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: history of present illness: the patient is a 50-year-old female with a history of tracheal stenosis, ? asthma, gastroesophageal reflux disease status post nissen fundoplication transferred from an outside hospital with acute shortness of breath. patient was in her usual state of health until six days prior to admission when she presented to the outside hospital with a history of days of shortness of breath, weakness, ? fever, cough. she was placed on cpap plus bipap with increased work of breathing; abg showed ph of 7.30, pco2 of 48, and po2 of 288 on 100% o2. she was eventually intubated and started on dexamethasone 20 mg iv q.8h. and started on levofloxacin for possible infection. had a bronchoscopy performed and a tracheal dilatation five days prior to admission. she was transferred to for possible tracheal stenting on . micu course: she was continued on the dexamethasone and on ventilation. she was extubated on hospital day #2. she finished her seven day course of ciprofloxacin for presumed pneumonia, although afebrile and no chest x-ray findings on outside hospital. she was afebrile upon transfer. she has been bradycardic since intubation. ekg showed q-t prolongation. baseline is normally in the 70s. cardiology was consulted and had no recommendations. she was ruled out for myocardial infarction on cardiac enzymes x3. she was continued on her fentanyl patch for pain control for her low back pain. patient received tube feeds while intubated. she is tolerating p.o. upon transfer. she is transferred to the medicine firm in stable condition. at present, she complains of low back pain, stating that the fentanyl patch is not working and constipation. she currently denies any fevers, chills, nausea, vomiting, dysphagia, chest pain, shortness of breath, paroxysmal nocturnal dyspnea, orthopnea, abdominal pain, hematemesis, hematochezia, melena, dysuria, or seizures. has ambulated and is tolerating p.o. well. past medical history: 1. tracheal stenosis secondary to tracheostomy status post scar revision. 2. gastroesophageal reflux disease status post antireflux operation, status post redo nissen fundoplication. 3. status post total abdominal hysterectomy and bilateral salpingo-oophorectomy for fibroids. 4. chronic low back pain secondary to l4-l5 and l5-s1 bulging disk status post mva on . 5. somatization disorder. 6. anxiety and depression. 7. degenerative joint disease of the spine. 8. question of intractable seizures, followed by dr. (neurology department). off tegretol x1.5 years. 9. question of asthma. 10. vocal cord dysfunction. 11. status post bladder surgery ?. social history: lives with her husband. she has five children. used to work as a nurse. she smoked 1.5 packs a day for 14 years, quit 10 years ago. denies any alcohol or iv drug use. family history: noncontributory. allergies: 1. ceftin (rash). 2. oxycontin, morphine (intolerance). medications at home: 1. celexa. 2. premarin. 3. percocet. 4. combivent. 5. zyrtec. 6. docusate. physical examination on transfer: in general, she is an obese female, sitting in a chair, complaining of low back pain in no apparent distress, avoids eye contact. vitals were a temperature of 97.1, pulse of 41 beats per minute and regular, blood pressure of 100/palp, and a respiratory rate of 20. her o2 saturation was 98% on room air. she is normocephalic, atraumatic. her pupils are equal, round, and reactive to light and accommodation. extraocular movements are intact. red reflex is present. anicteric sclerae. oropharynx is clear with moist mucous membranes. her neck was supple with no nodules, lymphadenopathy, or tenderness. trachea was midline. no jvd. carotid pulses were 2+ with no bruits. thyroid was not palpable. tracheostomy scar was well healed. right internal jugular line in place, no discharge. her lungs showed good air movement and clear to auscultation bilaterally. no wheezes or rhonchi were noted. lateral thoracotomy scar well healed. her heart was sinus bradycardic with regular rhythm. normal s1, s2. no murmurs, rubs, or gallops. abdomen was protuberant, soft, nontender, and nondistended. bowel sounds were normoactive and with no bruits noted. belly was intact to percussion with no masses or ascites noted. liver edge was not palpable. spleen tip was not palpable. no costovertebral angle tenderness. she had a foley in place, draining yellow urine. no hematuria. extremities were warm with no clubbing, cyanosis, or edema. she had 2+ pedal pulses. skin showed no jaundice or rashes. patient was alert and oriented to person, place, and time. patient made poor eye contact during the interview. cranial nerves ii through xii are intact. she had normal tone throughout the whole body. strength 5/5 throughout the whole body. no pronator drift. she had 1+ deep tendon reflexes at the knees and the ankles. sensation was intact to vibration and proprioception bilaterally. she had normal finger-to-nose testing. her gait was normal and she had a negative romberg. laboratories on transfer: her white count was 11.6, hematocrit of 36.5, platelets of 309. sodium of 138, potassium of 3.9, chloride of 99, bicarb of 30, bun 19, creatinine 0.6, glucose of 110. calcium 8.9, phosphate 4.5, magnesium 2.2. ekg shows sinus bradycardia with q-t prolongation. echocardiogram showed an ejection fraction of 55% with normal ventricular function. ct of the trachea showed