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 attending: chief complaint: hypotension major surgical or invasive procedure: chest tube placement vats intubation history of present illness: this is an 87 f with h/o htn, asthma, gerd, ibs, gait d/o who initially p/w fever, sob, s/p fall x 2 with generalized weakness. she was admitted on for increasing sob, fevers and s/p fall. initial imaging-head ct negative, initial cxr found to have a large l-sided pleural effusion. per chest ct noted to have loculated pleural effusion and lungs that appeared to be tacked to pleural surface. diagnostic thoracentesis (5-10cc) clear fluid grew out strep milleri, sensitivities pending. she was started on levo () and flagyl() for lll pna. she's remained febrile although fever curve trending down. per ct surge she underwent a vats on . intra-op 1 liter of straw colored fluid removed from l-pleural space, partial lung decortication & removal of pleural fibrin, also ~400cc estimated blood loss. 2 chest tubes were placed in l pleural space-left to water suction. she received 1 uprbc intra-op. she was extubated post operatively but remained on neosynephrine for low sbp. . pacu course: pt was mentating well, only c/o some chest discomfort at site of l chest tubes. she denied any cp/palpitations. her sob seemed improved to her. she denied any n/v/abdominal pain. no diarrhea. no dysuria. no ha/confusion. . past medical history: hypertension asthma gerd ibs rls gait disorder spinal stenosis shingles with residual neuralgia le neuropathy uti 2 months ago colonoscopy last year without concern for cancer hyperlipidemia insomnia 2 back surgeries for spinal stenosis (, ) social history: lives alone in an facility. walks with a walker. former smoker (quit 20 yrs ago, 18 pack years)-1ppevery 3 days x15years; no etoh . family history: mother with breast ca in 80s and father with ca in 80s. physical exam: vitals: t: 98.1 p: 86 bp: 130/60 r: 20 sao2: 94% on 4l general: awake, alert, nad. heent:perrl, eomi, dry mm resp: diffuse rhonchi w/diminished bs b/l l base>r, no expiratory/inspiratory wheezing cv: reg, nml s1s2, no m/r/g abdomen: soft, nt/nd, + bowel sounds, no rebound/guarding extremities: no c/c/e, warm, 1+dp pulses b/l skin: abrasion on forehead neurologic: a&o x3, no focal deficits, cn ii-xii intact pertinent results: 01:24pm pt-14.8* ptt-33.1 inr(pt)-1.3* 01:07pm lactate-1.4 12:30pm urine color-yellow appear-clear sp -1.018 12:30pm urine blood-neg nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.0 leuk-neg 12:30pm urine rbc-0 wbc-0 bacteria-occ yeast-none epi-<1 12:30pm urine hyaline-<1 12:15pm glucose-147* urea n-28* creat-1.0 sodium-130* potassium-3.6 chloride-90* total co2-24 anion gap-20 12:15pm estgfr-using this 12:15pm ck(cpk)-404* 12:15pm ctropnt-<0.01 12:15pm ck-mb-5 12:15pm wbc-25.9*# rbc-3.29* hgb-10.8* hct-29.5*# mcv-90 mch-32.7* mchc-36.4*# rdw-13.2 12:15pm neuts-92.1* bands-0 lymphs-4.0* monos-3.6 eos-0.2 basos-0 12:15pm hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 12:15pm plt smr-normal plt count-333 ekg: v1-rsr', nsr, twi v3-no new changes, no st-t segment changes . radiologic data: ct c-spine impression: no acute fracture. degenerative changes. loss of normal cervical lordosis is likely positional due to patient's spine collar. ct head: impression: no intracranial hemorrhage or mass effect. no fracture identified. ct pelvis: impression: 1. grade 2 anterolisthesis of l4 on l5. this is increased compared with prior exam dated , at which time it was grade 1. the acuity of this displacement is not clearly defined on the ct scan. 2. small left pleural effusion with compressive atelectasis at the left lower lobe. 3. dense atherosclerosis. . cxr (pa/lat) impression: large left pleural effusion. associated left lower lobe consolidation could be secondary to compressive atelectasis, however, an underlying pneumonia cannot be excluded. . . chest port. line placement 3:38 pm right picc line has been placed, with tip terminating in the mid superior vena cava. cardiac silhouette remains enlarged. chf has improved. left retrocardiac consolidation is also slightly improved. a moderate left and small right pleural effusions are unchanged. impression: right picc line terminates in superior vena cava. brief hospital course: ms. is an 87 year old woman with history of asthma, htn, gerd, and gait disorder who presented with falls, fever, and found to have lll pna with loculated parapneumonic effusion requiring vats decortication. hospital course was complicated by post-operative hypotension requiring pressors and admission to the micu. she was stabilized and moved to the general medical floor for further treatment of cultures growing strep milleri. . #) community acquired pneumonia with loculated parapneumonic effusion: strep milleri from diagnostic thoracentesis. she was treated initially with levofloxacin and metronidazole and underwent vats-decortication and chest tube placement. given post-operative hypotension, antibiotic coverage was broadened to clindamycin/vancomycin/ciprofloxacin. upon stabilization and transfer to the floor her she was changed to vancomycin. strep milleri did not successfully grow in culture and sensitivity data was not able to be obtained. picc line was placed for planned 14 day course of vancomycin. she has 7 days remaining of vancomycin therapy at time of discharge. . . #)mediastinal lymphadenopathy: the patient's initial chest ct noted mediastinal lymphadenopathy. though