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 / sulfa (sulfonamide antibiotics) attending: chief complaint: carotid stenosis major surgical or invasive procedure: left carotid endarterectomy cardiac catheterization balloon pump tandem heart+ecmo and high risk pci with 2des to the lad and 1 to the lcx. history of present illness: 71 year old female with pmh copd on home oxygen, htn, pvd s/p b/l fem- bipass who is pod #1 from lt cea. immediately post operatively she was hypotensive requiring neosynephrine ggt for several hours and received ~5l ivf. she was very transiently weaned of the neosynephrine to bp's in the high 90's but then decompensated again in the early am hours requiring retransfer to the pacu and reinitiation of neosynephrine. cxr performed showed pulmonary edema and she received 20iv lasix with some good relief. . on initial evaluation, she was feeling somewhat better. she only complained of some shortness of breath. she didn't have any chest pain or pressure. we did a trial of bipap which she didn't tolerate, and on re-evaluation ~1-2 hours later she began feeling nausea with chest burning and worsening dyspnea. echo was performed which showed, "severe regional left ventricular systolic dysfunction with severe hypokinesis of the setpum, inferior, inferolateral, distal 2/3rds of the anterior and the apical walls." given changes on echo patient was taken to the cardiac cath lab for evaluation for acs versus demand ischemia. . in the cath lab, he was noted to have elevated filling pressures with pa pressures of 48/29 and mean wedge of 32 and diffuse two vessel disease with 90% lad, 80% proximal lcx and occluded distal and 30% left main prox with nondominant rca. she was given iv lasix 120 x 1 with uop of 600 cc. she was also noted to have subclavian stenosis with 10-20 mm hg gradient. swan was left in place to measure pa presures. no intervention was done and she was tranferred to ccu for monitoring and ct surgery evaluation for cabg. . on cardiac review of symptoms, prior to arrival to the hospital she denies any chest pain, sob, orthopnea, doe. she does use home oxygen. she isn't very active due to hip pain. all other ros negative. . on review of systems, s/he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. s/he denies recent fevers, chills or rigors. s/he denies exertional buttock or calf pain. all of the other review of systems were negative. past medical history: past medical history: ?coronary artery disease copd on home oxygen on 2l at night peripheral vascular disease s/p fem/ bipass (?bilaterally), 4-cm thoracicaneurysm history of aaa abdominal repair chronic hyponatremia, right hip fracture repair in . . past surgical history: aaa s/p repair . social history: significant for tobacco use. she has roughly an 80 pack-year history of tobacco abuse. she admits to drinking alcoholic beverages 4-5 days a week. family history: father mi in his 40's physical exam: physical exam on transfer: 99.3 87 109/59 18 100 fi02 0.35 fm gen - thin diaphoretic female in mild respiratory distress heent - cn 2-12 intact, strength, sensation intact, incision w/ dressing, dressing cdi pulm - crackles throughout b/l cv - rrr, echo showing global ventricular dysfunction, ef 25% abd - soft ntnd extrem - warm, palp fem//dop dp/pt b/l pt deceased on pertinent results: wbc-12.1* hct-29.7* plt ct-250 wbc-12.9* hct-25.9* plt ct-196 wbc-21.0* hct-34.3* plt ct-233 pt-12.5 ptt-29.3 inr(pt)-1.1 glucose-109* urean-11 creat-0.6 na-133 k-4.0 cl-100 hco3-24 glucose-112* urean-11 creat-0.5 na-131* k-3.7 cl-103 hco3-20 ck-mb-9 ctropnt-0.20* ck-mb-41* ctropnt-0.60* probnp-3200* ck-mb-99* mb indx-8.4* ctropnt-1.18* ck-mb-109* mb indx-7.9* ctropnt-1.99* echo: global ventricular dysfunction, ef 25% 04:04am blood wbc-19.3* rbc-3.84* hgb-11.5* hct-33.8* mcv-88 mch-30.0 mchc-34.0 rdw-16.8* plt ct-66*# 04:04am blood pt-20.8* ptt-150* inr(pt)-1.9* 04:04am blood glucose-91 urean-45* creat-3.3* na-135 k-4.8 cl-100 hco3-16* angap-24* 09:39am blood alt-2065* ast-1419* ld(ldh)-1296* ck(cpk)-4089* alkphos-333* totbili-2.1* 09:39am blood ck-mb-22* mb indx-0.5 ctropnt-7.80* 04:04am blood calcium-8.6 phos-5.1* mg-1.9 06:13am blood vanco-6.7* 06:53am blood type-art temp-36.5 rates-25/ tidal v-535 peep-8 fio2-50 po2-457* pco2-34* ph-7.22* caltco2-15* base xs--12 intubat-intubated 06:53am blood lactate-6.6* 12:00am blood heparin dependent antibodies- neg echo the left ventricular cavity is dilated. there is severe global left ventricular hypokinesis (lvef = 20-25%), with some regional variation, most consistent with multivessel cad. there is focal hypokinesis of the apical free wall. there is a trivial circumferential pericardial effusion, outside of a rather large anterior fat pad. there are no echocardiographic signs of tamponade. . tte: normal left ventricular cavity size with severe systolic dysfunction c/w multivessel cad or other diffuse process. mild mitral regurgitation. pulmonary artery systolic hypertension. compared with the prior study (images reviewed) of , the severity of mitral regurgitation is slightly reduced. . cxr: findings: in comparison with the study of , the monitoring and support devices remain in place. the degree of pulmonary vascular congestion has decreased, especially on the right. the central pulmonary vessels and hila are also much less prominent. . micro: 9:18 pm sputum source: endotracheal. