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: patient recorded as having no known allergies to drugs attending: chief complaint: pna major surgical or invasive procedure: bronchoscopy c stent removal history of present illness: ms. is a 53 year-old female with a recent diagnosis of non-small cell lung cancer who admitted to osh on for dyspnea for 1-2 days pta. in addition, she reported increased respiratory secretions, fevers and chills. at osh, she was found to have pna and there was concern about a possible stent obstruction so she was transferred to bicmc on for urgent bronchscopy and stent evaluation. on she underwent rigid bronchoscopy and it was found that her y-stent migrated so it was removed was removed. she was noted to have thrush in her trachea. she was intubated for the procedure and it was decided to keep the patient ventillated post-bronch given the severity of her pna. . currently, she has been mildly hypotensive this morning, but is currently off pressors thought to be secondary to a medication effect. she is intubated and sedated and appears comfortable. . review of systems: unable to obtain sedation . past medical history: # nsclc - received her first cycle of carboplatin and taxol chemotherapy & silicone y-stent placed # tracheal stent placement # svc obstruction on ct scan # gerd social history: per records tob: ppd for 20 years. occasional etoh. no drug use. currently living with parents. family history: per , father c mi physical exam: general: intubated, sedated, responds to noxious stimuli. heent: sclera anicteric, mmm neck: supple, jvp not elevated, no lad lungs: rhonchi in rul and lll. ventilated breath sounds. cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema. a-line in place and 2 pivs. pertinent results: on admission: 138 100 19 agap=11 -------------<157 3.7 31 0.4 ca: 8.4 mg: 2.4 p: 4.8 mcv 98 wbc 7.4 hgb 9.2 plt 109 hct 29.5 n:94 band:0 l:2 m:3 e:0 bas:0 myelos: 1 hypochr: 1+ anisocy: 1+ macrocy: 1+ pt: 12.2 ptt: 33.3 inr: 1.0 ct chest : large right upper lung mass amputating the right upper lobe bronchus causing post-obstructive right upper lobe collapse. the mass also attenuates the right upper lobe pulmonary artery and vein and ends into the mediastinum causing atelectasis in the superior segment of the right lower lobe and left lower lobe. diffuse, scattered pulmonary nodules suggest metastatic disease and interlobular septal thickening consistent with lymphangitis carcinomatosa, superimposed centilobular nodules with a tree- in- configuration probably due to recent infection the adrenal gland thickening is probably a metastasis. stent culture : wound culture (final ): due to mixed bacterial types (>=3) an abbreviated workup is performed; p.aeruginosa, s.aureus and beta strep. are reported if present. susceptibility will be performed on p.aeruginosa and s.aureus if sparse growth or greater.. beta streptococci, not group a. fungal culture (preliminary): albicans. gram stain (final ): 2+ (1-5 per 1000x field): polymorphonuclear leukocytes. 4+ (>10 per 1000x field): gram negative rod(s). 3+ (5-10 per 1000x field): budding yeast with pseudohyphae. 2+ (1-5 per 1000x field): gram positive rod(s). 1+ (<1 per 1000x field): gram positive cocci. smear reviewed; results confirmed. respiratory culture (final ): oropharyngeal flora absent. due to mixed bacterial types ( >= 3 colony types) an abbreviated workup will be performed appropriate to the isolates recovered from this site. gram negative rod(s) work up requested by ,md #. enterobacter aerogenes. >100,000 organisms/ml.. this organism may develop resistance to third generation cephalosporins during prolonged therapy. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. for serious infections, repeat culture and sensitivity testing may therefore be warranted if third generation cephalosporins were used. stenotrophomonas (xanthomonas) maltophilia. >100,000 organisms/ml.. yeast. 10,000-100,000 organisms/ml.. enterobacter cloacae. ~/ml. this organism may develop resistance to third generation cephalosporins during prolonged therapy. