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: hypercarbic respiratory failure major surgical or invasive procedure: intubation history of present illness: ms. is a 39 year old woman with a history of morbid obesity, obstructive sleep apnea, and copd on home o2 that presented to the ed complaining of shortness of breath for about 1 week and a productive cough. her vital signs were initially t 102 hr 116 bp 112/palp and 96% on o2 (route/quantity unknown) and 76% ra and she could only speak in short phrases. initial abg was 7.34/71/58. she was started on bipap, and given azithro/ceftriaxone/solumedrol. her bp dropped and responded to iv fluids. she ultimately received 5l ns. a foley was placed at 10:30pm and 380cc returned. past medical history: supermorbid obesity obstructive sleep apnea venous thromboembolism pulmonary hypertension copd on home o2 asthma hypertension social history: the patient lives with her mother and sister at home. no tobacco and no alcohol use. family history: htn, breast cancer, and obesity (mother) physical exam: vs: tm 101.9 tc 100.5 bp (89-197)/(45-112) hr 114 (107-144) rr 18 (12-33) sat 76-99% vent: ac tv 600 peep 10 fio2 0.8 rate 18 plat 31 pip 34 map 17 gen: morbidly obese woman, intubated, sedated. heent: sclerae anicteric, dry mucus membranes cv: normal s1/s2, rrr pul: clear anteriorly abd: obese, soft, nt. ext: severe chronic venous stasis changes in le's. neuro: sedated, unarousable. . pertinent results: ekg: sinus tach 148bpm, normal axis, no st/t changes. . imaging: cxr 7:30pm: tip of the newly placed endotracheal tube is at the level of the sternal notch between 3 and 4 cm from the carina. nasogastric tube can be traced as far as the mid esophagus, but largely because of technical limitations in imaging in a patient of this size i cannot be sure it passes any further. severe cardiomegaly is longstanding finding. there may be a moderate-sized right pleural effusion layering posteriorly, but there is also a suggestion of worsening consolidation in the right lung and vascular congestion on the left. all in all findings suggest pneumonia and acute decompensation of chronic cardiac insufficiency. findings were discussed by telephone with dr. at the time of dictation. . swallow study : no aspiration on bedside swallow study, with functional swallow for thin liquids and regular consistency solids. recommend: begin po diet of thin liquids and regular consistency solids. give pills whole with thin liquids. cbc: wbc-16.9*# hct-39.2 mcv-81* plt ct-201 wbc-5.0 hct-33.7* mcv-79* plt ct-225 neuts-84* bands-11* lymphs-3* monos-2 eos-0 baso-0 atyps-0 metas-0 myelos-0 nrbc-1* neuts-64.8 lymphs-25.1 monos-6.0 eos-3.9 baso-0.3 coags: pt-23.9* ptt-29.1 inr(pt)-2.4* pt-74.7* ptt-48.9* inr(pt)-9.7* pt-19.0* ptt-89.3* inr(pt)-1.8* chemistry: glucose-117* urean-12 creat-0.7 na-140 k-4.2 cl-94* hco3-37* glucose-92 urean-7 creat-0.5 na-145 k-3.9 cl-101 hco3-33* calcium-7.9* phos-2.2*# mg-1.5* calcium-8.8 phos-2.7 mg-1.5* anemia workup: caltibc-277 ferritn-83 trf-213 iron-56 brief hospital course: a/p: 39f with supermorbid obesity, copd on home o2, presented with worsening shortness of breath, fevers, tachycardia, intubated for respiratory failure. . # respiratory failure: pt was intubated for hypercarbia/hypoxia and oxygenated and ventilated well on ac. pt was continued on ctx and azithro (both started ) but discontinued azithro after 4 days due to elevated inr thought to be interaction between azithro and coumadin. the patient was continued on mdi as well. plan to continue ctx and wean vent. the patient was extubated on , but developed respiratory distress with hypoxia and tachycardia soon after the tube was pulled. she was placed on non-invasive ventilation, and it was thought that she may need to be reintubated. the patient refused, however, and this decision was discussed with her mother and sister (her code status, however, is full, confirmed on day of discharge). an a-line was place for closer abg monitoring, and the patient was able to be maintained on non-invasive ventilation. she was eventually transitioned to a 50% face mask. she was provided with her home c-pap settings overnight, and her home machine was brought in prior to transfer to the floor. she completed a total of ten days of ceftriaxone for cap. on day of discharge she has been saturating 94% on 4l o2 consistently for the few days prior to discharge. she desaturates with transfers and should therefore have increased oxygen with activity. she is on 2l oxygen at home. she also uses nebulizers