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: prempro / fiorinal / erythromycin base / aleve attending: chief complaint: abdominal pain major surgical or invasive procedure: none history of present illness: this is a 65 year old woman with hisotry of myasthenia who presents with progressive abdominal pain and possible mg flare. . the pain started two weeks ago as diffuse pain which then moved to the mid pelvis region. it was described as sharp and crampy, worse when lying to her sides and after defecation. denied n/v/d/fever/chills/hematochez/melena. she has never had abdominal surgery or hernias. she was recently admitted to ets service with abdominal pain. ct abdomen at the time was reported as mild diverticulitis. initally treated with cipro/flagyl and then switched to cefpodoxime/flagyl. called pcp today with abd pain and told to come to ed. . in the ed initial vitals were: t:98 hr:100 bp:174/93 rr:40. looked in respiratory distress. nif was -20 and vc 1.6. abg: 7.42/48/87/32. she was thought to be having a myasthenia flare. she was given vanc/flagyl/zosyn for presumed intra-abdominal infection leading to the mg flare. in ct scan could not lay flat and she had to be intubated in ed. ct torso revealed no saddle embolus but poor scan so started heparin empirically. also with evidence of lll pna (not on ct abd a few days ago). also has worsening diverticulitis so surgery asked to eval in ed. neuro was consulted and said hold on tx for mg for now given possible infection currently, staffed with dr . . recommended micu admit, check nifs & vcs q6h - neuro will follow as consult. cdiff was sent as thought infection might have precipitated this flare. nif was -20. received vanc/zosyn/flagyl. intubated using etomidate and recuronium and versed/fentanyl. started on hep gtt. also got kcl for k of 2.9. surgery was called and said no changes in antibiotics and npo. prior to transfer to the floor ct chest read as ett too low. pulled back by ed and repeat cxr ok per ed report on arrival to the floor patient was intubated and sedated. past medical history: 1. myasthenia -first diagnosed in , followed by dr. at 2. multiple spinal compression fractures s/p steroid use for mg 3. hypercholesterolemia 4. h/o migraines 5. seasonal allergies 6. htn 7. osteoporosis social history: patient is single, lives alone. she is currently on disability. she used to work as a histology tech a . she denies tobacco, illicit drugs, occ etoh but none since starting narcotic medications. family history: mother: , first age 55, also chf, deceased age 77; father with rheumatic heart disease, deceased age 83 cva; sister died at age 5 of insulin dependent diabetes mellitus w/pna. . physical exam: vitals: t: 98.1 hr 77 bp 106/54 abg: 7.42/45/266/30 on ac at 450x16, 5, 99%fio2 general: sedated, intubated. heent: ncat, perrl, eomi, no scleral icterus, dry mm neck: supple, no significant jvd or carotid bruits appreciated pulmonary: lungs cta bilaterally, no wheezes, ronchi or rales cardiac: rr, nl s1 s2, no murmurs, rubs or gallops appreciated abdomen: ttp pelvic area, soft, nd, normoactive bowel sounds, no masses or organomegaly noted. no sign, no rebound extremities: no edema, 2+ radial, dp pulses b/l skin: no rashes or lesions noted. pertinent results: at admission: 07:35pm blood wbc-12.7* rbc-4.28 hgb-14.2 hct-42.4 mcv-99* mch-33.1* mchc-33.5 rdw-12.5 plt ct-206 07:35pm blood neuts-86.1* lymphs-8.2* monos-4.6 eos-0.6 baso-0.5 05:43am blood pt-16.0* ptt->150* inr(pt)-1.4* 07:35pm blood glucose-113* urean-16 creat-0.8 na-143 k-2.9* cl-100 hco3-31 angap-15 07:35pm blood alt-10 ast-17 ck(cpk)-87 alkphos-44 totbili-0.5 07:35pm blood ctropnt-<0.01 07:35pm blood albumin-4.2 04:30am blood calcium-7.9* phos-3.2 mg-2.2 10:02pm blood type-art po2-87 pco2-48* ph-7.42 caltco2-32* base xs-5 intubat-not intuba 08:01pm blood lactate-1.8 cxr: findings: in comparison with the study of earlier in this date, the tip of the endotracheal tube now measures approximately 2.6 cm above the carina. nasogastric tube again extends well into the stomach. extensive opacification is seen at the left base consistent with volume loss and pleural effusion. there is apparent opacification in the left perihilar region. this could represent an area of developing aspiration or volume loss related to mucus plugging. cta torso : 1. sigmoid diverticulitis with adjacent punctate foci of air compatible with focal perforation, mildly worsened in appearance from prior study. no drainable fluid collection. 2. new left lower lobe collapse secondary to mucus plugging/aspiration. 3. nondiagnostic study for evaluation of pulmonary embolism. no central thrombus. in case of continued clinical concern for pulmonary embolism, a repeat study can be obtained. cta chest : impression: 1. no pulmonary embolism or aortic pathology. 2. near-complete lll collapse and partial rll collapse, unchanged. small focal superimposed infection cannot be excluded. 3. marked left hemithorax volume loss, with leftward shift of mediastinal structures, also unchanged. no pneumothorax. 