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): gram negative rod(s). consistent with haemophilus species. respiratory culture (final ): sparse growth commensal respiratory flora. haemophilus influenzae, beta-lactamase positive. moderate growth. beta-lactamase positive: resistant to ampicillin. legionella culture (final ): no legionella isolated. brief hospital course: 71f with pvd (fem- bypass and aaa repair) post-op from cea who suffered nstemi complicated by acute systolic heart failure and flash pulmonary edema requiring emergent balloon pump followed by tandem heart and high risk pci ultimately made cmo after failure to wean from cardiopulmonary support. vascular surgery course: the patient was admitted to the vascular surgery service under the care of dr . she underwent an uncomplicated left carotid endarterectomy. in the pacu on pod 0 she became hypotensive and required starting a neo ggt as well as resuscitation w 5 l of crystal. she then became acutely hypoxic and was administered iv lasix after a cxr demonstrated pulmonary edema. a stat cardiac consult was done and an echo obtained. the echo showed diffuse ventricular disfunction. the patient was intubated in the pacu and taken ungently to the cath lab. the cath showed multivessel dx and the patient was transfered to the cardiac icu for further work up and treatment. . ccu course #. acute systolic heart failure: after post cea hypotension, pt was cathed and found to have diffuse two vessel disease with nondominant rca. 90% lad, 80% proximal lcx and occluded distal and 30% left main prox. she was continued on aspirin, atorvastatin 80 mg po qdaily and iv heparin gtt. she was extubated and while she was awaiting ct surgery evaluation, she had episode of flash pulmonary edema requiring reintubation. she was deemed too sick to be a candidate for cabg. she underwent intraortic ballon pump placement with revascularization with des to lad and lcx. she required further augmentation of her cardiac output so iabp was replaced with tandem heart in right atrium with oxygenator. she additionally required pressor support with multiple inotropes, with decreasing effect over time, and complications including atrial fibrillation requiring electrical cardioversion. she was not able to wean off tandem heart and her course was complicated by anuric acute kidney injury, ischemic limbs and metabolic acidosis. goals of care were discussed with family and the decision was made to cease pressor and mechanical support. pt was unable to maintain sufficient cardiac output to sustain life. #. hypoxemic respiratory failure: likely due to flash pulmonary edema and subsequent volume overload anuric . she was placed on tandem heart with oxygenator. she was unable to be weaned off respiratory support. she was continued on versed/fentanyl for sedation/compliance and vap precautions, however sedation was weaned without evidence of neurologic response. . # pvd: vascular consulted for r leg ischemia in setting of tandem heart. she underwent tandem flow to profunda with some improvement. . # hypoglycemia: likely in setting of critical illness. d5/bicarb gtt and closely monitor . # : pt with increase of cr from 0.8 - 3.3. likely atn cardiogenic shock. pt became grossly volume overloaded. renal was consulted however felt that cvvh unlikely to improve clinical status as lytes stable and pt continued to receive fluid boluses for pressure support. . # hib on sputum sample. pt initially started on cefepime then with persistent fevers and hypotension was broadened to meropenem/vancomycin. blood cultures remained negative. . # thrombocytopenia: initial concern for hit, heparin gtt was stopped and pt maitained on bivalrudin. when ab returned negative pt was restarted on heparin gtt. thrombocytopenia more likely related to critical illness and tandemheart . #. left cea pod#7. surgical site stable. . # goals of care: clinical status worsened despite maximum support, without evidence of neurologic dysfunction despite weaning sedation. in discussion with the pt's cousin the decision was made to transition to cmo. pressor support and tandem heart were decreased. morphine gtt was started. vent was dced. pt passed comfortably. medications on admission: proair hfa 90 mcg 2 puff qid, amlodipine 7.5', plavix 75', advair diskus 500 mcg-50 mcg 1 puff , isosorbide mononitrate er 30', metoprolol 100', singulair 10', simvastatin 40', tiotropium bromide 18 mcg 1 puff daily, asa 325', vit d3 400', propylene glycol 400 0.03-0.04% 1-2 drops per eye daily prn discharge medications: pt expired discharge disposition: expired discharge diagnosis: myocardial infarction heart failure hypoxemic respiratory failure discharge condition: deceased discharge instructions: deceased followup instructions: deceased procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more combined right and left heart cardiac catheterization coronary arteriography using two catheters parenteral infusion of concentrated nutritional substances atrial cardioversion implant of pulsation balloon endarterectomy, other vessels of head and neck insertion of drug-eluting coronary artery stent(s) extracorporeal membrane oxygenation [ecmo] excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel insertion of three vascular stents procedure on two vessels insertion of percutaneous external heart assist device diagnoses: acidosis thrombocytopenia, unspecified subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery tobacco use disorder mitral valve disorders acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified hyposmolality and/or hyponatremia thoracic aneurysm without mention of rupture chronic airway obstruction, not elsewhere classified cardiac complications, not elsewhere classified atrial fibrillation hematoma complicating a procedure other chronic pulmonary heart diseases occlusion and stenosis of carotid artery without mention of cerebral infarction acute respiratory failure cardiogenic shock other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation acute systolic heart failure stricture of artery atherosclerosis of native arteries of the extremities, unspecified alcohol abuse, continuous 

Answer: The patient is high likely exposed to