mild narrowing of the upper trachea (50 mm in the anteroposterior measurement). no changes with breathing. no nodules, consolidation, or interstitial lung disease, no lytic or sclerotic bone lesions were noted. hospital course: 1. tracheal stenosis: patient was made npo on the day of transfer for bronchoscopy the following morning. however, video straboscopy was performed prior to the bronchoscopy. in the past, she had been seen by the speech and swallow services for paradoxical vocal cord function, which was diagnosed at the time as functional muscle tension aphonia. on video straboscopy during this admission, she was found to have left vocal cord paralysis with bilateral posterior glottic granulomas and polypoid changes on the medial edge of the right true vocal cord, including changes secondary to gastroesophageal reflux disease. speech and swallow team recommended that aggressive reflux management and voice treatment as outpatient and an ent followup for her left vocal cord paralysis. interventional pulmonary team cancelled the bronchoscopy secondary to these results. interventional pulmonology discussed her case in the multidisciplinary airway conference the night prior to discharge. the consensus was that she was probably having laryngospasms made worse by her left true vocal cord paralyses. no tracheal surgery was deemed indicated at this time (no tracheal pathology identified). interventional pulmonology suggested continuation of her proton-pump inhibitor with antireflux medications and a follow up with dr. (ent) with outpatient speech therapy. etiology of vc paralysis and inflammatory changes were either related to recent intubation or prior surgery, with exacerbation by gerd. it was unclear if her tracheomalacia contributed to exertional dyspnea, but it was felt that her airway was safe and that further evaluation could be completed as an outpatient in the pulmonary service. 2. bradycardia: new onset identified on ekg after intubation. cardiology evaluated, thought likely neurological (enhanced vagal tone) etiology given no cardiac history, normal thyroid functions, and normal electrolytes. patient was ruled out from a myocardial infarction by cardiac enzymes x3. she was followed clinically, and she was asymptomatic throughout the hospitalization. the night prior to discharge the patient had an episode of diarrhea x4, nonbloody. her blood pressure at the time was found to be 81/48 with a pulse of 48. three hours later her pressure had dropped down to 62/38 and a pulse of 47 with the only symptoms being lightheadedness. at that time, she received a normal saline bolus and her blood pressure responded to 96/58 with pulse maintained at 47. ekg was performed and showed no changes from prior. other laboratories were checked and they were normal. next morning cardiology was reconsulted. cardiology fellow noted he was not entirely clear why she did not have an appropriate heart rate response to her hypotension, however, given her status in that she is asymptomatic, she was cleared for discharge. she was recommended to have adequate volume replacement for any further episodes. 3. chronic low back pain: she was continued on fentanyl patch and pain was well controlled throughout the hospitalization. 4. psychiatric issues: she is well known to her primary care physician. has a history of somatization disorder, anxiety, and depression. we continued her on citalopram and trazodone, and ativan prn for anxiety. she had no more issues throughout the hospitalization. 5. genitourinary: her foley was discontinued on hospital day #3. she had no urinary problems throughout the hospitalization. 6. constipation: the patient reports no bowel movements since admission. we continued her bowel regimen on senna and docusate. on hospital day #3, we added bisacodyl. patient had normal bowel movements on discharge. 7. fen: patient was maintained on a house diet and her electrolytes were replenished prn. 8. prophylaxis: patient was receiving heparin subcutaneously for dvt prophylaxis and maintained on protonix for gastric ulcer prophylaxis. discharge medications: 1. citalopram 60 mg p.o. q.d. 2. pantoprazole 40 mg q.d. 3. fentanyl 25 mcg/hour patch q.72h. 4. trazodone 200 mg p.o. q.h.s. prn. disposition: patient was discharged to home without services. discharge status: patient was discharged home in good condition, with o2 saturations of more than 96% on room air. patient is ambulating without assistance and tolerating p.o. well. discharge diagnoses: 1. acute respiratory distress. 2. tracheal stenosis and tracheomalacia. 3. sinus bradycardia of unknown etiology. 4. left vocal cord paralysis. 5. chronic low back pain. 6. gastroesophageal reflux disease status post nissen fundoplication x2. 7. critical care. code status: full. discharge followup: patient is scheduled to followup with dr. on at 9:50. she has to schedule an appointment in six weeks with (voice/speech/swallowing service) at . she is scheduled to see dr. (ent), on at 9:30 a.m. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours enteral infusion of concentrated nutritional substances diagnoses: pneumonia, organism unspecified esophageal reflux other pulmonary insufficiency, not elsewhere classified other specified cardiac dysrhythmias lumbago unilateral paralysis of vocal cords or larynx, partial laryngeal spasm other diseases of vocal cords 

Answer: The patient is high likely exposed to