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 known allergies / adverse drug reactions attending: chief complaint: hypoxia, shortness of breath, lethargy major surgical or invasive procedure: none history of present illness: pt is an 82 year old female with severe aortic stenosis, pvd, pulmonary hypertension, and chronic systolic heart failure (ef 35-40%), restrictive lung disease, and chronic hypoxia (on intermittent home o2, 2 l o2 nc when o2 sats < 88%) who presents with shortness of breath and lethargy. family reports patient has had various symptoms over the past few days of rapid breathing that has been 'on and off' since sunday. family attributed it to possible increase in her arthritis. on tuesday, the patient was noted to have increased wheezing, so dtr called on call physician (dr. who recommended either ed evaluation if breathing worsened or urgent care appointment, which was scheduled for the next day with geriatrics np. in the am, prior to the appointment, pt appeared less talkative and slightly altered to the family. when she came to her appointment, she was noted to be hypoxic in clinic to 72% on ra so was sent to the ed for further evaluation. per family, no medication changes except zyprexa was recently tapered off. family denies fevers, chest pain, abdominal pain, or dysuria. of note, patient was admitted to in for unresponsiveness after a bm, and was intubated for presumed chf exacerbation and pleural effusions. . in the ed, initial vs were: 99 107 129/60 24 72% on ra on arrival to ed. patient was given combivent nebs, vancomycin 1 gram iv x1, and levofloxacin 750 mg iv x1. pt was placed on bipap fio2 33% 12/5. noted to be lethargic initially but was reported to be more awake prior to transfer. in the icu, patient was unable to speak due to bipap mask being in place but was able to nod her head and squeeze hands to command. . review of systems: (+/-) per hpi past medical history: peripheral vascular disease, cardiomyopathy, diverticulosis, scoliosis, hiatal hernia aortic stenosis, pulm hypertension congestive heart failure with an ef in the low 30% range. recent tte ef 60-65%. social history: she was married and had four children. she has ten grandchildren her husband died in . she lived by herself and was able to manage the household by herself until . however, in around the time that she was supposed to have her cataract surgery, it suddenly became impossible for her to live alone. her children have been staying with her or having her come to their house since that time, so that she has never been alone since that time. she walks less and uses the wheelchair more. family history: her brother died of a heart attack, another brother had cabg x4 and her sister also has heart issues. . physical exam: on admission: ------------ vitals: t96.7, hr 79, bp 117/68, rr 27, sat 94% on 5l 02 nc general: elderly f wearing bipap, appears uncomfortable and tachypnic heent: sclera anicteric, mm dry, oropharynx clear neck: supple, unable to assess jvp, no lad lungs: diffuse ventilated breath sounds, slightly crackles in left upper lung fields. cv: regular rate and rhythm, normal s1 + loud s2, harsh late peaking sm heard best at rusb, no rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema on discharge: ------------- vitals: t97, bp 153/66, hr 66, rr 20, sat95% on 2l gen: on oxygen 2l nc, comfortable sitting in bed. heent: mucous membranes moist, no lesions noted. sclerae anicteric. no conjunctival pallor noted. neck: jvp not elevated. no lympadenopathy. cv: regular rate and rhythm, esm murmur best heard at right 2nd intercostal space radiating to carotid, no rubs or gallops pulm: clear and good a/e bilaterally, no wheezes or rales or rhonchi. abd: soft, non-tender, non distended, bowel sounds present. no hepatosplenomegaly extr: no edema, 2+ dorsalis pedis and radial pulses bilaterally. neuro: alert and oriented to person and place. somehow oriented to time. grossly intact. skin: no ulcerations or rashes noted. pertinent results: 04:35pm blood wbc-9.2 rbc-4.28 hgb-12.6 hct-38.7 mcv-91 mch-29.5 mchc-32.6 rdw-13.6 plt ct-222 04:35pm blood neuts-84.8* lymphs-9.8* monos-4.0 eos-0.2 baso-1.3 04:35pm blood pt-11.6 ptt-21.9* inr(pt)-1.0 04:35pm blood glucose-114* urean-51* creat-1.1 na-146* k-5.0 cl-100 hco3-38* angap-13 04:51pm blood lactate-1.4 k-4.3 06:23pm blood type-art po2-72* pco2-82* ph-7.31* caltco2-43* base xs-11 09:47pm blood type-art po2-63* pco2-52* ph-7.49* caltco2-41* base xs-13 02:53am blood type-art po2-177* pco2-66* ph-7.41 caltco2-43* base xs-14 06:06am blood type-art po2-97 pco2-81* ph-7.33* caltco2-45* base xs-12 cxr -> large hiatal hernia, scoliosis, small lung volumes, patch opacity in lul/lll (infection versus compressive atalectasis) 10:05am blood wbc-7.2 rbc-4.00* hgb-11.1* hct-35.2* mcv-88 mch-27.8 mchc-31.6 rdw-14.0 plt ct-275 10:05am blood glucose-118* urean-33* creat-0.8 na-143 k-4.7 cl-101 hco3-35* angap-12 brief hospital course: 82 yo f with severe as, pulmonary hypertension, chf presenting with tachynea and hypoxia admitted to the micu with hypoxic respiratory distress. . # hypoxia: patient with acute on chronic hypoxic respiratory distress. it was initially presumed that it is due to pneumonia (cap vs aspiration)or viral uri superimposed on her end stage restrictive lung disease. initial abg with