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: keflex / augmentin / amoxicillin attending: chief complaint: respiratory distress major surgical or invasive procedure: none history of present illness: pt is a 74 yo f with pmh of dm, copd, and hx of foot osteo s/p multiple debridements and surgeries admitted with respiratory distress. the pt was found at home today in bed in respiratory distress by her family. ems was called and she was found to have a o2 sat 60% and appeared to be cyanotic. she was given sl ntg and nebulizer and started on bipap in the field. on arrival to ed vitals t 102.2 hr 114 bp 156/60 rr 24 100% 40 fio2. ecg with sinus tachycardia. cxr negative for evidence of pna. she was started on vancomycin and levofloxacin for fever and was given solu-medrol 125 x1. . on arrival to the micu, the patient was in no acute distress. answering questions appropriately. she denies shortness of breath or chest pain. she was alert and oriented to place and time. her family reports that she has increased her tobacco usage over the past week secondary to r hip pain. she was found by her husband and daughter to be gagging, with minimal respiratory effort and appeared to have a blue-tinged color. past medical history: copd/asthma hypertension diabetes type ii peripheral neuropathy history of mrsa osteomyelitis right foot mrsa bacteremia . : bilateral cataracts, debridement of right foot osteomyelitis x3 social history: lives with husband, smokes 2 ppd x 50 years, has recently been under stress and admits to increasing her smoking to 3 ppd. occ etoh, lives in . family history: noncontributory. physical exam: admission exam: vs: t:98.7 r:18 sat:95% on bipap 10/8 bp:162/59 hr:89 gen: nad, well nourished heent: perrla, ncat neck: no lad cv: s1/s2 no murmur, pulses present pulm: wheezes and rhonchi throughout abd: soft ntnd bs + ext: no edema, ttp of r hip bursal sac, no pain on rom pertinent results: admission labs: . blood: 04:07pm glucose-284* urea n-30* creat-1.3* sodium-136 potassium-4.7 chloride-97 total co2-29 anion gap-15 04:07pm calcium-9.0 phosphate-4.2 magnesium-1.7 04:07pm wbc-12.9* rbc-4.91 hgb-15.1 hct-44.7 mcv-91 mch-30.7 mchc-33.8 rdw-13.5 04:07pm plt count-219 01:11pm ctropnt-0.03* 01:11pm ck-mb-9 01:11pm ck(cpk)-120 . urine: 01:30pm urine blood-mod nitrite-neg protein-500 glucose-250 ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 01:30pm urine rbc-* wbc-* bacteria-many yeast-none epi-0 . . discharge labs: cbc:13.3/15.5/45.1/287 chem 7: 142/3.7/102/30/54/1.2/123 imaging: procedure: cta chest with and without contrast on . . comparison: . . technique: pre- and post-contrast examination of the thorax with contiguous axial images from the thoracic inlet to the subdiaphragmatic area, coupled with sagittal/oblique and coronal reformatted images. . history: 74-year-old woman with hypoxemia and tachycardia, please evaluate for pe. . findings: . the pulmonary arteries are well visualized up to the first segmental level showing no pe. beyond that the opacification is faint and so no peripheral pe can be excluded. the aorta is unremarkable in size, showing no evidence of dissection or aneurysmal dilatation. . stable coronary calcifications are again seen. the heart size is within normal limits. mitral annular valve calcification is stable. there is no pleural or pericardial effusion. . the lungs have relatively cleared as previously there was diffuse tree-in- nodularity, indicative of an infectious process. however, there are persistent prominent lymph nodes in the mediastinum and hilar areas stable to slightly increased in size on today's examination. for example, the subcarinal lymph node which is 9.3 mm is stable in size while the 5.4-mm left prevascular lymph node was previously 4.6 mm in size. . mitral annular valve calcification is stable. . new minimal bibasilar atelectasis is seen in both lung fields. . the bony structures do not show any lesion suspicious for malignancy, however, there are significant disc osteophyte complexes seen at multiple thoracic vertebral body levels better appreciated in the sagittal reformatted images. . in the abdomen, stable subcentimeter right adrenal adenoma is noted. no other abnormalities are seen. . impression: 1. negative examination for pe in the major and first segmental branches. 2. almost complete resolution of the infectious process seen in both lungs. 3. persistent but slightly increased bilateral lymphadenopathy. 4. stable pulmonary artery calcifications. 5. stable right adrenal adenoma. . . chest xray : history: 74-year-old female with shortness of breath. . comparison: none available. . portable upright chest radiograph: the heart size is normal and the aortic contour mildly unfolded. the lungs are well expanded, and note is made of patchy infiltrate in the left lung base. no evidence of pneumothorax or large pleural effusion is seen. degenerative changes are noted along the visualized thoracic spine. . impression: patchy infiltrate in the left lung base could be consistent with pneumonia. brief hospital course: pt is a 74 yo f with pmh of dm, copd, and hx of foot osteo admitted with respiratory distress, found to have uti and question of lingular pna. initially managed in micu with non-invasive ventilation support, steroids, and antitbiotics and transferred to the floor once no longer requiring ventilation support. on floor patient was continued on po steroids