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 / levofloxacin attending: chief complaint: transfer for possible intervention/bronch for tracheal stenosis major surgical or invasive procedure: bronchoscopy history of present illness: 64 yo f w/ h/o copd s/p trach in , cad s/p cabg in , chf (lvef 60%), who on had a #10 t-tube placed by dr. . however, due to significant supraglottic redundant tissue stenosis was not amenable to dilation. since the time of procedure, the patient has had persistent dyspnea and on the day of transfer was referred to ed by her vna due to increased work of breathing. the patient in had wheezing, respiratory distress, spo2 89%. patient reports increased production of white sputum. denies fevers or chills. no chest pain, nausea, vomiting, diarrhea, constipation any other complaints. past medical history: 1. dmii - on insulin 2. cad s/p cabg for 3-v disease approximately 12 years ago at . 3. pt had a severe copd exacerbation and question pna approximately two years ago. she was on a ventilator at that time which was eventually converted to a trach. she has never been able to come off of the trach. 4. chf - ef 25% in 5. gerd 6. depression 7. pvd social history: patient lives at home with her daughter, her daughter's family as well as sister and much of extended family. patient reports a 47 pack-year history of smoking (quit 2 years ago s/p trach placement), denies any use of etoh, ivdu or other illicit drug use. family history: patient's parents with heart disease, lung ca. physical exam: vitals: t 95.7; hr 77; bp 103/46; rr 26; o2 sat 98% on fio2 50% general: obese hispanic female, somnolent, sitting upright in bed with humidified o2 mask over trachea, increased work of breathing, mild respiratory distress. heent: ncat, eomi. neck: obese, no palpable lad chest: course inspiratory and expiratory breath sounds diffusely. cor: difficult exam given patient's body habitus and course breath sounds. normal s1and s2, no m appreciated abdomen: obese, soft, non-tender, non-distended. +nabs extrem: no cyanosis, clubbing. venous stasis changes are present bilaterally. pertinent results: 04:15am blood wbc-14.2* rbc-4.08* hgb-10.6* hct-32.2* mcv-79* mch-25.9* mchc-32.9 rdw-14.6 plt ct-305 11:28pm blood wbc-14.5* rbc-3.92* hgb-10.7* hct-31.1* mcv-79* mch-27.3 mchc-34.4 rdw-14.9 plt ct-240 04:15am blood plt ct-305 03:11am blood pt-13.6* ptt-25.1 inr(pt)-1.2 04:15am blood glucose-104 urean-18 creat-0.8 na-138 k-3.8 cl-98 hco3-29 angap-15 11:28pm blood glucose-50* urean-9 creat-0.7 na-138 k-4.4 cl-101 hco3-27 angap-14 04:15am blood calcium-8.0* phos-3.6 mg-1.9 11:28pm blood calcium-8.3* phos-3.5 mg-1.7 11:47am blood caltibc-281 ferritn-22 trf-216 12:59pm blood type-art po2-113* pco2-57* ph-7.33* calhco3-31* base xs-2 07:51am blood type-art temp-36.1 po2-101 pco2-52* ph-7.39 calhco3-33* base xs-4 03:56pm blood type-art temp-36.8 rates-/24 fio2-35 o2 flow-15 po2-88 pco2-58* ph-7.42 calhco3-39* base xs-10 intubat-not intuba 10:36pm blood type-art temp-36.7 fio2-50 po2-90 pco2-56* ph-7.39 calhco3-35* base xs-6 intubat-not intuba 12:49pm blood type-art temp-36.6 rates- tidal v-300 peep-5 fio2-30 po2-56* pco2-56* ph-7.40 calhco3-36* base xs-7 intubat-intubated vent-spontaneou 10:15pm blood type-art po2-138* pco2-61* ph-7.32* calhco3-33* base xs-3 . cxr : the cardiac silhouette and pulmonary vascularity appear slightly more prominent compared to previous studies, but could potentially be accentuated by extreme apical lordotic projection. however, it is difficult to exclude mild volume overload as a cause for these findings. there are no confluent areas of consolidation within the lungs or significant atelectasis. . cxr : tracheostomy tube has a longer than standard intrathoracic component, presumably treatment for the tracheal stricture demonstrated on chest ct scan. lungs are clear. there is no atelectasis and no pneumothorax or pleural effusion. moderate cardiomegaly is stable. dilated right pulmonary artery may be due to pulmonary arterial hypertension or adenopathy. the patient has had median sternotomy and coronary bypass grafting. . cxr : no evidence of pneumonia on a limited study. followup views should be obtained if there is persistent concern. brief hospital course: a 64 year-old female with copd, cad, chf with h/o tracheal stenosis who is s/p #10 t tube placement (on ) who presented with increased work of breathing and dyspnea. . 