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: amlodipine attending: chief complaint: 81 yo f smoker w/ copd, severe tbm, s/p tracheobronchoplasty s/p perc trach major surgical or invasive procedure: bronchoscopy 3/31,4/2,3,, , s/p trachealplasty percutaneous tracheostomy after failed extubation down size trach on to size 6 cuffless history of present illness: this 81 year old woman has a history of copd. over the past five years she has had progressive difficulties with her breathing. in she was admitted to for respiratory failure due to a copd exacerbation. due to persistent hypoxemia, she required intubation and a eventual bronchoscopy on revealed marked narrowing of the airways on expiration consistent with tracheomalacia. she subsequently underwent placement of two silicone stents, one in the left main stem and one in the trachea. during the admission the patient had complaints of chest pain and ruled out for an mi. she was subsequently discharged to for physical and pulmonary rehab. repeat bronchoscopy on revealed granulation tissue at the distal right lateral wall of the tracheal stent. there was significant malacia of the peripheral and central airways with complete collapse of the airways on coughing and forced expiration. small nodules were also noted on the vocal cords. she has noticed improvement in her respiratory status, but most recently has been in discussion with dr. regarding possible tracheobronchial plasty with mesh. tracheal stents d/c in anticipation of surgery. in terms of symptoms, she describes many years of intermittent chest pain that she describes as left sided and occurring at any time. currently, she notices it about three times a week, and states that it seems to resolve after three nitroglycerin. she currently is dependent on oxygen and wears 1.5-2 liters around the clock. she has frequent coughing and brings up "dark sputum". past medical history: copd flare s/p intubation, s/p distal tracheal to left main stem stents placed . stents d/c'd , cad w/ atypical angina (lad 30%, rca 30%, ef 63%), ^chol, hypothyroidism, htn, hiatal hernia, lacunar cva, s/p ped struck -> head injury & rib fx, depression pmh: copd, s/p admit for exacerbation requiring intubation tracheobronchomalacia, s/p bronchial stenting large hiatal hernia lacunar cva hypothyroidism by records in ccc, although patient denies and is not taking any medication depression mva, s/p head injury approximately 10 years ago hypertension hysterectomy social history: social history: the patient is married and worked as a clinical psychologist. her husband is a pediatric neurologist at . they have several children, one of which is a nurse. family history: family history: (+) fhx cad; father with an mi in his 40's, died of a cva at age 59 physical exam: admit h+p general-lovely 81 yr old feamle in nad. neuro- intermittently anxious, mae, perrla, l eye ptosis, symetrical smile, gossly intact. heent-perrla, sclera anicteric, pharynx- no exud or erythema resp-clear upper, diffuse ronchi, intermit exp wheezes cor- rrr, no m, r, g abd- soft, nt, nd, no masses. slight protrusion at area of hiatal hernia ext- no edema or clubbing brief hospital course: 82 y/o female admitted for consideration of tracheoplasty. bronchoscopy done confirming severe tbm. underwent tracheoplasty , complicated by resp failure d/t mucous plugging, hypoxia requiring re-intubation resulting in prolonged icu and hospital course. also developed right upper extrem dvt from mid line. pain- epidural accidently d/c'd pod#1, pt briefly used dilaudid pca intermittently w/ fair pain control. pt required re-intubation for resp failure d/t secretions and pca d/c at that time. propofol for sedation while intubated. sedation d/c'd for weaning trial w/ ett- failed trial. trach -weaning efforts as below. minimal c/o pain since . presently pain free. neuro- initially intact- post op aggitation, inhibiting weaning efforts . psych eval -started on zyprexa and ativan w/ improvement in anxiety. presently a+ox3- cooperative and lovely. resp- extubated pod#2 then required re-intub for hypoxia d/t poor cough and mucous plugging. simv/ps alt w/cmv at night x4-5d, with cpap attempts during day. bronchoscopy qd for secretion management. bronch revealed swollen epiglottis, bronch - good leak w/ ett cuff deflated. bronch for eval/trach placement. last bronch w/ min secretions present, sputum sent. perc trach done(#8 portex- cuffed low pressure maintained to preserve tracheoplasty site). cpap15/peep5 