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: ancef / keflex attending: chief complaint: left empyema necessitans. major surgical or invasive procedure: diagnostic thoracentesis. bronchoscopy. left thoracotomy with drainage of left pleural empyema, left lower lobectomy, decortication and repair of left diaphragm. flexible bronchoscopy with therapeutic aspiration. flexible bronchoscopy and therapeutic aspiration. flexible bronchoscopy with therapeutic aspiration. flexible bronchoscopy with therapeutic aspiration. picc line placement history of present illness: ms. is a 62-year-old female with history of rheumatoid arthritis, asthma, chronic reflux and recently significant pneumonia of the rml and rul in . she was treated as an outpatient with avelox for 10 days. although she never felt totally recovered. she presented to the ed yesterday with a history of several days of progressive left-sided chest discomfort ("like squeezing a sponge"), dyspnea, cough with sputum, chills, and night sweats. no chest pain, pleuritic pain, fever, or chills. her admission cxr showed multiple air-fluid levels. subsequently, she underwent a ct scan that revealed a large multiloculated left empyema, with multiple air-fluid levels, and erosion through the left chest wall, communicating with an extrathoracic fluid collection. she was referred for managment of the empyema. past medical history: kyphoscoliosis s/p multiple fusion/rods , pyloric stenosis s/p loop gastrojej 's s/p roux-en-y multiple pneumonias , , rheumatoid arthritis asthma hypertension anxiety chronic anemia social history: married, lives with husband currently unemployed no history of tobacco or etoh use family history: non-contributory physical exam: general: 62 year-old female in no added distress heent: sclera anicteric, pale conjunctives. oropharynx clear, no gum bleeding or palatal petechiae. : supple. chest: decreased breath sounds bilaterally with scattered rhonchi on left heart: regular, rate & rhythm. normal s1,s2 no murmur/gallop or rub abdomen: soft, nondistended, nontender. neither hepato- nor splenomegaly appreciated. normal bs lymph nodes: no cervical, supraclavicular, axillary, or inguinal nodes ext: no edema. no swelling. neuro: non-focal pertinent results: echo conclusions: the left atrium is normal in size. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild to moderate (+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is mild pulmonary artery systolic hypertension. cxr status post-left lower lobectomy. chest tube is present in the left lower hemithorax. since the previous study of , there has been a significant reduction in the subcutaneous emphysema in the left chest wall. persistent subcutaneous emphysema is present in both chest walls and in the neck bilaterally. no definite pneumothorax. ill-defined opacity in the left lower zone is unchanged as is the pleural thickening or fluid along the left axillary margin. hardware present in lumbar spine. cbc 5.2 3.46* 9.7* 30.5* 88 27.9 31.7 18.9* 508* brief hospital course: pt was admiited to w/ left empyema necessitans. an ultrasound guided tap was done of the left chest fluid collection for micro. pt was started on broad spectrum ivab while waiting culture data. infectious disease was consulted and pt was placed on resp isolation and r'd/o for tuberculosis. pre-op w/u revealed elevated inr of 5.3 w/o history of anticoagulation. hepatology was consulted and pt was found to have vit k deficiency. she was also transfused with prbc for anemia. she was given vit k and ffp to correct her inr prior to going to the or on hd# 3 for bronchoscopy,left thoracotomy with drainage of left pleural empyema, left lower lobectomy, decortication and repair of left diaphragm. 3 chest tubes were placed intraoperatively for continued draiange and lung expansion. post -op pt remained intubated and admitted to the icu for pulmonary and hemodyanmic monitoring on neo. extubated on pod#1. required serial bronchoscopies post operatively for left lung collapse d/t secretions and inability to participate in pul tiolet. pod#2 pt was transferred out of the intensive care unit. she continued to required serial bronchoscopies for pul tiolet. chest tubes placed to water seal and pt developed extensive sq air in the chest, neck and face. chest tubes were placed back to sxn w/ slow resolution of sq air over the ensuing days. one chest tube and one were removed on pod#9 and 11. the remaining chest tube was converted to an empyema tube w/ stable chest xray. infectious disease followed pt closely thru out her hospital course. her culture data: bal - contaminant lll s. milleri at this point her antibiotics were tapered and she was placed on pcn g ( she had a questionable allergy to pcn and therefore was moved to the icu for her initial dosing. dosing well and was d/c'd from the icu. a left brachial picc line was placed on with the tip in the svc after repostioning. pt progressed slowly but well and was d/c'd to home with pcn g thru w/ close id follow up and vna/pt services. medications on admission: amirtriptyline 75, clarinex 5, clonazepam 0.5''', protonix 40, flexeril 10prn, verapamil 120, albuterol inh prn, advair 250/50'', flonase prn, prednisone 5, ranitidine 300, lomotil prn, darvocet prn . discharge medications: 1. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 2. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical q24 (). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 5. clonazepam 0.5 mg tablet sig: one (1) tablet po tid (3 times a day). 6. hydrocodone-acetaminophen 5-500 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. disp:*75 tablet(s)* refills:*0* 7. cyclobenzaprine 10 mg tablet sig: one (1) tablet po tid (3 times a day) as needed. 8. metoprolol tartrate 50 mg tablet sig: 1 tablet po bid (2 times a day). disp:*90 tablet(s)* refills:*2* 9. heparin lock flush (porcine) 100 unit/ml syringe sig: one (1) ml intravenous daily (daily) as needed. 10. penicillin g potassium 20,000,000 unit recon soln sig: 4 million units recon solns injection q4h (every 4 hours): end date . disp:*216 recon soln(s)* refills:*0* 11. outpatient lab work sma7, lft's and cbc weekly fax results to infectious disease dr. discharge disposition: home with service facility: , discharge diagnosis: kyphoscoliosis s/p fusions / (l rib bone graft in ), pyloric stenosis in s/p gastrojej /roux en y , mult pneumonias , seasonal affective dz, anxiety left upper lobectomy via left thoracotomy. discharge condition: good discharge instructions: call dr. office if you develop chest pain, shortness of breath, fever, chills, redness or drainage from your incisions or chest tube site. if your chest or face fills up with air, call the office immediately and come to the hospital emergency room. if your chest tube sutures become loose, tape the tube securely and call the office immediately- . if the tube falls out, cover the site with gauze and call the office immediately. you will need to come to the hospital emergency room. you may not shower until the chest tube is removed. picc line care intravenous antibiotic- pen-g through you are no longer taking verapamil. followup instructions: you have a follow up apppintment with dr. who is covering for dr. on at 10:30am on the in the clinical center . plaese arrive 45 minutes prior to your appointment for a cxr. the vna will draw your blood weekly - lytes, bun/cre and lft's weekly: please fax results to dr. . please follow up with your pcp and cardiologist regarding recent medication changes. procedure: thoracentesis decortication of lung closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus other incision of pleura transfusion of packed cells transfusion of other serum diagnoses: esophageal reflux unspecified essential hypertension long-term (current) use of steroids asthma, unspecified type, unspecified paroxysmal ventricular tachycardia rheumatoid arthritis streptococcus infection in conditions classified elsewhere and of unspecified site, other streptococcus empyema without mention of fistula deficiency of vitamin k 

Answer: The patient is high likely exposed to