1. dyspnea: etiology: copd exacerbation vs. chf exacerbation vs. pneumonia (had elevated wbc on admission) or t tube obstruction. initially on cmv ventilation at 300x12/35%/5, and at the time of discharge was on 15l/m fio2 35% via facemask. the pt. required frequent suctioning of upper airway mucus/secretions. pt. bronched and evaluated by interventional pulmonology, recommended leaving t-tube in place with continued suctioning prn and encouragement to cough on her own to clear mucus/secretions. continue albuterol and ipratropium nebs. plan to continue prednisone taper (for copd exacerbation) post-discharge (today is day 2 of 3 of 20mg/day). pt. was switched to iv lasix during hospitalization, and was switched back to po in preparation for discharge. her daily weights and strict is/os were monitored. due to rising bicarbonate, she was also given diamox 500mg iv q12 for two days. . 2. cad s/p cabg. home doses of asa, carvedilol, lisinopril, lipitor and zetia were continued during hospitalization. telemetry monitoring was continued throughout the entire hospitalization. . 3. pvd. continued trental. . 4. gerd. continued protonix. . 5. dm. patient was found to be hypoglycemic on admission. she was maintained on an iss, and her home dose of nph insulin (60u qam) was restarted prior to d/c. her nph dose was adjusted during hospitalization based on her po intake. fingersticks were monitored routinely. . 6. chf ef 25% (). patient appeared to be mildly volume overloaded. iv lasix (and diamox) were used for diuresis. the patient was diuresed with a goal of >500cc negative per day. . 7. uti: the patients admission urinalysis was consistent with a uti. she was treated with a three day course of bactrim (today is day 2). . 8. depression: continued fluoxetine. . 9. fen: cardiac diet. repleted electrolytes as per routine. . 10. prophylaxis: bowel regimen. heparin sq. ppi. . 11. code: full. . 12. communication: patient & her daughter. medications on admission: ranitidine 150mg po qd trental 400mg tid lisinopril 10mg po qd zetia 10mg po qd asa 81 mg po qd senokot 2 tabs po bid nitropatch 0.4mg q am protonix 40mg po qd mucinex 1200mg po bid prozac 40 mg po qd kcl 20 meq po bid albuterol nebs qid prn regular insulin sliding scale nph 60 units sq discharge medications: 1. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 2. pentoxifylline 400 mg tablet sustained release sig: one (1) tablet sustained release po tid (3 times a day). 3. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 4. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 5. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 6. senna 8.6 mg tablet sig: two (2) tablet po hs (at bedtime). 7. fluoxetine 20 mg capsule sig: two (2) capsule po daily (daily). 8. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). 9. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 10. prednisone 20 mg tablet sig: one (1) tablet po once a day for 2 days. 11. prednisone 10 mg tablet sig: one (1) tablet po once a day for 3 days: please start after final dose of 20mg prednisone. 12. albuterol sulfate 0.083 % solution sig: one (1) inhalation q2h (every 2 hours). 13. ipratropium bromide 0.02 % solution sig: one (1) inhalation q2h (every 2 hours). 14. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 15. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation q4-6h (every 4 to 6 hours) as needed. 16. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 17. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 18. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po bid (2 times a day) for 1 days: please give this dose in am on . 19. furosemide 80 mg tablet sig: two (2) tablet po bid (2 times a day). 20. metolazone 2.5 mg tablet sig: one (1) tablet po bid (2 times a day). 21. sodium chloride 0.9% flush 3 ml iv daily:prn peripheral iv - inspect site every shift 22. lorazepam 0.5-1 mg iv q4h:prn anxiety hold for rr<10 23. nph 60u qam 24. insulin sliding scale in addition to nph to cover for hyperglycemia. discharge disposition: extended care facility: hospital - discharge diagnosis: primary: copd secondary: cad chf pvd gerd uti depression discharge condition: stable. discharge instructions: please continue to take all medications as prescribed. you will be going to a rehabilitation hospital so that your breathing and lung function can heal and improve. you will receive special care there including suctioning of your trach tube as necessary. followup instructions: please continue to follow up with your pcp : medical, p.c. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours fiber-optic bronchoscopy diagnoses: esophageal reflux urinary tract infection, site not specified congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled obstructive chronic bronchitis with (acute) exacerbation aortocoronary bypass status peripheral vascular disease, unspecified long-term (current) use of insulin chronic respiratory failure tracheostomy status 

Answer: The patient is high likely exposed to