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: confusion/weakness major surgical or invasive procedure: extubation history of present illness: 71 year old with a hx. of copd, htn, who was taken by her sons to today after having two days of confusion, weakness, diminished po intake, weakness, dyspnea at home. at , reportedly found to have a chest xr revealing bilateral pna, was using accessory muscles to breathe, and was in respiratory distress, unable to speak in full sentences. she had significant wheezing on exam. she was given a dose of levaquin and solumedrol iv. while there, she progressively became more obtunded, and had abg revealing hypercarbic respiratory failure with 7.2/95/66/37. she was intubated, and started on neosynephrine for sbp of 73/47. an ecg there revealed st elevations in the inferior leads (ii, iii, f). she was transferred to the for further management. on arrival here, she was found to have a sbp of 48. a central line was placed in the rt. subclavian vein. cardiology was consulted, and they felt that the ecg was not especially convincing for an imi, given the ecg here did not show the degree of st changes as those of the osh, and that there were no enzyme or marker elevations, and no reciprocal changes. a cxr here did not reveal any infiltrates. ua was negative. blood cultures were sent. she was given 4 mg iv ativan for sedation and her neo was up to 60 ucg per minute. her sbp was in the 90's, and she was transferred to the ccu (micu team). on arrival there, she was transitioned to levophed, and an a line was placed. fentanyl and versed were started for sedation. past medical history: copd: baseline o2 2l nc hypertension osteoporosis social history: lives in with sons. 40 pk yr tob, quit 15 yrs ago. no etoh family history: non-contributory physical exam: tc 97.7, tm 99, pc 86, pr 80s, bpc 109/44, bpr 90s-110s/40s-50s, resp 26, 92% 4l nc 18h i/o gen: elderly female, alert, oriented to person, "hospital", (not date). breathing comfortably, nad heent: anicteric, nl conjunctiva, ommm, op clear, neck supple, unable to assess jvp 2/2 body habitus, neck supple, no cervical lad. cardiac: rrr, no m/r/g appreciated pulm: diffuse expiratory wheezing, decreased ls at left base abd: obese, soft nt/nd, no masses ext: trace le edema at ankles bilaterally neuro: cn ii-xii grossly intact and symmetric bilaterally. moves all 4 extremities equally. 1+ dtr throughout. pertinent results: ekg:nsr@90, nl axis/int, no st/t changes, u waves . cxr: slightly increased bibasilar atelectasis. right sc line in svc. no evidence of chf or ptx . echo : conclusions: poor image quality. the left atrium is normal in size. left ventricular wall thicknesses and cavity size are normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. tissue velocity imaging demonstrates an e/e' <8 suggesting a normal left ventricular filling pressure. the right ventricular cavity is mildly dilated. free wall motion is good. the aortic valve leaflets appear structurally normal with good leaflet excursion. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. the pulmonary artery systolic pressure could not be estimated. there is an anterior space which most likely represents a fat pad. . impression: mild right ventricular cavity enlargement with good free wall motion. preserved global left ventricular systolic function. . : leni: lower extremity venous ultrasound (bilateral): grayscale, color, and doppler images of the right and left common femoral, superficial femoral, and popliteal veins were obtained. normal flow, compressibility, augmentation, and waveforms are demonstrated. no intraluminal thrombus is identified. impression: no deep venous thrombosis in right or left common femoral, superficial femoral, or popliteal veins. . : cxr: endotracheal tube is 3 cm above carina. right jugular cv line is in proximal svc. no pneumothorax. ng-tube is difficult to localize on this film, but appears to extend below the diaphragm. no pneumothorax. there is slight elevation of the left hemidiaphragm and blunting of the left costophrenic angle. small area of ill-defined opacity consistent with atelectasis is present at the right lung base. . : cxr: impression: bilateral lower lobe opacities, right greater than left with associated bronchial wall thickening. aspiration or evolving aspiration pneumonia should be considered. . :ap chest radiograph: the previously seen bibasilar atelectasis