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: sulfa (sulfonamide antibiotics) attending: chief complaint: respiratory distress major surgical or invasive procedure: bronchoscopy x 2 history of present illness: 75f with wegener's granulomatosis and polyangitis c/b tracheobronchial disease and bilateral bronchial stenosis s/p dilations and intralesional steroid injections presenting with respiratory distress s/p elective bronchoscopy today. patient was seen in routine followup in clinic yesterday for recent lms stent palcement in s/p repeat bronch and bal of rul and lms stnet in for mucus plugging. she was scheduled for elective followup bronch today, with forceps dilation of lll/bronchus and had visualization of purulent material in the lll. patient had signficiant difficulty breathing afterwards. was placed on bipap and sent to micu for monitoring overnight. on arrival to the micu, patient's vs: t 97.5, hr 111, bp 138/82, rr 31, o2 sat 91%. she was on bipap in nad. she had significant expiratory and inspiratory wheezez and rhonchi and was immediately treated with a combineb. past medical history: - wegener's granulomatosis: recently complicated by tracheobronchial disease in particular bilateral bronchial stenosis status post balloon dilation with intralesional steroid therapy by pulmonology - prior bilateral mainstem balloon dilations , intratracheal injection of dexamethasone with to rul , and intratracheal injection of mitomycin with dilation to right mainstem and upper lobe , repeat intervention to left mainstem stenosis with manual debridement, balloon dilatation and intratracheal dexamethasone on , lms balloon dilation and stent placement , bal of the rll, as well as therapeutic aspiration of mucous occluding the lms stent in - hypothyroidism - osteoporosis - history of breast cancer: in , s/p surgery and chemo - minimal short term memory social history: lives with her son . quit smoking ~50 years ago. former social drinker, no alcohol in 2 years. family history: -brother with disease -mother passed from sudden cardiac arrest s/p "hand procedure" at age 75 -father passed at 89 from "old age" with parkinson's disease -hypertension in several family members - history of cancer, autoimmune diseases physical exam: on arrival to micu general: alert, oriented, no acute distress gen: caucasian female, in bed, no apparent distress, nasal canula in place, able to speak full sentences heent: op without lesions neck: no lad, low jvd cardiac: rr, nl rate, no m/r/g pulm: monophonic expiratory wheezes, prolonged expiratory phase, sound reproducible over trachea, no distress abd: soft, nontender, nondistended, +bs ext: small ecchymotic lesions overlying shin, no edema, clubbing, warm and well perfused skin . transfer from the micu general: alert, oriented, no acute distress gen: caucasian female, in bed, no apparent distress, on nc, able to speak full sentences without difficulty heent: op without lesions neck: no lad, low jvd cardiac: rr, nl rate, no m/r/g pulm: bilateral inspiratory/expiratory rhonchi abd: soft, nontender, nondistended, +bs ext: small ecchymotic lesions overlying shin, no edema, clubbing, warm and well perfused skin discharge exam: vs: 97.8 128/71 75 18 99% 2l nc gen: alert and oriented x3, nad heent: nc/at, eomi, perrl, op clear, mmm cv: rrr, nl s1 s2, no mrg resp: good air movement without distress, coarse airway noise throughout, no rales or wheezes abd: soft, non-tender, non-distended ext: eccymoses b/l shins, no edema, warm and well-perfused pertinent results: admission labs: 04:16pm pt-11.1 ptt-29.2 inr(pt)-1.0 04:16pm plt count-633* 04:16pm neuts-95.1* lymphs-2.5* monos-2.1 eos-0.2 basos-0.2 04:16pm wbc-18.0* rbc-4.41 hgb-12.3 hct-41.9 mcv-95 mch-28.0 mchc-29.4* rdw-14.6 04:16pm calcium-9.0 phosphate-3.2 magnesium-1.7 04:16pm glucose-88 urea n-14 creat-0.6 sodium-139 potassium-4.2 chloride-99 total co2-31 anion gap-13 discharge labs: 05:35am blood wbc-5.9 rbc-4.21 hgb-12.0 hct-39.9 mcv-95 mch-28.4 mchc-29.9* rdw-14.7 plt ct-607* 05:35am blood glucose-68* urean-17 creat-0.6 na-137 k-4.8 cl-99 hco3-29 angap-14 05:35am blood calcium-8.4 phos-2.2* mg-2. microbiology: time taken not noted log-in date/time: 12:00 pm bronchoalveolar lavage gram stain (final ): 3+ (5-10 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. smear reviewed; results confirmed. respiratory culture (preliminary): 10,000-100,000 organisms/ml. commensal respiratory flora. gram negative rod #1. 10,000-100,000 organisms/ml.. gram negative rod #2. ~4000/ml. further workup on request only. isolates are considered potential pathogens in amounts >=10,000 cfu/ml. yeast. ~1000/ml. isolates are considered potential pathogens in amounts >=10,000 cfu/ml. acid fast smear (final ): no acid fast bacilli seen on concentrated smear. acid fast culture (preliminary): fungal culture (preliminary): no fungus isolated. blood culture - pending imaging: cxr : findings: prior to the most recent prior radiograph, there are increased opacities in the right lower lobe which may be consistent with infectious etiology. additionally, there are some increased opacities in the left mid lung which also may be concerning for infectious process. the lungs remain hyperinflated. cardiomediastinal silhouette is unchanged. a stent is seen within the left main stem bronchus. no evidence of pneumothorax or pleural effusion. impression: 1. increased opacities in the right lower lobe and left middle lung may represent infectious process. cxr : probable background hyperinflation. again seen is extensive parenchymal opacity. the right base opacity may be slightly improved compared with . left main stem bronchus stent is no longer seen on this study. otherwise, no significant interval change. 