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: compazine attending: chief complaint: shortness of breath major surgical or invasive procedure: tracheostomy and peg tube placement central line placement picc line placement history of present illness: 45 yo woman with severe asthma and copd with fev1 of 0.24 being evaluated for possible lung transplant comes in after 2 days of fevers to 102, cough, congestion, unable to bring up sputum and shortness of breath. she tried increasing frequency of her home nebs, spoke with her pcp and was started on erythromycin and mucinex. as she was still short of breath, she came in to the ed for evaluation via ems. she denies any sick contacts and has been compliant with med regimen. she denies any other symptoms. . in ed started on continuous nebs with heliox and improvement in respiratory distress, but still tachypnic and working to breathe. received solumedrol, 125mg iv, levoquin 500mg once, magnesium 2gm and continuous neb as above. past medical history: 1. copd, pfts in with fev1 0.24(10%), fvc 1.25(41%) and fvc/fev1 28%- on home o2 at 2l nc, on chronic steroids, hx of prolonged intubation requiring trach for resp failure in , last flare 2. hypertension 3. anxiety 4. leukocytosis of unknown etiology with negative bmbx. 5. osteoporosis- on fosamax 6. shoulder pain 7. history of positive ppd s/p 6mos of isoniazid 8. mitral valve prolapse social history: +smoker, has young son and involved mother family history: nc physical exam: vs:101.2 axillary, 144 123/79 28 97%2lnc gen aao, tachypneic in mod resp distress, able to answer in short word phrases with increased work of breathing heent perrl, drymm, + trach scar chest diffuse wheezes bilaterally, no crackles cv rrr, tachycardic abd soft, nt/nd, +bs ext no edema pertinent results: 10:43am type-art rates-/24 po2-264* pco2-50* ph-7.35 total co2-29 base xs-1 intubated-not intuba 07:43am glucose-183* lactate-2.0 na+-130* k+-3.8 cl--94* 07:43am hgb-13.1 calchct-39 07:43am freeca-1.23 07:30am glucose-155* urea n-11 creat-0.7 sodium-132* potassium-3.9 chloride-94* total co2-32* anion gap-10 07:30am calcium-9.8 phosphate-3.0 magnesium-3.3* 07:30am tsh-0.46 07:30am wbc-14.0* rbc-4.33 hgb-13.5 hct-38.6 mcv-89 mch-31.1 mchc-34.9 rdw-13.0 * ct sinus: pansinus opacification with air-fluid levels. * cta: 1. no evidence of pe. 2. severe emphysematous changes of the lungs and interstitial changes in the periphery of the bases. 3. new tree-in- opacities in the lower lobes could represent an acute infectious process in the bases versus aspiration * mri c-spine: ) no evidence of epidural abscess. 2) t5 vertebral body compression fracture. * brief hospital course: a/p: 45 yo with end stage pulmonary disease secondary to emphysema and asthma here with copd exacerbation and prolonged respiratory failure. * 1) respiratory failure: secondary to copd exacerbation with poor fev1(0.23) at baseline from pfts and was on transplant list but taken off for continued smoking. unclear trigger of exacerbating event, but on arrival was febrile to 101. started on and completed 7 day course of levoquin for suspected pneumonia/bronchitis. her dfa for influenza was negative and sputum was minimal with sputum cultures growing only oropharyngeal flora. she was intubated for increased respiratory distress and remained on ventilator with slow wean despite steroids and bronchodilators. initially was difficult to ventilate without excessive sedating meds, of note on last prolonged respiratory failure last year- she had required paralytics. cta (-) for pe. given prolonged ventilator wean, patient had trach and peg placed by ct surgery . current respiratory status improving and tolerating pressure support. . 2) steroid myopathy: after weaning of sedation, patient initially noted to be weak. she had c-spine imaged and neurology consult. her c-spine was negative for epidural abscess, but noted to have a t-5 fracture- that is assymptomatic and will just be followed. neurology was consulted and the patient had an emg that was consistent with axonal polyneuropathy. given brisk le reflexes, she underwent a thoraic and lumbar mri , results pending at time of dictation. . 3) sinusitis: after 2weeks into her stay after intubation, patient developed fevers and had a positive head ct for sinusitis and was treated empirically with 10 days of vancomycin and ceftaz; she will complete her course on . at time of discharge, she remained afebrile with wbc 12.5 (trending down). * 4) fluid overload: following admission, the patient was aggressively hydrated given low urine output with good response. over the course of her stay, however, she was noted to have a positive fluid balance with increased lower extremity edema. she was treated with iv furosemide with good results and was transitioned over to po lasix for a goal i/o (-) 500 cc/day. her volume state (including daily weights) will need to be monitored following discharge and her furosemide dose adjusted as needed for clinical euvolemia. * 5) esophageal candidiasis: during peg placement on , she was noted to have evidence of esophageal candidiasis and was treated with a 7 day course of fluconazole. * 6) cephalic vein clot: on , the patient was noted to have increased right upper extremeity edema. a right upper extremity ultrasound confirmed an occlusive thrombus in the right cephalic vein. she completed a 7 day course of heparin for a superficial clot. * 7) htn: the patient blood pressure was initially elevated, however it improved with appropriate pain/anxiety management. she was discharged on her home dose of captopril. * 8) anxiety: the patient's chronic anxiety was a major management issue during this hospitalization. following intubation, she was initially sedated with propofol, however was transitioned to fenanyl/versed with better results. she was continued on home doses of seroquel, and neurontin. klonopin was added to her regimen along with prn ativan. she had multiple episodes of severe anxiety with associated tachypnea (respiratory rate in the 30s) and tachycardia (hr 120s-140s) requiring iv ativan/haldol. effexor was restarted on once she was able to take oral medications (using passy muir valve). * 9) ileus: secondary to excessive narcotics regemin and resolved with aggressive bowel regemin. * 10) fen: passed swallow evaluation on who recommended advancing pt to po diet as tolerated (thin liquids and soft solids) with pmv in place. medications whole with water as tolerated (or via peg). at time of discharge, the patient's oral intake is limited by tachypnea. she continues to receive tube feeds via peg tube and is only receiving effexor by mouth. medications on admission: albuterol/atrovent nebs flovent serevent singulair tiotropium captoril fosomax efffexor neurontin seroqul protonix oxybutinin klonopin discharge disposition: extended care facility: - discharge diagnosis: copd exacerbation discharge condition: fair discharge instructions: please follow-up with primary care physician . () within 1 week following discharge from rehab facility. followup instructions: provider: , md where: phone: date/time: 1:00 provider: , md where: phone: date/time: 2:10 md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube percutaneous [endoscopic] gastrostomy [peg] arterial catheterization temporary tracheostomy transfusion of packed cells diagnoses: acidosis anemia, unspecified tobacco use disorder mitral valve disorders unspecified essential hypertension adrenal cortical steroids causing adverse effects in therapeutic use constipation, unspecified anxiety state, unspecified acute respiratory failure alkalosis paralytic ileus closed fracture of dorsal [thoracic] vertebra without mention of spinal cord injury chronic obstructive asthma with (acute) exacerbation toxic myopathy unspecified sedatives and hypnotics causing adverse effects in therapeutic use tachycardia, unspecified unspecified sinusitis (chronic) schizoaffective disorder, unspecified candidal esophagitis fracture, cause unspecified 

Answer: The patient is high likely exposed to