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: codeine / penicillins / aspirin / fentanyl attending: chief complaint: elective bronchoscopy major surgical or invasive procedure: bronchoscopy x2 with biopsy of lul mass intubation arterial line central venous line history of present illness: 80 year old woman with past medical history significant for broncheoalveolar carcinoma who was undergoing an elective bronchoscopy for biopsy of a lul mass on . approximately ~45 minutes into procedure, the patient became hypertensive , rigid and unresponsive, with oxygen saturations falling into the 50s. these symptoms resolved immediately once the bronchoscope was removed and she was bagged. she was given hydralazine iv with improvement in her sbp from 2227 to 125. she was subsequently intubated for airway protection. the patient had received 3.5mg versed and 100mg fentanyl over 45 minutes. noted by ip staff to be very difficult to ventillate when bagmask initiated. she was transferred to the micu with what was thought to be a dystonic reaction to fentanyl. she was noted to have a right sided neck mass after cvl placement (during which the subclavian artery was hit) and underwent an u/s which did not show a hematoma. she was also noted to have very labile bps with systolics going into the 80s after propofol. an arterial line was placed. she was briefly placed on neo with resultant sbps in the 220s and then controlled on a labetolol gtt; once bps were well controlled she was transitioned to po meds (norvasc, isordil). she was extubated without incident on . she was also noted to have a uti (gnr) and was started on ciprofloxacin. past medical history: 1. chronic obstructive pulmonary disease. 2. bronchoalveolar carcinoma; status post right and left upper lobectomies. 3. hypothyroidism. 4. history of strokes and transient ischemic attacks. 5. parkinson disease. 6. claudication. 7. cervical myelopathy; status post anterior disc excisions and fusions at c3-c4, c4-c5, and c5-c6. 8. hypertension. 9. osteoarthritis. 10. status post right total hip replacement in . 11. history of drop attacks; previously on dilantin but this was stopped and she has had no further symptoms. 12. obstructive sleep apnea; on continuous positive airway pressure at home. 13. restless leg syndrome. social history: the patient lives in in springhouse. she is widowed. she has no children. she smoked three quarters of a pack per day for 45 years; she quit in . she drank wine, one to three glasses per day, for 30 years until several months ago. no history of illicit drug use. she is a retired lawyer. family history: father died of gastric cancer in his 70s. mother died of a myocardial infarction in her 60s. physical exam: tm 99.2 bp 133-193/51-83 hr 69-80 rr 15 o2sat 96%ra gen: reclining in bed, nad. very gravelly voice. heent: perrl, eomi, op clear, mmm neck: non tender right sided neck bulge, +subclavian line. cv: regular, s1s2 2/6 sem at rusb lungs: coarse breath sounds bilaterally abd: soft, ntnd, +bs ext: w/wp, no edema neuro: alert and oriented x3. pertinent results: chemistries 03:55pm glucose-104 urea n-28* creat-1.8* sodium-144 potassium-4.0 chloride-107 total co2-27 anion gap-14 03:55pm calcium-8.8 phosphate-4.0 magnesium-1.8 cbc 03:55pm wbc-7.6 rbc-3.80* hgb-11.9* hct-33.8* mcv-89 mch-31.3 mchc-35.2* rdw-13.6 03:55pm plt count-350 coags 03:55pm pt-12.2 ptt-25.3 inr(pt)-0.9 03:50am blood ck(cpk)-43 04:28am blood ck(cpk)-130 03:50am blood ck-mb-2 ctropnt-<0.01 04:28am blood ck-mb-3 ctropnt-<0.01 10:40 am urine culture > 100,000 klebsiella, i to nitrofurantoin, s to all else. bronch complications: muscle rigidity secondary to fentanyl resulting in hypoxemia, airway obstruction and respiratory failure. bronch description of procedure: the bronchoscope was inserted via the endotracheal tube which terminated 2 cm proximal to the carina. the right-sided airways were within normal limits, as was the trachea and left mainstem bronchus, except the presence of severe tracheobronchomalacia. the left lower lobe was patent, however, the left upper lobe lingular bronchus was completely obstructed. endobronchial biopsies of the soft tissue mass were obtained and sent to pathology. complications: none. tissue biopsies of lul pending on discharge brief hospital course: 80 year old woman with complicated pmh including broncheoalveolar carcinoma for which she was undergoing an elective bronchoscopy when she had an episode of rigidity, hypertension and desaturation attributed to a dystonic reaction to fentanyl and was subsequently intubated and in the micu. s/p extubation she was transferred to the floor for observation prior to discharge back to . dystonic reaction the