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: oxycodone / morphine attending: chief complaint: change in mental status, shortness of breath major surgical or invasive procedure: bronchoalveolar lavage intubation history of present illness: 78 f recent hospitalization for cellulitis, was at and doing well with the exception of a mild cough this past week. this morning, she was noted to be more somnolent and with a cough productive of green sputum. . she was transferred to the ed where she was noted to be febrile to 102 and tachycardic to 105. she initially received 2 mg narcan with minimal effect. cxr showed multifocal lower lobe patchy opacities. she received ceftaz & vancomycin. she was intubated for respiratory distress. she briefly became hypotensive while on propofol, but responded to 3l ns. . on arrival to icu, again noted to be hypotensive to sbp 70s. propofol stopped, and started on levophed but was quickly weaned off. past medical history: 1. spinal stenosis 2. depression 3. hypothyroidism 4. status post bilateral adrenalectomy secondary to b/l pheos 5. history of tuberculosis at age 16 6. chronic headaches 7. melanoma 8. recurrent urinary tract infection 9. b/l knee replacement first in , second in . 10. gerd social history: currently living at . married for 55 years to . daughter (hcp) family history: nc physical exam: physical examination on arrival vs - t 96.8, bp 112/55, hr 80 100% on ac 500x14, fio2 1.0, peep 5 general - intubated & sedated, but opens eyes to voice, nods to yes/no questions heent - et tube and rij in place, perrl cv - rrr, no m/r/g chest - coarse ventilated breath sounds abd - obest, soft, nt/nd ext - bilat chronic venous stasis on discharge, the patient was awake, alert and oriented. her vital signs were stable. she was afebrile. breathing was unlabored. her bilateral lower extremities had skin changes consistent with chronic venous stasis. pertinent results: echo (): the left atrium is mildly dilated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. ct head (): no evidence of intracranial hemorrhage, mass effect, shift of midline structures, hydrocephalus, or acute major vascular territorial infarcts. -white matter differentiation is well preserved. small calcific density within the posterior left parietal lobe may represent old sequelae of infection, trauma, or thrombosed vascular anomaly. soft tissues and osseous structures appear unremarkable. there is pooling of secretions within the oropharynx consistent with patient's intubated status. mri/mra (): no evidence for acute ischemia. ct abdomen/pelvis/chest: 1. no evidence of abdominal or pelvic abscess. 2. the endotracheal tube is located 1 cm above the carina. 3. bilateral pleural effusions are noted. 4. there is a marked amount of stool noted within the rectum and sigmoid colon. 5. there is extensive degenerative change noted in the humeral head bilaterally. 6. there is bronchomalacia of the carina as well as the right and left bronchus. 7. hyperdensities in the lower posterior lung fields may represent barium aspiration or sequelae of prior granulomatous disease. 8. pulmonary artery enlargement. . 06:28am blood wbc-9.4 rbc-3.88* hgb-9.7* hct-30.1* mcv-78* mch-24.9* mchc-32.1 rdw-15.8* plt ct-504* 06:28am blood glucose-84 urean-10 creat-0.8 na-142 k-3.3 cl-103 hco3-32 angap-10 01:55am blood alt-9 ast-12 alkphos-62 totbili-0.4 06:28am blood calcium-9.0 phos-2.8 mg-2.5 brief hospital course: 78 year old female who was originally admitted with fever, respiratory distress and acute change in mental status. she was found somnolent at her rehabilitation center, where she has been living since her knee replacement over the summer. she was initially admitted to the intensive care unit where she was intubated for airway protection. she was treated for a presumed multi-focal pneumonia with vancomycin, zosyn and azithromycin given her elevated white blood cell count and fever. while in the icu she had a bal which did not show any evidence of gram negative rods, which had been noted on a previous sputum. cultures from her sputum were negative for legionella, acid fast bacilli and pcp. addition on presentation, the patient was hypotensive, which resolved with fluids, antibiotics and stress dose steriods. she then developed episodes of hypertension during sedative weaning. the patient was started on beta blocker to help with hypertension. chest x-ray after extubation demonstrated evidence of mild pulmonary edema. she was diuresed with a slightly higher dose of lasix (compared to her home dose). the patient also had a cardiac work-up to exclude acute coronary disease as well as an echo, which did not show any evidence of an acute process. after extubation, her altered mental status persisted, prompting an evaluation by the neurologists. she had a negative head ct as well as an mri which was also negative for any acute process. as the infection cleared as well as sedating medication, her