this is likely reactive in the setting of parapneumonic effusion, an interval chest ct should be obtained 1 month following discharge. . #. hypotension: most likely in setting of volume loss and volume shifts as 1l fluid was removed from vats in addition to 400cc blood loss intra-op. pt responded well to iv fluids in pacu w/transient period off neo once arrived to micu. no evidence of cardiac etiology-no ekg changes, no changes in cardiac enzymes. no tachycardia, no cp, or changes in o2 require to suggest pe. lactate level was not elevated. pt was weaned from pressors without incident. . #) asthma: no pft data available on admission, with history seemed more consistent with chronic obstructive lung disease. we maximized therapy with singulair, pulmicort neb, ipratropium nebulizer, albuterol nebulizer. if not already obtained, the patient should have outpatient pft's to guide management in the future. . #) fall: ct head on admission without any evidence of bleeding. no focal neurological deficits. . #) anemia: iron studies consistent with acute inflammatory state. had 1 unit prbc transfused intraoperively. pt's hematocrit was trending upwards at time of discharge. stools guaiac negative. . #) hyperglycemia: patient had elevated bg's in the setting of acute infection as no history of diabetes. we measured her finger sticks qid, and maintained humalong sliding scale as needed. at time of discharge she did not have an insulin requirement. . #) hyperlipidemia: we continued atorvastatin . #) chronic back pain: we continued neurontin . #) code status: the patient is full code (discussed w/patient in micu and w/grandaughter-hcp . #) communication: hcp (grand daughter) (; (; (son) (; (. medications on admission: atenolol 50 mg q.d. neurontin 300 mg four pills four times a day singulair 10 mg at nighttime lipitor 10 mg at night trazodone 50 mg bedtime nexium 40 mg daily hydrochlorothiazide 12 1/2 mg a day dicyclomine 10 mg po before meals vicodan 1 q 4 hrs prn pain pulmicourt (0.5 mg) 1 neb duoneb q 4-6 hrs prn centrum silver b complex oscal vitamin c. discharge medications: 1. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 2. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 4. budesonide 0.5 mg/2 ml solution for nebulization sig: one (1) ml inhalation (). 5. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 6. hexavitamin tablet sig: one (1) cap po daily (daily). 7. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 8. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 9. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 10. dicyclomine 10 mg capsule sig: two (2) capsule po tid before meals (). 11. gabapentin 300 mg capsule sig: one (1) capsule po qid (4 times a day). 12. oxycodone 5 mg tablet sig: one (1) tablet po q2h (every 2 hours) as needed. 13. albuterol sulfate 0.083 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for sob. 14. hydrocodone-acetaminophen 5-500 mg tablet sig: one (1) tablet po q4h (every 4 hours): patient may refuse, hold for sedation. 15. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 16. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed. 17. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 10 days. 18. atenolol 50 mg tablet sig: one (1) tablet po once a day. 19. heparin lock flush (porcine) 100 unit/ml syringe sig: one (1) ml intravenous daily (daily) as needed. 20. vancomycin in dextrose 1 g/200 ml piggyback sig: one (1) intravenous q 12h (every 12 hours) for 7 days. 21. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day): only while not ambulating for dvt prophylaxis. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: primary: community acquired pneumonia secondary: asthma coronary artery diseas hyperlipidemia hypertension discharge condition: stable. discharge instructions: you were admitted after a fall and found to have a severe pneumonia that required placement of a chest tube for drainage. you were given intravenous antibiotics and medicines to help support your blood pressure in the icu. on the general medicine floor we gave you antibiotics and continued with breathing treatments. . please take all of your medications as prescribed. . call dr. if you experience any fevers, chills, shortness of breath, severe wheezing, fatigue, worsening weakness, numbness or tingling. followup instructions: please see dr. within a week of discharge from rehab you should have a ct scan of your chest within the next 1-2months to follow up a scan here that showed enlargement of some lymph nodes. md procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified fiber-optic bronchoscopy fiber-optic bronchoscopy other intubation of respiratory tract decortication of lung transfusion of packed cells diagnoses: pneumonia, organism unspecified other iatrogenic hypotension coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia unspecified pleural effusion unspecified essential hypertension acute posthemorrhagic anemia hyposmolality and/or hyponatremia asthma, unspecified type, unspecified abnormality of gait mononeuritis of lower limb, unspecified other and unspecified hyperlipidemia hypoxemia diarrhea hypovolemia enlargement of lymph nodes spinal stenosis, unspecified region empyema without mention of fistula streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, unspecified insomnia, unspecified other diseases of trachea and bronchus irritable bowel syndrome restless legs syndrome (rls) 

Answer: The patient is high likely exposed to