chronic respiratory alkalosis was likely due to pt's restrictive lung disease. the patient was started on treatment for presumed aspiration pneumonia with cftx/levofloxacin and was placed on bipap which she tolerated well and transitionted to facemask with o2 supplementation. lasix was held during hospitalization because it is believed that the patient is preload dependent. after improvement in the micu, she was transferred to the medical where she further improved in her overall status. antibiotics were discontinued after being on the medical floor since the patient was afebrile and no leukocytosis or other indication of an infection. her home medications were continued during her in-hospital stay except for lasix. lasix was restarted on discharge to be every other day 20mg orally. also albuterol & ipratropium nebulizers were administered also. . # altered mental status: likely due to hypoxic respiratory distress and possible pneumonia. only recent medication change had been tapering of her zyprexa. patient was treated for presumptive pneumonia initially. she was continued on remeron. . # aortic stenosis: critical as with 0.8 cm^2 on recent tte (). possible candidate for valvuloplasty if as worsens. patient was likely a pre-load dependent, so was not aggressively diuresed. home lasix was held during hospitalization and restarted on discharge to be every other day 20mg orally. she was continued on beta blocker. she will be having an echocardiogram as outpatient, and then to be evaluated by a cardiologist for candidacy for valvuloplasty. . # restrictive lung disease: likely has end stage restrictive lung disease with markedly reduced fev1 and fvc on pfts, which is most likely due to her scoliosis. albuterol, ipratroprium nebs were given while in-hospital. # chf: ef 35-40%, on recent tte on noted to have ef of 65%. followed by dr. . home lasix was held during hospitalization and restarted on discharge to be every other day 20mg orally. continued carvedilol. . # cad: continued aspirin, statin, beta-blocker . # pulmonary hypertension: not on sildenafil due to cost. . # depression: continued remeron. . # htn: carvedilol and amlodipine continued . # hypercholesterolemia: continued simvastatin. medications on admission: amlodipine 5 mg po daily carvedilol 6.25 mg po bid lasix 20 mg po daily mirtazapine 5 mg po qhs oxygen 2 l/min as needed for sleep discharge medications: 1. carvedilol 3.125 mg tablet sig: two (2) tablet po bid (2 times a day). 2. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 3. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 4. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 5. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 6. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: puff inhalation every six (6) hours as needed for shortness of breath or wheezing. disp:*1 puffer* refills:*0* 7. lasix 20 mg tablet sig: one (1) tablet po every other day. discharge disposition: home with service facility: vna discharge diagnosis: severe aortic stenosis pulm hypertension scoliosis chronic hypoxia (on intermittent home o2, 2 l o2 nc when o2 sats < 88%) discharge condition: code: full mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear mrs , you were admitted to the hospital because you were breathing fast and your blood oxygen level was low. initially you were admitted to the medical icu where you were started on treatment for presumed aspiration pneumonia and were put on a machine to help you breath. you became progressively better during your stay in the icu, then you were transferred to general medical floor with supplemental oxygen. in the medical floor, you improved further. you were seen by physical therapy who recommended getting physical therapy at home. your lasix is changed to 20 mg orally every other day. you were given a prescription for a breathing treatment which you can use if you wheeze or feel short of breath. you will be having an echocardiogram as outpatient, and then to be evaluated by a cardiologist regarding your narrow valve management. followup instructions: you have the following appointments scheduled: department: gerontology when: wednesday at 9:30 am with: , rnc building: lm campus: west best parking: garage this appointment is with a member of dr. team as part of your transition from the hospital back to your primary care provider. this visit, you will see your regular primary care provider. department: cardiac services when: thursday at 1 pm with: echocardiogram building: sc clinical ctr campus: east best parking: garage department: cardiac services when: thursday at 2:00 pm with: , np building: sc clinical ctr campus: east best parking: garage procedure: non-invasive mechanical ventilation diagnoses: other primary cardiomyopathies pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension aortic valve disorders depressive disorder, not elsewhere classified hypopotassemia diaphragmatic hernia without mention of obstruction or gangrene acute respiratory failure pneumonitis due to inhalation of food or vomitus primary pulmonary hypertension hyperosmolality and/or hypernatremia acute on chronic systolic heart failure atherosclerosis of native arteries of the extremities, unspecified diverticulosis of colon (without mention of hemorrhage) 

Answer: The patient is high likely exposed to