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: erythromycin base / lipitor / actonel / lisinopril / simvastatin / zetia attending: chief complaint: chest pain, cough major surgical or invasive procedure: - cardiac catheterization with balloon angioplasty - subtotal colectomy, end ileostomy - r chest pigtail catheter placement - tracheostomy and peg placement history of present illness: 81 year-old female with dm, htn, hld, who presents with chest pain that began the night prior to admission . she states that she has been having a cough that began the day before she was discharged from her last hospitalization on , that has lingered since that time. in the interim she has been using her albuterol and flovent inhalers, was prescribed a prednisone taper about 2 weeks ago from her pulmonologist and was tried on both azithromycin and levaquin, both of which upset her stomach, she took 2 days of azithromycin and 4 of 5 days of levaquin. during this time she says that she had an increase in the frequency of her sputum and the sputum that had previously been white changed to yellow. denies any fever/chills, shortness of breath, nausea/vomiting/diarrhea, associated. the night prior to admission, she was sleeping, woke up coughing and then experienced a sharp chest pain that radiated to her back, and worsened with deep inspiration. she has never had pain like this before and she pressed her life line, the ambulance came and there was initial concern for an stemi. in the ambulance she received asa and oxygen with resolution of her chest pain. on arrival to the er it was felt that she was not having an stemi, she had a cta that showed no pe or dissection. she was found to have an elevated wbc, and consolidations seen on ct so she was given a dose of levaquin. past medical history: pmhx: nstemi (), dm2, htn, asthma, pr, osteoporosis, right eye blindness hx: hysteroscopy/d&c , s/p excision of benign left breast lesion, repair of left radial fracture , cardiac cath and social history: patient is widowed, currently lives alone, no children, her sister and brother-in-law live in 30 min away. no etoh, no smoking history, but did work with excessive second hand smoke for years, no illicit drug use family history: father had ca physical exam: t 98.4 hr 91 bp 114-121/ 50-63 rr 16-18 sao2 95-97 % ra gen: thin, elderly female sitting up in bed in nad heent: eomi, perlla, mmm, o/p clear cv: rrr normal s1,s2 no murmurs. jvp flat. lungs: decreased bs bilateral bases, but clear, no wheeze or ronchi abd: +bs, soft, nt nd no appreciable hsm ext: no edema, 2+ dp, pt pulses b/l neuro: a&ox3, strength 5/5 b/l ue and le pertinent results: 02:36am blood ctropnt-<0.01 12:40pm blood ck-mb-18* mb indx-14.0* ctropnt-0.13* 09:36pm blood ck-mb-13* mb indx-11.0* ctropnt-0.14* 07:30am blood ck-mb-9 ctropnt-0.13* 02:36am blood wbc-21.6* rbc-4.57 hgb-13.8 hct-42.0 mcv-92 mch-30.3 mchc-33.0 rdw-13.4 plt ct-279 06:35am blood wbc-10.0 rbc-3.79* hgb-11.2* hct-34.6* mcv-91 mch-29.5 mchc-32.2 rdw-12.9 plt ct-231 cardiac catheterization: 1. coronary angiography in this right dominant system revealed single vessel disease. the lmca had no angiographically apparent disease. the lad and lcx had no areas of stenosis. the rca had a complex 90% stenosis in the mid-portion. 2. resting hemodynamics revealed mild systolic hypertension with sbp 148 mmhg, and a widened pulse pressure with a dbp of 60 mmhg. brief hospital course: 81 year-old female presented on with chest pain and pna. she was started on levaquin for her pna and she underwent cardiology evaluation for elevated troponins and ekg changes. she was diagnosed with nstemi. therefore, she underwent cardiac catheterization and balloon angioplasty of her rca on . patient's post-cath course includes being placed on a heparin gtt for atrial fibrillation and stable conservative management of a right groin hematoma. on post-catheterization day #5, the patient went into rapid atrial fibrillation in the early am. her hr was in the 150s and sbp in low 80s. her heart rate was converted back to sinus with digoxin and her sbp was now in 100s. however, 30 minutes after the patient went into afib, she complained of severe abdominal pain in her right lower quadrant. general surgery consult was called a little later that morning, as there was concern that the patient displayed peritoneal signs. the general surgery team evaluated the patient 20 minutes after administration