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: penicillins attending: chief complaint: transfer from outside hospital for concern of tracheomalacia major surgical or invasive procedure: flexible bronchoscopy () placement of interpulmonary stent () history of present illness: pt is a 66f transferred from with tracheomalacia. she was admitted on for copd exacerbation after outpatient taper of prednisone from 40 to 20mg and was intubated there. ms. was extubated over the weekend prior to admission but night of had increased bp, tachycardia. she was re-intubated , s/p bronch which demonstrated 90% occlusion w/ expiration. patient experienced hypotension to systolic 80's during bronch thought to be medication related (7mg versed). pt rec'd 700 cc of ns, and levophed at 2mcg/min weaned to off on the ride over from osh. of note, lovenox was d/c'd this a.m. due to hematuria but with stable hct. past medical history: copd gerd depression 50 pack year smoker social history: lives at home with husband. 50 pack year hx quit in 82. occ etoh. family history: mother died at 63 from mi, father died 81 from etoh related physical exam: v/s: tm 101 hr 114 bp 121-147/50s 100% on fio2 40% ps 17 peep 8 gen: awakes to name, follows commands suchs as hand squeeze and toe movement heent: intubated, perrla cv: s1 s2 no m/r/g lungs: occais wheezes anteriorly abd: soft, nt/nd +bs, bruising on lower abd extending to upper labia ext: no c/c/e, bruising on upper arm pertinent results: labs on admission: 08:52pm blood wbc-8.5 rbc-3.39* hgb-11.0* hct-31.3* mcv-92 mch-32.4* mchc-35.0 rdw-14.3 plt ct-226 08:52pm blood neuts-84.8* bands-0 lymphs-10.1* monos-4.5 eos-0.5 baso-0.1 08:52pm blood pt-12.7 ptt-23.7 inr(pt)-1.1 08:52pm blood glucose-119* urean-17 creat-0.6 na-142 k-3.6 cl-103 hco3-28 angap-15 08:52pm blood alt-31 ast-16 ld(ldh)-231 alkphos-44 amylase-26 totbili-0.5 08:52pm blood albumin-3.3* calcium-8.5 phos-2.9 mg-2.0 09:23pm blood lactate-1.4 09:23pm blood freeca-1.13 labs on discharge: microbiological data: c diff- negative 12:56 am sputum source: endotracheal. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 3+ (5-10 per 1000x field): gram negative rod(s). 3+ (5-10 per 1000x field): gram positive cocci. in pairs and clusters. 2+ (1-5 per 1000x field): gram positive rod(s). respiratory culture (final ): sparse growth oropharyngeal flora. bcx -pending -bcx- pending -ucx- no growth - gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 2+ (1-5 per 1000x field): gram positive cocci. in pairs and clusters. respiratory culture (final ): sparse growth oropharyngeal flora. bcx x 2- no growth ucx- no growth _______________________________________ radiology: cxr ap-lungs are clear. heart size is normal and there is no evidence of appreciable pleural effusion. et tube and right subclavian line are in standard placements respectively and a nasogastric tube passes below the diaphragm and out of view. no pneumothorax. cxr ap- the et tube tip is 5.4 cm above the carina. the ng tube tip terminates in the stomach. the right subclavian line tip is in the mid svc. heart size is normal. lungs are unremarkable. no sizeable pleural effusion is identified. cxr ap- interval development of mild lower lobe interstitial pulmonary edema. findings were discussed with dr. on date of exam at approximately 4:30 p.m. cxr ap-impression: no chf or pneumonia. satisfactory endotracheal tube tip placement. -impression: no pneumomediastinum. support tubes and lines stable. lungs clear. brief hospital course: impression/plan: 66 yo female with copd flare s/p intubation; transferred secondary to concern for tracheomalacia. s/p stent by interventional pulmonary on . 1. copd- initially admitted for exacerbation at osh and was intubated. she was successfully extubated but reintubated due to ?tracheomalacia. pt was transferred here vented and is s/p ip stent placement with good resolution of tracheomalacia on . she was continued on a steroid taper and nebulizer treatments. in terms of weaning, she was changed from ac to pressure support but had a lot of tachypnea, likely secondary to a large anxiety component. ativan was too sedating for her. on hd 5, she was able to be changed to pressure support and was weaned down. she was successfully extubated on . she required bipap for a short period of time on for increased wob, but has been stable since then, on l nc and comfortable. she had pfts and a 6 minute walk test with ip prior to discharge. she remained stable on 2-3l nc (baseline). 