patient's rigidity, desaturation and hypertension were thought to be due to a dystonic reaction to fentanyl. she was intubated for airway protection and extubated without diffuculty. she subsequently maintained her oxygen saturations on room air. fentanly was added to the patient's allergies. broncheoalveolar cancer the patient successfully underwent bronchoscopy the day after her dystonic reaction and biopsy specimens were obtained of her lul mass. these were pending on discharge. right neck mass after right sided central line placement, complicated by puncture of the subclavian artery, the patient was noted to have a right sided neck mass. this mass was non tender and stable in size, however, a neck u/s was done to rule out hematoma/aneurism and was negative. this should be followed as an outpatient. labile bp the patient has a history of hypertension and was on isordil and norvasc as an outpatient. during her dystonic reaction her systolic pressure went as high as 225, she was given 10mg iv diltiazem with good effect and systolic pressure returning down to 125. subsequently her icu course was complicated by lability in blood pressures, with systolics falling to the 80s with administration of propofol. for this the patient was briefly on a neo gtt and pressures again went >200 for which she was on a labetolol gtt. prior to leaving the micu her pressures were stabilized on her home medications and remained well controlled through the remainder of her stay. uti in the micu, the patient was noted to have a urinary tract infection growing gram negative rods. she was started on a 7 day course of ciprofloxacin for a complicated uti, which grew out klebsiella that was pan sensitive (i to nitrofurantoin). elevated cr peaked at 2.2 and trended down; likely uti and prerenal. osa the patient will resume her cpap at night on discharge (she declined it here). ?dementia continued aricept. hypothyroidism. continued levoxyl. claudication. continue pletal. gerd continue prevacid. access radial line dc'd . right subclavian central line dc'd on . communication with patient and nephew, . discharged back to with her 24 hour caregiver. medications on admission: methylphenidate 10mg aricept 10mg qhs mvt norvasc 10mg daily zocor 40mg daily lexapro 20mg daily pletal 100mg levoxyl 50mg daily prevacid 30mg daily loratidine 10mg daily isordil 10mg tid discharge medications: 1. donepezil hydrochloride 5 mg tablet sig: two (2) tablet po hs (at bedtime). 2. methylphenidate hcl 5 mg tablet sig: two (2) tablet po bid (2 times a day). 3. multivitamin capsule sig: one (1) cap po daily (daily). 4. amlodipine besylate 5 mg tablet sig: two (2) tablet po hs (at bedtime). 5. escitalopram oxalate 10 mg tablet sig: two (2) tablet po daily (daily). 6. simvastatin 40 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 7. pletal 100 mg tablet sig: one (1) tablet po twice a day. 8. levothyroxine sodium 50 mcg tablet sig: one (1) tablet po daily (daily). 9. prevacid 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 10. isosorbide dinitrate 10 mg tablet sig: one (1) tablet po tid (3 times a day). 11. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 4 days. disp:*4 tablet(s)* refills:*0* discharge disposition: home with service discharge diagnosis: 1. respiratory failure requiring intubation reaction to fentanyl 2. labile hypertension 3. catheter associated uti 4. tracheobronchomalacia 5. copd discharge condition: stable discharge instructions: 1. please f/u with your pcp (dr. or dr. in the next week. call to schedule an appointment 2. please note that you are allergic to a medicine called fentanyl. please list it as an allergy on all medical papers. 3. you have been diagnosed with a bladder infection. please take the antibiotic cipro for next 5 days. 4. take all other medications as previously prescribed. 5. call dr. should you develop worsening shortness of breath, chest pain, blood sputum. 6. call your pcp if you develop painful swallowing or swelling of the mouth or worsened swelling of the right side of the face. followup instructions: call dr. office at ( to schedule a follow up appointment in 1 week. keep the following appointment: provider: , orthopedic private practice where: orthopedic private practice date/time: 2:30 md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed endoscopic biopsy of lung diagnoses: anemia, unspecified urinary tract infection, site not specified acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified malignant neoplasm of upper lobe, bronchus or lung other diseases of lung, not elsewhere classified infection and inflammatory reaction due to indwelling urinary catheter 

Answer: The patient is high likely exposed to