as needed at home. she was kept on standing nebs q6 hours here, but will be transitioned back to her advair and fluticasone inhalers at rehab, with nebs prn. . # history of dvt/?pe: on chronic lifelong anticoagulation. pt was initially continued on lower dose coumadin, but due to elevating inr (5), coumadin and azithromycin was discontinued. despite discontinuation of azithro and coumdin, inr continued to rise on (to ), so pt received ffp and vit k as central line placement was also intended to occur. her heparin drip was restarted once her inr was below 2, and she was maintained on the drip until coumadin could be restarted. once she passed a speech and swallow eval, her coumadin was restarted at 5mg qhs and increased to 6 mg po qhs. the pt will remain on heparin gtt for 48 hrs after inr is . . # hypertension- the patient was started on iv lopressor for persistent hypertension, and this effectively lowered her blood pressure. she was changed over to oral lopressor once her speech and swallow eval was completed. given that she did not have a prior diagnosis of hypertension, her blood pressure may normalize once her breathing has stabilized and her infection has cleared. . # f/e/n: npo initially and started tubefeeds via og. the tube feeds were then held in anticipation of extubation, and following extubation, the patient underwent a speech and swallow evaluation which she successfully passed. she was placed on a regular, low sodium diet with thin liquids, however can resume regular liquids at rehab. . # code: full, addressed with patient on discharge. . # comm: # (r and sister medications on admission: detrol albuterol coumadin 6mg qhs advair mvi combivent discharge medications: 1. heparin (porcine) in d5w 100 unit/ml parenteral solution sig: see sliding scale attached intravenous asdir (as directed): to be continued until inr at goal of on coumadin for 48 hours. 2. warfarin 2 mg tablet sig: three (3) tablet po hs (at bedtime): please titrate dose to achieve inr of . 3. tolterodine 1 mg tablet sig: one (1) tablet po bid (2 times a day). 4. albuterol sulfate 0.083 % solution sig: one (1) neb inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 5. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 6. advair diskus 100-50 mcg/dose disk with device sig: inh inhalation twice a day. 7. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po twice a day. 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 9. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 10. cepacol 2 mg lozenge sig: one (1) lozenge mucous membrane prn (as needed). 11. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 12. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily). 13. lactulose 10 g/15 ml syrup sig: thirty (30) ml po q8h (every 8 hours) as needed: please titrate to 1 bm daily. 14. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 15. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 16. multivitamin capsule sig: one (1) cap po daily (daily). 17. combivent 103-18 mcg/actuation aerosol sig: two (2) inh inhalation every six (6) hours. discharge disposition: extended care facility: and rehab center discharge diagnosis: community acquired pneumonia supratherapeutic inr secondary: morbid obesity obstructive sleep apnea deep venous thrombosis pulmonary hypertension chronic obstructive pulmonary disease asthma hypertension iron deficiency anemia discharge condition: improved, still on 4l oxygen via nasal cannula (on 2l home o2). needs assistance with transfers. discharge instructions: please resume your previous medications. we have started two new medications here: 1) metoprolol, for your high blood pressure. you should continue this medication after you leave. 2) iron supplements (ferrous sulfate) for your anemia. you should have a colonoscopy with dr. as an outpatient if you haven't had one recently. you will be on a heparin drip at rehab until your coumadin is therapeutic again (ie until inr is at goal of ). followup instructions: please see your primary care (dr. doctor within the next 2 weeks. md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube arterial catheterization transfusion of other serum diagnoses: pneumonia, organism unspecified abnormal coagulation profile unspecified essential hypertension other chronic pulmonary heart diseases acute respiratory failure alkalosis unspecified sleep apnea morbid obesity long-term (current) use of anticoagulants iron deficiency anemia, unspecified chronic obstructive asthma, unspecified 

Answer: The patient is high likely exposed to