mental status cleared to her baseline. the patient has baseline anemia which has been stable over the course of this admission. the patient was admitted on coumadin which was started by her orthopedic doctors after a recent total knee replacement in . the coumadin was held during this admission until the records were obtained. once records were obtained verifying the reason for anti-coagulation, the patient was restarted on her home dose of coumadin. goal inr per ortho is between 2 and 3 and should be maintained for six months. the patient also experienced renal insufficiency which resolved with intravenous fluids to normal. the patient has baseline adrenal insufficiency; secondary to bilateral adrenalectomy. she was initially started on higher doses of her home medications to treat with stress dose steriods. she has been transitioned to her home doses of corticosteroids, fludrocortisone, and levothyroxine. given her long standing history of constipation, the patient was maintained on an aggressive bowel regimen. she has been moving her bowels daily. daughter, (cell) or (home) medications on admission: hydrocort 20 qam, 10 qpm zyprexa 1.25 qam synthroid 175 qam iron 325 qam fludrocort 0.1 qam discharge medications: 1. senna 8.6 mg tablet sig: two (2) tablet po bid (2 times a day). 2. levothyroxine 175 mcg tablet sig: one (1) tablet po daily (daily). 3. hydrocortisone 5 mg tablet sig: four (4) tablet po qam (once a day (in the morning)). 4. furosemide 20 mg tablet sig: one (1) tablet po once a day. 5. fluoxetine 10 mg capsule sig: one (1) capsule po daily (daily). 6. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 7. gabapentin 300 mg capsule sig: two (2) capsule po hs (at bedtime). 8. fludrocortisone 0.1 mg tablet sig: one (1) tablet po daily (daily). 9. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 10. potassium please take 20 mg by mouth daily 11. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 12. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 13. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 14. hydrocortisone 5 mg tablet sig: two (2) tablet po qpm (once a day (in the evening)). 15. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 16. tolterodine 1 mg tablet sig: two (2) tablet po daily (daily). 17. warfarin 2 mg tablet sig: two (2) tablet po daily16 (once daily at 16). 18. multivitamin capsule sig: one (1) capsule po once a day. 19. methadone the patient has not been taking methadone as an inpatient, however she has used it in the past for pain control. the patient may take methadone 20 mg po tid as needed for pain. 20. ondansetron 4 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po q8h (every 8 hours) as needed for nausea. 21. olanzapine 2.5 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for agitation. 22. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed. 23. albuterol sulfate 0.083 % (0.83 mg/ml) solution sig: one (1) puff inhalation q4h (every 4 hours) as needed. 24. miralax 17 gram po daily prn constipation discharge disposition: extended care facility: - discharge diagnosis: primary diagnosis: pneumonia with respiratory failure secondary diagnosis: 1. spinal stenosis 2. depression 3. hypothyroidism 4. status post bilateral adrenalectomy secondary to b/l pheos 5. b/l knee replacement first in , second in . 6. gerd discharge condition: stable, saturating well on room air discharge instructions: you were admitted to the hospital for change in mental status. when you arrived to the hospital you were found to have a fever and a fast heart rate. because of your difficulty breathing, you were intubated to help you breathe. while you were in the hospital you were maintained on most of your outpatient medications. we held your methadone because your mental status was altered. we also started a medication named metoprolol because your blood pressure was slightly high. please continue your outpatient medications as prescribed by your doctors. followup instructions: please follow up with dr. on at 2:30 pm. . please follow up with your orthopedic doctors as needed. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube closed [endoscopic] biopsy of bronchus insertion of (naso-)intestinal tube diagnoses: pneumonia, organism unspecified abnormal coagulation profile anemia, unspecified esophageal reflux congestive heart failure, unspecified acute kidney failure, unspecified unspecified acquired hypothyroidism depressive disorder, not elsewhere classified hypopotassemia constipation, unspecified acute respiratory failure hypotension, unspecified metabolic encephalopathy acute diastolic heart failure accidents occurring in residential institution knee joint replacement tachycardia, unspecified venous (peripheral) insufficiency, unspecified other diuretics causing adverse effects in therapeutic use other adrenal hypofunction malignant melanoma of skin of lower limb, including hip 

Answer: The patient is high likely exposed to