2. pt had several fever spikes during her first few days of hospitalization. patient was pancultured, without any obvious source. cxr did not reveal evidence of pna. sputum cultures here were mixed oropharyngeal flora. the central line was d/cd on hd #6 when a picc was placed; tip was sent to culture. it is possible that the central line (placed ) at osh was a potential source. pt was on vancomycin and levaquin started on hd 3 for a 10 day course (end ). she had no futher fever after transfer to the floor. 3. tachycardia and htn- ekg showed sinus tachycardia which was attributed to severe anxiety. she was started on iv metoprolol q4 hours which was required hd and then d/cd. her tachycardia is also likely albuterol nebs and dehydration. ivf were given, which helped her tachycardia to some degree. patient was not symptomatic. her tachycardia has improved since transfer to the floor, she is baseline in the low 100's (sinus tach) with occasional bumps to the 120's with anxiety. 4. anxiety- as above. ativan was attempted but lead to severe somnolence. lexapro was continued. 5. gerd- continued protonix 6. anemia-baseline hct is 34. there was evidence of extensive ecchymosis from lovenox sc on pt's lower abdomen/labial area. she was guaiac positive though hct remained stable. ppi was increased to and this will need to be addressed as an outpt. 7. hypokalemia - pt had mild hypokalemia noted on the day of discharge. she was repleted with po kcl and lab rechecked. it should be monitored intermittently while in rehab. 8. fen- was on tubefeeds while intubated. 9. ppx- pneumoboots, insulin sliding scale as on iv steroids . heparin sc not given ecchymosis was above. pneumoboots were employed. 10. access- rij placed d/cd when picc was placed. we d/ced a-line on 10. code- full medications on admission: duonebs combivent ativan spiriva colace lovenox 40 sc lexapro 20' (from celexa 40 qday) 60'' lasix 20 iv prn (last given 23:51) insulin ss solumedrol 10 mg' pantoprazole 40 iv' propofol drip senakot tylenol prn ativan 2mg iv prn maalox prn zofran discharge medications: 1. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day) as needed. 2. fexofenadine 60 mg tablet : one (1) tablet po bid (2 times a day). 3. prednisone 10 mg tablet : as instructed tablet po once a day: take 4 tablets daily x 3 days (40 mg), 3 tablets daily x 3 days (30 mg), 2 tablets daily x 3 days (20 mg), 1 tablet daily x 3 days (10 mg) and then 0.5 tablet daily x 3 days (5 mg), then stop. disp:*22 tablet(s)* refills:*0* 4. escitalopram 10 mg tablet : two (2) tablet po daily (daily). 5. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr po bid (2 times a day). 6. guaifenesin 100 mg/5 ml syrup : 5-10 mls po q6h (every 6 hours) as needed. 7. albuterol sulfate 0.083 % (0.83 mg/ml) solution : one (1) neb inhalation q6h (every 6 hours) as needed. 8. fluticasone-salmeterol 250-50 mcg/dose disk with device : one (1) disk with device inhalation (2 times a day). 9. guaifenesin 600 mg tablet sustained release : two (2) tablet sustained release po bid (). 10. tiotropium bromide 18 mcg capsule, w/inhalation device : one (1) cap inhalation daily (daily). 11. lorazepam 0.5 mg tablet : one (1) tablet po q6h (every 6 hours) as needed for anxiety. disp:*15 tablet(s)* refills:*0* discharge disposition: extended care facility: - discharge diagnosis: tracheomalacia s/p stenting copd pneumonia discharge condition: stable. discharge instructions: you were hospitalized for tracheomalacia following intubation for copd. you had a stent placed in your trachea by interventional pulmonology and will need to be carefully followed by them after your discharge. you were also treated for pneumonia, and will need to continue antibiotics as an outpatient until . call your doctor or return to the emergency department if you experience any of the following: - worsening shortness of breath - new cough - chest pain or difficulty breathing - fever > 102 - any new or concerning symptoms followup instructions: please follow up with the interventional pulmonology clinic one week following your discharge. you will need to call for an appointment. the number to call is (. please make an appointment to see you primary care provider after your discharge from rehab. md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more fiber-optic bronchoscopy fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances other bronchoscopy non-invasive mechanical ventilation other intubation of respiratory tract diagnoses: pneumonia, organism unspecified esophageal reflux chronic airway obstruction, not elsewhere classified hypopotassemia anxiety state, unspecified acute respiratory failure family history of ischemic heart disease nonspecific abnormal findings in stool contents tachycardia, unspecified other diseases of trachea and bronchus 

Answer: The patient is high likely exposed to