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: no drug allergy information on file attending: chief complaint: respiratory distress. major surgical or invasive procedure: transferred with ett and l ij cvl (). bronchosopy () with bal. esophageal balloon study (). terminal extubation (). history of present illness: 22 yo woman with history of rubinstein taybi disease (with associated kyphoscoliosis, small lung volumes and chronic right lung compression, obesity, mental retardation, and short stature) who presents from osh with cc of respiratory distress. history was obtained from her mother. pt was reportedly in her usoh until morning of transfer, when she developed acute onset shortness of breath. per her mother she was being treated with prolonged prednisone taper after uri approx one month ago. she received about one week of antibiotics (cipro + cephalosporin) and was treated with prolonged prednisone taper, down to 5 mg on the day prior to admission. she was in her usoh until this morning, when she became acutely hypoxic to 50s. her mother thumped on her chest a few times after which she coughed up a large mucus plug. however, she continued to have increasing oxygen requirements which prompted her mother to bring her to hospital ed. at osh ed, she was noted to have initial bp 146/93, hr 118, rr 32, with sats 88-91% on nrb 15l. ekg showed sinus tachycardia with rad and rbbb. cardiac enzymes were negative. white count was noted to be 24k. cxr showed complete white-out both lung fields although this was difficult to interpret in the setting of severe kyphoscoliosis. patient was intubated for hypoxemic respiratory failure. left ij placed. she underwent bronchoscopy that showed moderate thick yellowish mucus plug in the rll with clot. there were no visible neoplasms. patient was given rocephin, vancomycin, and azithromycin and transferred to for further care. at time of transfer patient was hypoxic to 60s on 100% fio2. hr was 130s and regular with stable blood pressure. abgs were consistent with respiratory acidosis and hypoxemia. patient underwent bronchoscopy that showed scant secretions, most prominent in the left lingula. secretions were suctioned and washed without incident. bal was then performed after which there was frank bleeding, after which small amount of iced saline was applied with resulting cessation of bleeding. after the bronch her vent settings were adjusted to pressure control, 30/15, fio2 100% and rr 28 with resulting increase in o2 sat to 90%. **of note pt is on chronic oxygen therapy at home with cpap at night. per report she uses 2-4l oxygen by nc to maintain sats in the low 90s. she is ambulatory at baseline. review of systems: unable to attain. past medical history: #rubinstein taybe disease, complicated by mental retardation, short stature, severe kyphoscoliosis, restrictive and obstructive lung physiology #tachycardia thought to be related to underlying lung disease for which patient takes cardizem social history: patient lives with mother and father on . per report she is ambulatory at baseline and attends school. of note, pt with multiple sick contacts recently (including visiting nurses and multiple family members). family history: non-contributory. physical exam: bp 96/59, hr 118, sat 91%, rr 28 ventilation: pressure control 30/15, fio2 100%, rr 28 general: intubated and sedated heent: small indurated, raised eythematous lesion on left jaw (per mother this lesion is not new) neck: supple heart: rrr, normal s1/s2, tachycardic lungs: coarse breath sounds bilaterally abdomen: obese, soft, non-tender extremities: warm, well-perfused, non-edematous pertinent results: 04:00pm blood wbc-32.0* rbc-4.51 hgb-11.0* hct-37.1 mcv-82 mch-24.5* mchc-29.8* rdw-16.8* plt ct-134* 06:29pm blood wbc-26.8* rbc-4.13* hgb-10.2* hct-33.5* mcv-81* mch-24.7* mchc-30.4* rdw-16.9* plt ct-127* 04:01am blood wbc-16.9* rbc-3.27* hgb-8.3* hct-26.7* mcv-82 mch-25.5* mchc-31.2 rdw-16.7* plt ct-139* 04:01am blood pt-16.3* ptt-24.4 inr(pt)-1.4* 04:00pm blood glucose-169* urean-15 creat-0.6 na-146* k-3.4 cl-98 hco3-41* angap-10 04:48am blood calcium-8.6 phos-2.8 mg-1.8 iron-16* 06:29pm blood anca-negative b 06:29pm blood -negative 11:08pm blood lactate-0.9 studies/images: transthoracic echocardiogram (): the left atrium and right atrium are normal in cavity size. left ventricular wall thicknesses and cavity size are normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is low normal (lvef 50-55%). the right ventricular cavity is moderately dilated with mild global free wall hypokinesis. there is abnormal septal motion/position consistent with right ventricular pressure/volume overload. 