is slightly more prominent on today's exam. there is a right subclavian line with its tip in the upper svc. there is no pneumothorax. no chf. the cardiac, mediastinal, and hilar contours are stable. impression: slightly worsened bibasilar atelectasis. . cxr: history: 71-year-old woman with hypotension, possible fluid overload or focal infiltrates. patient with worsening respiratory distress. findings: compared to previous study from . the cardiac silhouette and mediastinum is within normal limits and unchanged. there remains some streaky density at the bases most consistent with subsegmental atelectasis, right side is slightly worse in the interval. there are no signs of focal consolidation or pulmonary edema. . hematology complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 06:35am 7.7 3.43* 10.2* 32.3* 94 29.7 31.6 14.7 265 06:15am 7.1 3.58* 10.6* 33.2* 93 29.6 31.9 14.9 290 06:05am 7.9 3.26* 9.7* 29.2* 90 29.8 33.2 14.8 306 06:25am 8.1 3.46* 10.7* 31.9* 92 31.0 33.6 14.9 284 06:40am 7.7 3.43* 10.5* 31.6* 92 30.7 33.3 14.7 276 10:24am 8.4 3.62* 10.7* 33.2* 92 29.6 32.3 14.8 243 12:02pm 9.2 3.54* 10.7* 32.0* 90 30.1 33.4 15.0 226 02:23am 10.4 3.46* 10.4* 31.5* 91 30.1 33.1 15.0 177 02:54am 8.8 3.28* 9.9* 29.3* 90 30.3 33.8 15.0 163 03:21pm 11.0 3.72* 11.4* 33.2* 89 30.6 34.2 14.9 170 04:30am 9.9# 3.97* 12.3 34.9* 88 30.9 35.2* 14.8 165 03:21pm 6.4 4.12* 12.6 36.5 89 30.5 34.4 14.9 158 06:27am 5.8 4.18* 12.7 37.7 90 30.4 33.8 14.8 162 12:50am 6.5 4.16* 12.8 37.0 89 30.8 34.6 14.5 161 hemolytic workup ret aut 12:02pm 2.2 chemistry renal & glucose glucose urean creat na k cl hco3 angap 06:35am 80 23* 0.8 147*1 3.8 102 44*2 5* enzymes & bilirubin alt ast ld(ldh) ck(cpk) alkphos amylase totbili dirbili 12:02pm 631* other enzymes & bilirubins lipase 06:27am 33 cpk isoenzymes ck-mb mb indx ctropnt 12:02pm 2 <0.011 1 <0.01 chemistry totprot albumin globuln calcium phos mg uricacd iron 06:35am 8.6 4.2# 2.0 hematologic caltibc vitb12 folate ferritn trf 12:02pm * greater th1 555* 200 pituitary tsh 12:02pm 1.7 cardiac/pulmonary theophy 03:21pm 4.5* blood gas blood gases type temp rates tidal v peep fio2 o2 flow po2 pco2 ph calhco3 base xs aado2 req o2 intubat vent comment 10:07am art 92 4 64* 68*1 7.42 46*2 15 544 88 brief hospital course: following transfer to , pt was transitioned from neo to levophed (d/c'd ), and central line was placed. cardiology was consulted, who felt the patient was unlikely to have had mi given inconsistent ekg and negative cardiac markers. she continued steroids for copd/possible adrenal insufficiency and levo/flagyl (subsequently flagyl d/c given low suspicion of aspiration) for pneumonia. her respiratory status, the decline of which was attributed to copd exacerbation and possible pneumonia, gradually improved and she was extubated . micu course also notable for runs of svt (possible mat), and arf (cr 1.5 on admit, which resolved during course of stay). . after being called out of the micu, the pt was on the floor for <24 hours. she was not given any nebulizer treatments overnight. was written for standing inhalers, which she doesn't use with good technique. in the morning, pt was noted to have worsening sob. given one nebulizer treatment for poor air movement. pt was sat'ing 94-90% on 4l, increased to 70% fm w/o2 sats in low 90s. cxr showed slighly increased bibasilar atelectasis, no chf. pt was given lasix 10 and 20 iv x once each, with uo of ~200-500cc, and no improvement in breathing. abg 7.43/60/52. stat labs and cardiac enzymes were sent. currently, pt states that she feels like she's "suffocating". denies cp, palpitations, nausea, vomiting, any other symptoms. she was transferred back to the micu. . in the micu, patient responded well to nebulizers and was maintained on albuterol/atrovent q6 hrs. she was also continued on her prednisone - this will be tapered over a 2 week course. . on retransfer to floor on , she remained stable on 4l nc. she remained stable on 4l nc with goal o2 sats 88-92%, although this dropped on minimal exertion. her prednisone taper and around-the-clock neb treatments were continued and she completed a 10-day course of levaquin. her mental status improved to baseline. on her lisinopril was restarted at a low dose (5mg). patient on the floor completed the levoquin and her respiratory function was close to her baseline with her o2 sats in low to upper 90s on 4l nc. patient's cough has also