+ dp/pt pulses bilaterally, no rashes, no swelling of her joints, rom intact. physical exam on transfer to the medicine floor vs: 99.3 130/64 77 18 94% on 4l nc gen: tired-appearing woman who appears her stated age. skin: warm and dry. no rashes. heent: nc, at. eoms intact. perrla. oral mucosa pink and moist. no lymphadenopathy. card: rrr, no murmurs. pulm: diffuse rhonchi throughout lung fields except for lll where there are few breath sounds. wheezes in upper lung fields. abd: soft, nt, nd. no masses. ext: wwp, 1+ edema bilaterally. neuro: a&ox3, cnii-xii intact. pertinent results: labs on transfer to the medicine floor chem : 139/4.3/100/36/6/0.3/104 abg : 7.46/56/93/40 hct 27.0 plt 470 . cxr : 1. left-sided picc terminating in the mid svc. 2. slight improvement in apical consolidations, but persistent diffuse bilateral airspace opacities. . cxr : the current study demonstrates interval progression in the right lower lobe consolidation with unchanged appearance of extensive left lower lobe and left upper lobe airspace opacities, finding consistent with progression of the known pneumonia that might be complicated by interval development of ards. bilateral pleural effusions cannot be excluded. overall, no findings to suggest pulmonary edema. . le us : no evidence of lower extremity dvt bilaterally. . cxr : marked interval worsening of airspace opacities and bilateral pleural effusions, particularly worse on the left side when compared to . pneumonia is not excluded. there is likely superimposed pulmonary edema. . cta chest : 1. negative examination for pe. 2. left lower lobe consolidation and multifocal pneumonia in the other lung fields. 3. small left parapneumonic pleural effusion. 4. bilateral left more than right axillary lymphadenopathy. clinical evaluation is recommended since the patient is status post breast implant. . cxr : in comparison with the study of , there has been development of increased opacification, consistent with a lower lobe pneumonia. there may well be an associated pleural effusion. . ekg: sinus at 90 bpm, normal axis, normal intervals, low voltage in limb leads, ? laa, no raa, lvh or rvh, no st-segment or tw changes in lateral, inferior leads, twi in lead v2 anteriorly, but no st-segment changes. . cxr : ap chest radiograph compared to shows no change. the lungs are clear. the heart, mediastinum, hila and pulmonary vascularity are normal. there is no pleural effusion or pneumothorax. rest of lab results: 05:30pm neuts-84.9* lymphs-10.4* monos-3.5 eos-0.8 basos-0.3 05:30pm wbc-13.4*# rbc-3.77* hgb-12.2 hct-35.1* mcv-93 mch-32.3* mchc-34.7 rdw-12.8 brief hospital course: ms. is a 49 year old woman with h/o genital herpes who is called out from micu after course with severe legionella pna, never requiring intubation. pt is currently sating well on 4l nc with metabolic alkalosis thought due to n/v. 1)pneumonia/ respiratory distress- on admission the patient had a clear cxr. had an asthma attack in the ed, and then another asthma attack on . both responded immediately to albuterol. since the second attack she has had persistent coughing productive of clear sputum. found on cxr on to have a large pneumonia and she was started on azithromycin and ceftriaxone. she continued to require increasing o2 to maintain her saturation. on she went for cta which was negative for pe. it is unclear if this pna is related to her underlying presenting symptoms or if this is a superimposed process. on her antibiotics were broadened to vanc, increased dose of ceftriaxone, azithro, and doxycycline. she continued to receive albuterol and atrovent nebs as needed. pulmonary was consulted and a sputum culture was sent. due to increasing respiratory distress and increasing oxygen requirements, patient was transferred to micu. patient was given oxygen via high flow mask and transiently required non invasive positive pressure ventilation. patient did not require intubation however. infectious workup revealed legionella pneumonia. patient was treated initially with double coverage using levofloxacin and azithromycin, with subsequent switch to monotherapy using iv azithromycin. patient improved significantly and was able to be transferred out of the micu with oxygen supplementation via nasal cannula. on the medicine floor, the patient's respiratory status remained improved on oxygen. she was continued on azithromycin. her oxygen requirement decreased during the remainder of her course. she remained afebrile while on the medicine floor. on discharge, she was off oxygen. she was afebrile and her rash had resolved. 2)nausea, vomiting, metabolic alkalosis: per the patient's report, nausea and vomiting did not begin until transfer to the micu. her nausea and vomiting continued on and off during her micu stay, but was adequately controlled on zofran. arterial blood gas prior to transfer to the medicine floor revealed a metabolic alkalosis thought secondary to vomiting. after transfer to the floor, her nausea and vomiting remained well controlled on zofran. on discharge, she denied nausea or vomiting. 3)anemia - patient has new anemia with hct in the low 30's. hemolysis labs (except for an elevated ldh) are not elevated. her anemia may be due to the cause of her underlying process. 4)transaminitis - patient with a new transaminitis. likely secondary to legionella. on discharge, transaminitis had resolved. 5)hypotension - patient developed significant autodiuresis after micu stay. she had episodic hypotension which was occasionally symptomatic in the setting of 2l daily diuresis. patient was instructed to increase po intake and salt intake and was ambulatory without symptoms at the time of discharge. medications on admission: aspirin 81 mg daily mvi cqditalopram 20 mg discharge medications: 1. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 2. azithromycin 500 mg tablet sig: one (1) tablet po once a day for 3 days. disp:*3 tablet(s)* refills:*0* 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 4. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed. 5. compazine 5 mg tablet sig: one (1) tablet po once a day as needed for nausea for 3 days: please take prior to taking azithromycin. thank you. disp:*3 tablet(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: primary: legionella pneumonia discharge condition: stable. pain controlled. stable on room air. asymptomatic systolic blood pressures in 90s. discharge instructions: you have been admitted with fever, rash, shortness of breath, cough, and joint pain and were found to be positive for legionella in your urine. you had a prolonged course, with hypoxia leading to a transfer to the medical icu, but never required intubation. your respiratory status improved and you were transferred to the medicine floor where you progressively improved. . you were started on azithromycin for legionella, and you will need to continue the antibiotic course until . you also had episodes of low blood pressure. please continue to drink fluids and increase your salt intake over the next few days. . if you develop any fevers, chest pain, shortness of breath, weakness or any other general worsening of condition, please call your pcp or come directly to the ed. followup instructions: you have a follow up appointment with dr. on at 9:50 am. if you are unable to keep your appointment, please call ( to reschedule. thank you. . you have a follow up appointment with dr. on 7 in the pulmonary clinic on at 12:30 pm. if you are unable to keep your appointment, please call ( to reschedule. thank you. . you have an appointment in radiology on at 8:45 am. if you are unable to keep your appointment, please call ( to reschedule. thank you. md, procedure: venous catheterization, not elsewhere classified thoracentesis diagnoses: anemia, unspecified unspecified pleural effusion acute kidney failure, unspecified acute respiratory failure alkalosis pneumonia due to legionnaires' disease 

Answer: The patient is high likely exposed to