4. small left-sided pleural effusion tracks along the major fissure. most recent labs: 03:41am blood wbc-8.7 rbc-3.84* hgb-12.7 hct-38.7 mcv-101* mch-33.1* mchc-32.8 rdw-12.3 plt ct-209 03:41am blood glucose-94 urean-14 creat-0.8 na-140 k-3.1* cl-96 hco3-35* angap-12 06:18am blood glucose-86 urean-13 creat-0.9 na-140 k-3.8 cl-95* hco3-35* angap-14 02:56am blood alt-7 ast-16 ld(ldh)-195 alkphos-24* totbili-0.3 07:35pm blood lipase-21 07:35pm blood ctropnt-<0.01 03:41am blood calcium-8.9 phos-4.0 mg-2.2 05:43pm blood hapto-259* 04:30am blood triglyc-58 03:21am blood tsh-4.2 02:47pm blood type-art temp-37 po2-77* pco2-52* ph-7.46* caltco2-38* base xs-10 brief hospital course: ms. is a 65 year old woman with history of myasthenia who was admitted to the on with progressive abdominal pain, respiratory distress requiring intubation, and possible mg flare. she has known diverticular disease and imaging at admission was consistent with diverticulitis flare with microperforation. surgery was consulted and she was treated with bowel rest with improvement; she was cleared from a surgical standpoint given resolution of her abdominal pain and ability to tolerate po diet. she is to complete a 14 day course of zosyn. . her respiratory distress was initially thought to be multifactorial: diaphragm weakness from mg flare and splinting from abd pain, but imaging was suggestive of pna and this was thought to be the main cause of her respiratory failure. there was also initial concern for pe, but this was ruled out on cta chest. she was noted to improve on antibiotics (vancomycin and zosyn). barriers to extubation were weak nif (-20), fluid overload and copious secretions. she was diuresed to contraction alkalosis. we held her mestinon, her secretions subsided and her nif improved to -60. she was successfully extubated on and progressively weaned from face tent at 50% to nasal cannula. her mestinon was restarted 6 hours after extubation. an abg on showed mild alkalosis with appropriate respiratory compensation. her respiratory status continued to improve, and she completed an 8 day course of vancomycin and zosyn for hospital acquired pneumonia (still has 4 days of zosyn left at the time of discharge for the diverticulitis). she remains on 3l/min od o2 via nc, but her supplemental o2 needs continue to decrease. . for her mg, the patient was on pyridostigmine at home. neuro was consulted and they recommended continuing this medication as an inpatient. she did not require steroids or ivig treatment as it was not felt that she was having a flare. (no weakening off of mestinon) . of note, on prior ct abdomen () the patient was noted to have a heterogeneous endometrium measuring up to 1.5 cm, abnormal in a post-menopausal patient. patient will need further evaluation with pelvic ultrasound as an outpatient. on she developed diarrhea. stool was sent for c.diff and was negative. her diarrhea abated. her potassium also dropped to 3.1 on . she was started on potassium repletion and will need to have her potassium (and, possibly, magnesium) followed at - - next level reccomended to be drawn on . at the time of discharge from the patient was clinically and hemodynamically stable. she will be discharge to -. . ms. code status was confirmed as full code this admission. medications on admission: hydrochlorothiazide 25 mg po qam, lidocaine 5% patch apply dialy for 12 hours, metoprolol 25 mg po bid, percocet 10-325 mg po qid prn pain, pyridostigmine bromide 60 mg po ttid, evista 60 mg po daily, simvastatin 40 mg po daily discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 2. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain, fever. 3. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 4. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation every four (4) hours as needed for sob. 5. pyridostigmine bromide 60 mg tablet sig: one (1) tablet po q8h (every 8 hours). 6. hydrochlorothiazide 12.5 mg capsule sig: two (2) capsule po daily (daily). capsule(s) 7. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day): hold if sbp < 95 or hr < 60. 8. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 9. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 10. potassium chloride 20 meq tab sust.rel. particle/crystal sig: two (2) tab sust.rel. particle/crystal po tid (3 times a day) for 2 days. 11. zosyn 4.5 gram recon soln sig: one (1) intravenous every eight (8) hours for 4 days. 12. heparin flush (10 units/ml) 2 ml iv prn line flush picc, heparin dependent: flush with 10ml normal saline followed by heparin as above daily and prn per lumen. discharge disposition: extended care facility: & rehab center discharge diagnosis: diverticulosis with microperforation nosocomial lll pneumonia and atelectasis acute respiratory failure requiring intubation and mechanical ventilation volume overload myasthenia diagnosed in spinal compression fractures hyperlipidemia migraine headaches hypertension osteoporosis discharge condition: stable mental status: clear and coherent level of consciousness: alert and interactive activity status: out of bed with assistance to chair or wheelchair discharge instructions: you were admitted with abdominal pain and difficulty breathing. you were diagnosed with diverticulitis and pneumonia. you were treated for a period of time in the intensive care unit, but with antibiotics and supportive care you improved. you are now ready for rehabilitation in a specialized rehabilitation hospital. followup instructions: patient needs to see her primary care physician in within 2 weeks of discharge from -. department: when: monday at 9:40 am with: , m.d. building: sc clinical ctr campus: east best parking: garage department: adult specialties when: monday at 11:30 am with: ,m building: (, ma) campus: off campus best parking: free parking on site procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances diagnoses: pneumonia, organism unspecified anemia, unspecified hypopotassemia pulmonary collapse other and unspecified hyperlipidemia acute respiratory failure alkalosis osteoporosis, unspecified migraine, unspecified, without mention of intractable migraine without mention of status migrainosus diverticulosis of colon (without mention of hemorrhage) myasthenia gravis without (acute) exacerbation benign essential hypertension personal history of pathologic fracture 

Answer: The patient is high likely exposed to