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. for serious infections, repeat culture and sensitivity testing may therefore be warranted if third generation cephalosporins were used. sensitivities: mic expressed in mcg/ml _________________________________________________________ enterobacter aerogenes | stenotrophomonas (xanthomonas) maltoph | | enterobacter cloacae | | | cefepime-------------- <=1 s <=1 s ceftazidime----------- <=1 s <=1 s ceftriaxone----------- <=1 s <=1 s ciprofloxacin---------<=0.25 s <=0.25 s gentamicin------------ <=1 s <=1 s meropenem-------------<=0.25 s <=0.25 s piperacillin---------- <=4 s <=4 s tobramycin------------ <=1 s <=1 s trimethoprim/sulfa---- <=1 s <=1 s <=1 s legionella culture (final ): no legionella isolated. potassium hydroxide preparation (final ): test cancelled, patient credited. this is a low yield procedure based on our in-house studies if pulmonary histoplasmosis, coccidioidomycosis, blastomycosis, aspergillosis or mucormycosis is strongly suspected, contact the microbiology laboratory (7-2306). immunoflourescent test for pneumocystis jirovecii (carinii) (final ): negative for pneumocystis jirovecii (carinii).. fungal culture (preliminary): yeast. acid fast smear (final ): no acid fast bacilli seen on concentrated smear. acid fast culture (preliminary): viral culture: r/o cytomegalovirus (preliminary): no virus isolated so far. brief hospital course: this is a 53 yo with recent diagnosis of nsclc who presented to osh with pneumonia she is s/p y-stent removal at and is being transferred to the icu team for further management as unable to extubate after stent removal. . # respiratory failure - per the pulmonary team, the patient was intubated for airway protection in preparation for her bronchoscopy and stent removal, new stent could not be placed anatomy. given her substantial pnuemonia she was not able to be extubated post-procedure. pt was maintained on mechanical ventilation in ac mode at ardsnet settings. pt required sedation with midazolam and fentanyl in order to remain synchronous c the vent. pt's prognosis was felt to be very poor and family ultimately felt that pt would not have wanted to remain intubated and pt was transitioned to cmo on . pt was terminally extubated on . her oxygen saturations dropped precipitously and pt became bradycardic and then asystolic. family was at the bedside. . # hypotension - patient was hypotensive upon arrival to the icu, possibly secondary to evolving sepsis versus medication effect, no evidence of active bleeding. pt was fluid responsive and did not require vasopressors. pt received fluid boluses to maintain map>65. sedation was also kept at the minimum level required for pt to be synchronous c ventilator. pt had been on decadron at home and then pulsed c hydrocortisone 100 q8h at osh. pt was placed back on decadron (started at 6 tid, home dose 8 ) and the decadron slowly weaned. pt was transitioned to cmo on . . # pna - patient with both a post-obstructive rul and likely lll pna. given her home steroid usage, concerned for both typical pneumonia organisms as well as opportunistic infections. patient was noted to have thrush in airway. pt was initially placed on zosyn, cipro, vancomycin and fluconazole and cultures sent from bal and . the stent was also sent for culture. id consult was called and the recommendation was made to switch from fluconazole to micafungin out of concern for fungal pna. gram stain of bal and also a sputum culture from 2 days later all showed gnrs and so vancomycin was discontinued and pt maintainted on zosyn, cipro, micafungin. all meds were discontinued on when pt became cmo. . # nsclc - pt scheduled for q3 week chemotherapy. this was held in the setting of severe infection. . # anemia/thrombocytopenia - most likely secondary to recent chemotherapy. all cell counts were trended until she became cmo. . # prophylaxis: subcutaneous heparin, famotidine, bowel reg. . hcp (sister). cell: medications on admission: home meds decadron 8mg po bid klonopin 0.5 mg po qhs percocet-dose unknown mucinex -dose unknown meds on transfer from osh # fluconazole 400 mg po q24h # heparin 5000 unit sc tid # hydrocortisone na succ. 100 mg iv q8h # insulin sc # albuterol inhaler puff ih q4h:prn wheezing # pantoprazole 40 mg iv q24h # chlorhexidine gluconate 0.12% oral rinse 15 ml oral # piperacillin-tazobactam 4.5 g iv q6h # ciprofloxacin 200 mg iv once # propofol 20-50 mcg/kg/min iv drip titrate to sedation # ciprofloxacin 400 mg iv q12h # clonazepam 0.5 mg po qhs # docusate sodium 100 mg po bid # vancomycin 1000 mg iv q 12h # fentanyl citrate 25-100 mcg/hr iv drip infusion discharge medications: discharge disposition: expired discharge diagnosis: discharge condition: procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube closed [endoscopic] biopsy of bronchus diagnoses: pneumonia, organism unspecified anemia, unspecified candidiasis of mouth acute respiratory failure hypotension, unspecified malignant neoplasm of upper lobe, bronchus or lung antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use encounter for palliative care personal history of antineoplastic chemotherapy ulcer of anus and rectum 

Answer: The patient is high likely exposed to