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. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: suboptimal image quality. dilated right ventricle with evidence of right ventricular pressure and volume over load. if clinically indicated, a cardiac mr () is recommended to further assess biventricular structure and function. lower extremity doppler ultrasound (): impression: no evidence of lower extremity dvt. limited study due to patient's body habitus. brief hospital course: # respiratory distress, hypoxemia, hypercarbia, and hemoptysis. differential includes infectious etiologies (viral, bacterial, fungal), autoimmune/inflammatory disorders (goodpasture's, wegeners)- resulting in ards or diffuse alveolar hemorrhage. inr slightly elevated at 1.2 with platelets of 134 (no baseline available). patient with no h/o exposure to antiplatelet agents or anticoagulants. she underwent bronchoscopy and bal fluid was sent for microbial analysis. she was treated with broad-spectrum antibiotics (vancomycin, levofloacin, cefepime) for pneumonia, given her tenuous status. she was also started on high dose steroids because she had just completed a prolonged steroid taper and there was concern of airway inflammation/obstructive lung disease. in addition, because she was so difficult to oxygenate, she underwent esophageal balloon study to help assess and adjust her ventilator settings. with increasing the peep and driving pressure, her oxygenation improved significantly and we were able to wean down on the fio2. clinically, she appeared stable to slightly improved, though still ventilated with high peak expiratory and inspiratory pressures. due to her recurrent admissions, high liklihood of prolonged ventilator-dependence, and overall poor prognosis, her family decided (over the course of several days) to withdraw care. she was extubated on and passed away shortly thereafter # tachycardia. patient has chronic tachycardia which is felt to be related to chronic hypoxemia from underlying lung disease. other considerations include intravascular volume depletion, anemia from blood loss, and pulmonary embolism. her hct dropped slightly from 37 at admission to 33, although after discussion with her family it seemed this was consistent with her baseline. she underwent lower extremity doppler that showed no evidence of dvt. she also underwent transthoracic echocardiogram that showed right ventricular dilation and mild pulmonary hypertension, although both were unchanged from a study one year prior (making acute pe less likely). when her oxygenation improved (see above), the tachycardia likewise improved. thus the tachycardia was likely a compensatory response to the hypoxemia. # leukocytosis. we suspect this is secondary to pulmonary infection versus acute inflammatory response. there was no bandemia, and currently patient is afebrile. antibiotics and steroids were initiated as above. # thrombocytopenia. platelets ranging from 120-130s, which was consistent with her baseline. # goals of care. her family, including her parents who are also her health care proxies, were aware that she would likely be ventilator-dependent for several days, possibly well-over one week. with this in mind, and believing that her quality of life would be significantly impaired were she to become ventilator-dependent, they decided to withdraw care on the fifth hospital day. her medications were stopped, morphine was started and titrated to comfort, and she was extubated. she passed away shortly thereafter. medications on admission: -nexium 40 mg daily -cardizem 60 mg qid -albuterol inh -pulmicort inh discharge medications: deceased. discharge disposition: expired discharge diagnosis: deceased. discharge condition: deceased. discharge instructions: deceased. followup instructions: deceased. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnostic ultrasound of heart closed [endoscopic] biopsy of bronchus diagnoses: acidosis thrombocytopenia, unspecified obstructive sleep apnea (adult)(pediatric) other chronic pulmonary heart diseases acute respiratory failure other diseases of lung, not elsewhere classified tachycardia, unspecified leukocytosis, unspecified unspecified intellectual disabilities other dependence on machines, supplemental oxygen other anomalies of spine other specified congenital anomalies short stature 

Answer: The patient is high likely exposed to