of prochlorperazine for nausea, and thus she was slightly sedated. however, she did complain of abdominal pain in mid-abdomen. she had not been passing flatus for the previous 36 hours, and she had one episode of vomiting earlier in the am. a ct scan of the abdomen/pelvis was ordered on the patient and showed right and cecum with pneumatosis, areas of portal venous gas seen in liver, and air in veins running through iliac fossa that were likely branches of the portal vein. the patient and her family members were immediately contact with the gravity of the diagnosis - the patient likely had ischemic injury to her either from a thrombus to a branch of the sma or she had ischemic from a low flow state that was a consequence of her atrial fibrillation. after thorough discussion between dr. , the patient, and her family members reviewing all the risks and benefits of surgery, the patient was taken emergently to the operating room. patient underwent exploratory laparotomy on . findings included toxic megacolon and ischemic injury extending from the right through the transverse . the patient underwent a subtotal colectomy and end ileostomy. because the patient's case occurred late in the evening on , she was kept intubated postoperatively. the patient's early postoperative course was marked by rapid atrial fibrillation with rvr. during the first 24 hours postoperative, she dropped her pressures to systolic of 50 and required cardioversion and adenosine injections. she was started on an esmolol gtt to control her atrial fibrillation, and this was then changed over to an amiodarone gtt. the patient was transfused one unit of packed red blood cells and was temporarily placed on a dobutamine gtt. the patient was evaluated by cardiology, who recommended that she placed back onto an amiodarone gtt. the patient underwent an echo cardiogram on pod 2 that revealed normal lv and rv function and an ef of 55-60%. the patient also had a leukocytosis and an elevation of her lfts from pod4 through pod7. concern was raised as to whether the patient could have acute cholecystitis. however, she underwent a right upper quadrant ultrasound on pod5 that showed patient had no evidence of acute cholecystitis, and rather she may have an element of shock liver. the patient's lfts and wbc eventually normalized. the patient was on and off neosynephrine gtt during this time period, however this was thought to be due to her slightly lower blood pressure as a consequence of propofol - the patient was intubated during this time period and remained on propofol. she was started on tube feeds and this was tolerated to goal. once the patient's leukocytosis and lfts improved, the patient was extubated on pod 10. she had slight tachypnea. she was given lasix to remove excess fluid. however, the patient tired out on pod11 and she was re-intubated. cxr post-intubated showed a large right pleural effusion. the patient underwent thoracentesis by the sicu service and 900 cc of transudative pleural fluid was removed. however, post-thoracentesis cxr showed a right basilar pneumothorax. patient therefore had a right pigtail tube placed in the right chest by ip. between pod 11 and pod 16, the patient remained intubated and still on-and-off the neosynephrine gtt. after careful discussion with the patient's family regarding the patient's unlikelihood of weaning off the vent, the family consented to having the patient undergo a tracheostomy and peg placement. the patient underwent peg and trach on . the pigtail was removed on pod16 (). the patient did very well with tracheostomy in place and was able to wean off the vent and onto trach mask by pod 17. the patient was also able to tolerate tf at goal on the peg. the patient was evaluated once more cardiology on the day before discharge. as she had been off the neosynephrine gtt since pod15, they recommended the patient remain on enteral amiodarone and lopressor for control of her heart rate/rhythm. furthermore, the patient had remained on a heparin gtt from pod2 through pod 19 for her atrial fibrillation. she was started on coumadin (3 mg qday) on pod17. at the time of discharge, the patient was tolerating trach mask and was off of pressors for greater than 72 hours. she was awake and following commands. she was tolerating goal tube feeds. the heparin gtt was discontinued on pod19 (the day of discharge) and patient was discharged on lovenox bridge. the patient was stable at the time of discharge. medications on admission: mflovent 110mcg 1puff glyburide 1.25mg plavix 75mg-patient stopped secondary to hemoptysis hydralazine 50mg metoprolol 75mg tid boniva 150mg every 4th of the month asa 81mg fish oil 1000mg red yeast rice extract 600mg tid discharge medications: 1. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day). 2. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day): administer via g tube. 3. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: six (6) puff inhalation q4h (every 4 hours) as needed for wheezing. 4. ipratropium bromide 17 mcg/actuation aerosol sig: six (6) puff inhalation q6h (every 6 hours). 5. famotidine 20 mg tablet sig: one (1) tablet po q24h (every 24 hours): administer via g tube. 6. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed for thrush. disp:*50 ml(s)* refills:*0* 7. acetaminophen 160 mg/5 ml solution sig: six y (650) mg po q6h (every 6 hours) as needed for pain. 8. oxycodone-acetaminophen 5-325 mg/5 ml solution sig: 5-10 mls po q4h (every 4 hours) as needed for pain: via g tube. 9. warfarin 1 mg tablet sig: three (3) tablets po daily (daily): via g tube. check inr daily. keep inr . 10. enoxaparin 60 mg/0.6 ml syringe sig: one (1) injection subcutaneous twice a day: continue until inr>2. discharge disposition: extended care facility: & rehab center - discharge diagnosis: threatened stemi w/ autolysis; toxic megacolon s/p subtotal colectomy and end ileostomy; asthma exacerbation, failure to wean from vent discharge condition: stable, working with pt, tolerating tf at goal, tolerating trach mask discharge instructions: it was a pleasure being involved in your care, ms. . you were admitted to due to chest pain and were found to have a heart attack, for which you received a cardiac catheterization and balloon angioplasty of a completely occluded vessel. this means the chest pain you were having was due to a blockage in one of the small arteries that supplies your heart. you also had a cough with suspicion for pneumonia so you were started on antibiotics, nebulizers and cough medicine to help your breathing. you were then found to have ischemic and required an exploratory laparotomy. you underwent subtotal colectomy with end ileostomy. you spent the remainder of your hospital stay in the icu due to a heart arrhythmia and inability to wean off the vent. you underwent a gastrostomy feeding tube placement and tracheostomy on . continue tube feeds at goal. stay npo otherwise. please continue to take your other medications as listed. please call your doctor or 911 if you have any further chest pain, difficulty breathing, intractable nausea/vomiting, blood in your urine vomit or stool, fever, chills, signs of wound infection, or any other concerning symptoms. followup instructions: 1) please follow-up with your pulmonologist dr. in 3 weeks at the . please phone to schedule an appointment. 2) follow-up with your primary care doctor in weeks. call dr. at to schedule an appointment. 3) also, please follow up with your cardiologist, dr. on wednesday in 2 weeks. call to schedule the appointment. procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances other endoscopy of small intestine injection or infusion of platelet inhibitor left heart cardiac catheterization coronary arteriography using a single catheter insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis other and unspecified partial excision of large intestine temporary ileostomy percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy closed [endoscopic] biopsy of bronchus angiocardiography of right heart structures excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: pneumonia, organism unspecified subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis unspecified pleural effusion unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute and subacute necrosis of liver unspecified protein-calorie malnutrition atrial fibrillation hematoma complicating a procedure atrial flutter other and unspecified hyperlipidemia acute respiratory failure iatrogenic pneumothorax osteoporosis, unspecified cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other diseases of lung, not elsewhere classified ulcerative colitis, unspecified acute vascular insufficiency of intestine asthma, unspecified type, with (acute) exacerbation nontoxic multinodular goiter shock, unspecified 

Answer: The patient is high likely exposed to