05:35am blood wbc-5.9 rbc-4.21 hgb-12.0 hct-39.9 mcv-95 mch-28.4 mchc-29.9* rdw-14.7 plt ct-607* 05:35am blood glucose-68* urean-17 creat-0.6 na-137 k-4.8 cl-99 hco3-29 angap-14 05:35am blood calcium-8.4 phos-2.2* mg-2.0 brief hospital course: 75f with wegener's granulomatosis and polyangitis c/b tracheobronchial disease and bilateral bronchial stenosis s/p dilations and intralesional steroid injections presetning with sob s/p elective bronchoscopy. # shortness of breath - patient arrived to micu on bipap with respiratory distress after elective bronchosopy. this procedure was scheduled for routine followup s/p stenting of her lms on and repeat bal/bronch on . she was weaned to face tent immediately on arrival to micu and tolerated this well. frank pus was visualized in lll on bronchoscopy and cxr was concerning for pna. patient was therefore empirically started on vanc/zosyn. underwent repeat rigid and flexible bronchoscopy with foreign body removal (lms stent), tumor ablation via electrocautery, and cryodebridement as well as mechanical debridement with flexible forceps. she also recieved intralesional injection of methylprednisolone acetate in 1cc aliquots of a 40mg/ml solution to 2 affected areas. post-procedure, the patient was extubated and monitored in the micu for 2 days with stabilization of respiratory function. the patient was subsequently transferred to the general medical floor. shortly after arriving to the floor, she was weaned to her home 2l nc. the night of she had an episode of pink-tinged sputum production, however this was likely due to slight epistaxis. this resolved by morning and the patient remained comfortable on her home oxygen without respiratory distress. she continued home nebulizer treatments for wheezing and reactive airway disease. # wegener's - nothing to suggest worsening of disease on repeat bronch. patient was continued on home prednisone and atovaquone as well as prn nebulizers. # pna - following the bronchoscopy, she was treated with a 7 day course of augmentin () for the purulent material found on bronchoscopy. # hypotension - patient had several episodes of hypotension in micu. these were initially thought to be due to dehydration, responded to fluids. there was also concern for adrenal insufficiency, although trial dose of steroids was not effective. her bp normalized prior to transfer to the general medicine floor. # hypothyroidism - continued home levothyroxine # depression - continued home citalopram. during the icu course, it was observed that the patient's qtc interval was borderline elongated, thus her dose was halved. transitional issues: - monitor ekg for qtc interval and adjust citalopram dose as necessary - blood culture pending, ngtd medications on admission: - albuterol sulfate neb q4-6h:prn - atovaquone 1500mg daily - prednisone 20 mg daily - alendronate 70 mg weekly - levothyroxine 125 mcg daily - citalopram 20 mg daily - fluticasone disk 250/50 1 puff - furosemide 20 mg daily - cholecalciferol 800 unit daily - calcium carbonate 500 mg tid - vitamin c-vitamin e daily - b complex vitamins daily - omega-3 fatty acids 1,000 mg daily discharge medications: 1. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : one (1) neb inhalation every 4-6 hours as needed for sob. 2. atovaquone 750 mg/5 ml suspension : ten (10) ml po daily (daily). 3. prednisone 20 mg tablet : one (1) tablet po daily (daily). 4. alendronate 70 mg tablet : one (1) tablet po once a week. 5. levothyroxine 125 mcg tablet : one (1) tablet po daily (daily). 6. citalopram 10 mg tablet : one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 7. fluticasone-salmeterol 250-50 mcg/dose disk with device : one (1) disk with device inhalation (2 times a day). 8. furosemide 20 mg tablet : one (1) tablet po daily (daily). 9. cholecalciferol (vitamin d3) 400 unit tablet : two (2) tablet po daily (daily). 10. calcium carbonate 200 mg calcium (500 mg) tablet, chewable : one (1) tablet, chewable po tid (3 times a day). 11. vitamin c-vitamin e capsule : one (1) capsule po once a day. 12. b complex vitamins capsule : one (1) capsule po once a day. discharge disposition: home with service facility: discharge diagnosis: wegener's granulomatosis hypothyroidism discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the after having difficutly breathing after a routine bronchoscopy. you were admitted to the intensive care unit for close monitoring and did very well overnight. a repeat bronchoscopy was performed and you tolerated that procedure well. during that procedure we discovered signs of infection, treated with augmentin for 7 days. with this treatment you were able to breathe comfortably on your home oxygen level. we made the following changes to your home medications: - stop fish oil (at your request) - reduce citalopram to half your previous dose to avoid heart arrhythmias please follow-up with your physicians as listed below. followup instructions: department: when: friday at 12:10 pm with: dr. location: post clinic building: sc clinical ctr central campus: east best parking: garage this appointment is with a hospital-based doctor as part of your transition from the hospital back to your primary care provider. this visit, you will see your regular primary care doctor in follow up. department: west clinic when: tuesday at 11:15 am with: , md building: de building ( complex) campus: west best parking: garage md, procedure: closed [endoscopic] biopsy of bronchus endoscopic excision or destruction of lesion or tissue of bronchus endoscopic excision or destruction of lesion or tissue of bronchus endoscopic removal of bronchial device(s) or substances diagnoses: pneumonia, organism unspecified long-term (current) use of steroids unspecified acquired hypothyroidism personal history of malignant neoplasm of breast depressive disorder, not elsewhere classified alkalosis osteoporosis, unspecified dehydration epistaxis polyarteritis nodosa other diseases of trachea and bronchus wegener's granulomatosis 

Answer: The patient is high likely exposed to