initiated post trach placement. weaning ongoing. - aggressive weaning w/ increasing episodes of cpap, progressing to trach mask. -trach mask overnight w/ no episodes of sob, or hemodynamic instability. trach changed to #6 portex- capped and well x48hrs on 2lnp. productive cough. aggressive pt as well w/ oob > chair -tid to total 4-6hr qd. ambulation ~100-120 ft w/ pt assist. id- vancomycin started post-op for graft prophylaxis. fever spike w/ bal & sputum sent> + mrsa. vanco cont to weeks post trachealplasty. fever low grade , > cultured- no new results. - wbc 20.8 . cardiac-hypertension controlled w/ hydralazine iv, then d/c and cont controlled. hr 65-75 nsr. avoiding b blockers. lasix 20mg iv qd. - rue redness and swelling at site of midline, rue dvt by ultrasound, midline d/c; heparin gtt started and therapeutic range monitored. changed to lovenox sq . coags in good control (48.2/13.8/1.2) access- r midline placed for access- clotted and d/c'd. rue redness and swelling and dvt via ultrasound. - l brachial picc line placed- tpn resumed. gi-large hiatal hernia- unable to place enteral feeding tube at bedside or underfluoro. re-attempt by egd doboff tube placed distal esophagus, dislodged in 12hours and removed. nutrition- ppn/tpn initiated - . picc placed . speech and swallow eval - rec change trach form #8 to #6 portex to allow improved epiglotis and oropharyngeal movement to assist w/ swallowing. then re-eval. trach changed to #6 cuffless portex trach. passed repeat swallow eval and diet of regular solids w/ thin liquids- chin tuck to swallow thin liquids. give meds whole w/ apple sauce. would recommend repeat video swallow eval in days to possibly eliminate chin tuck- see page 3 referral. endo- hypothyroid, maintained on levoxyl. muscu/skel- oob> chair 4-6hours/day, pt consulting. medications on admission: advair 250/50", atrovent, imdur 60', lasix 40', lexapro 20', lipitor 10', prilosec 20', mucinex 600", synthroid 75', detrol la 4', ambien 5', trazadone 75', melatonin prn discharge medications: 1. albuterol sulfate 0.083 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for wheezing. 2. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for wheezing. 3. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 4. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 5. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 6. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 7. sodium chloride 0.65 % aerosol, spray sig: sprays nasal qid (4 times a day) as needed. 8. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical tid (3 times a day) as needed. 9. enoxaparin sodium 60 mg/0.6ml syringe sig: one (1) subcutaneous q12h (every 12 hours). 10. trazodone hcl 50 mg tablet sig: 1.5 tablets po hs (at bedtime) as needed. 11. escitalopram oxalate 10 mg tablet sig: two (2) tablet po daily (daily). 12. nystatin 100,000 unit/g cream sig: one (1) appl topical (2 times a day). 13. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 14. tolterodine tartrate 2 mg tablet sig: one (1) tablet po bid (2 times a day). 15. levothyroxine sodium 75 mcg tablet sig: one (1) tablet po daily (daily). 16. heparin lock flush (porcine) 100 unit/ml syringe sig: one (1) ml intravenous daily (daily) as needed. discharge disposition: extended care facility: & rehab center - discharge diagnosis: copd, coronary artery disease/atypical angina (lad 30%, rca 30%, ef 63%), hypercholesterolemia, hypothyroidism, hypertension, hiatal hernia, cerebral vascular accident,s/p motor vehicle colision-> head injury & rib fracture. tbm- s/p tracheoplasty. discharge condition: good discharge instructions: please update dr. office for: fever, shortness of breath, chest pain , productive cough or if you have any questions or concerns. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances arterial catheterization other intubation of respiratory tract other intubation of respiratory tract other intubation of respiratory tract other intubation of respiratory tract other intubation of respiratory tract other intubation of respiratory tract other intubation of respiratory tract temporary tracheostomy other repair and plastic operations on trachea injection or infusion of oxazolidinone class of antibiotics diagnoses: acidosis chronic airway obstruction, not elsewhere classified diaphragmatic hernia without mention of obstruction or gangrene acute venous embolism and thrombosis of unspecified deep vessels of lower extremity 

Answer: The patient is high likely exposed to