improved. she hasn't been febrile and no wbc while on the floor. . # anemia: unknown baseline @ low 30s c/w anemia of chronic disease, as patient has no iron deficiency and nl b12/fe studies. retic ct of 2.5% with guiac negative stools. . # hypernatremia - appear to be consistent with poor po intake. patient corrects intermittently with encourage po free water intake. continue to monitor. . f/u - patient is being transfered to associated acute rehab/care unit. patient's pcp . will follow the patient. patient should be set up with an outpatient pulmonologist as well. medications on admission: combivent inhaler fosamax prednisone 15 mg daily lisinopril 40 hctz 25 vitamin d theophylline clonazapam discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. prednisone 10 mg tablet sig: five (5) tablet po once a day: please reduce by by 10 mg/q week. 4. albuterol-ipratropium 103-18 mcg/actuation aerosol sig: puffs inhalation q4-6:prn. 5. albuterol sulfate 0.083 % solution sig: puff inhalation q2h (every 2 hours) as needed. 6. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 7. insulin lispro (human) 100 unit/ml solution sig: 1-10 units subcutaneous asdir (as directed): per insulin sliding scale. 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 9. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 10. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 11. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 12. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). discharge disposition: extended care facility: tcu discharge diagnosis: primary: 1) pneumonia - community acquired - bilateral lower lobe 2) copd flare, on 2l home o2 at baseline, prednisone dependent 3) respiratory failure requiring intubation, hypoxemia secondary: 4) delirium - resolved 5) supraventricular tachycardia, ? multifocal atrial tachycardia 6) acute renal failure 7) hypotension - resolved 8) anemia - nos 9) hypernatremia, resolved 10) chronic hypertension 11) prednisone dependent x 3 yrs, on 15 mg prednisone prior to admission, cushingnoid appearance 12) probable osteoporosis discharge condition: improved, on 4l o2 via nasal cannula with oxygen saturation around 95% (uses 2l o2 at home at baseline). discharge instructions: you have been hospitalized, as you know, with a bad flare of your copd with a pneumonia that has now been treated. please call your doctor or return to the emergency room if you have increasing shortness of breath, fevers, chest pain, or anything else concerning to you. we have added a few new medications as follows: you should take a baby aspirin (81 mg) daily to help prevent heart problems. we have started a new inhaler called fluticasone (flovent) which delivers steroids directly to the lung and may help you get off oral steroids eventually. lastly, we have started a medication called pantoprazole (protonix) which you should continue taking once daily for as long as you are on oral steroids (prednisone). . please have your pcp, . , also arrange you with a pulmonologist appointment around the area where you live. followup instructions: follow-up: 1) follow up with a new pulmonologist that your pcp should help you set up in your area. follow-up chest x-ray in 6 weeks to ensure resolution of bilateral lower lobe infiltrates 2) consider outpatient stress test which your primary care doctor should set you up with. 3) please consider having a colonoscopy if you have not had one in the recent past to further evaluate your anemia. sometimes, anemia can be caused by colon cancer. a colonoscopy can help detect this early when it is more easily treated. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances non-invasive mechanical ventilation diagnoses: pneumonia, organism unspecified anemia of other chronic disease congestive heart failure, unspecified unspecified essential hypertension other specified disorders of pancreatic internal secretion adrenal cortical steroids causing adverse effects in therapeutic use acute kidney failure, unspecified atrial fibrillation obstructive chronic bronchitis with (acute) exacerbation acute respiratory failure other specified cardiac dysrhythmias hypotension, unspecified osteoporosis, unspecified acute diastolic heart failure hyperosmolality and/or hypernatremia other alteration of consciousness mixed acid-base balance disorder nonspecific abnormal electrocardiogram [ecg] [ekg] 

Answer: The patient is high likely exposed to