and antibiotics for uti and concern for lingular pna. patient continued to require oxygen therapy and was discharged to rehab in stable condition with o2, steroid taper and antibiotics. patient was also counseled for smoking cessation. . respiratory failure: pt found by ems with 02 sat 60% at home, improved with initiation of cpap. patient initially managed in micu and then on floor with po steroids and antibiotics. she continued to require oxygen, which was a change from her home status so there was a concern for pe. cta was done and showed no central pe. her lung exam improved as did her symptoms however she continued to need oxygen and it was determiend she needed home o2 and was discharge on it. . fever: febrile on initial presentation with a negative workup. no clear infiltrate on cxr though concern for lingular pna and was treated with 7 day course of po levofloxacin. . uti: found on screening ua, pan-sensitive e. coli, treated with 7 day course of levofloxacin. . diabetes: continue home regimen of 70/30 28u qam and 32 u qpm. fingersticks elevated with start of steroids, managed with ssi. . right hip pain: on admission, pt with point tenderness over r hip bursa on exam, no pain on rom of hip. managed with home dose of ultram. . peripheral neuropathy: continued home gabapentin. . code status: full per patient. medications on admission: albuterol - 90 mcg aerosol prn citalopram - 10 mg tablet - daily fexofenadine - 60mg daily fluticasone-salmeterol 250 mcg-50 mcg/dose daily gabapentin - 300 mg capsule qhs hydrochlorothiazide - 12.5 mg daily metoprolol succinate - 100 mg tablet daily simvastatin - 40 mg tablet qhs aspirin - 81 mg tablet daily ultram insulin nph & regular human - 100 unit/ml (70-30) suspension - 28 units qam, 32 units qpm twice a day discharge medications: 1. ipratropium bromide 0.02 % solution sig: two (2) puffs inhalation q6h (every 6 hours). 2. albuterol 90 mcg/actuation aerosol sig: two (2) puffs inhalation every four (4) hours: can do nebs instead if needed. 3. citalopram 20 mg tablet sig: 0.5 tablet po daily (daily). 4. fexofenadine 60 mg tablet sig: one (1) tablet po bid (2 times a day). 5. gabapentin 300 mg capsule sig: one (1) capsule po hs (at bedtime). 6. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 7. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 8. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po once a day: hold for sbp < 100. 9. calcium 500 mg tablet sig: one (1) tablet po twice a day. 10. toprol xl 100 mg tablet sustained release 24 hr sig: 1.5 tablet sustained release 24 hrs po once a day: hold for sbp < 95 or hr < 55. 11. levofloxacin 750 mg tablet sig: one (1) tablet po every other day for 1 doses: last dose due . 12. amlodipine 5 mg tablet sig: one (1) tablet po once a day: hold for sbp < 100. 13. advair diskus 250-50 mcg/dose disk with device sig: one (1) inhalation twice a day. 14. ultram 50 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain. 15. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day): stop when patient is ambulatory. 16. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 17. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed. 18. prednisone 10 mg tablet sig: variable tablet po once a day: see instructions and calendar. 19. insulin insulin 70/30, 28 units every morning and 32 units every evening with dinner plus attached sliding scale 20. nicotine 21 mg/24 hr patch 24 hr sig: one (1) patch transdermal every twenty-four(24) hours. 21. senna 8.6 mg tablet sig: two (2) tablet po twice a day as needed for constipation. 22. colace 100 mg capsule sig: one (1) capsule po twice a day. discharge disposition: extended care facility: & retirement home - discharge diagnosis: primary: chronic obstructive pulmonary disease, acute exacerbation secondary: asthma hypertension diabetes, type 2 discharge condition: stable. discharge instructions: you were admitted to the hospital for respiratory distress and low oxygen. upon admission, you first went to the medical intensive care unit where antibiotics and steroids were started. once stabilzed, you were transferred to the medical floor. a ct angiogram was performed and showed no evidence of pulmonary embolism. a urinalysis showed a urinary tract infection which will be covered with your current antibiotic. physical therapy was consulted for support and logistics regarding outpatient disposition. . please continue taking the antibiotic as prescribed. . follow-up with dr. as outpatient for copd/asthma. . resume your home medication regimen, but please note the following important changes: * metoprolol (toprol xl) increased to 150 mg daily. * amlodipine started due to high blood pressure. * hctz increased due to high blood pressure. * started prednisone taper per attached calendar for copd flare. briefly, prednisone 50 mg daily for 2 days, 40 mg daily for 2 days, 30 mg daily for 2 days, 20 mg daily for 2 days, 10 mg daily for 2 days, then stop. * start calcium and vitamin d for protection of the bones. * you will need one more dose of levofloxacin (which you will get on friday) for treatment of pneumonia and urinary tract infection. . please contact your doctor or return to the emergency department if you develop fevers (>101.5), shaking chills, difficulty breathing, shortness of breath, or pain on urination. . please stop smoking, as we have discussed. this is the most important thing you can do for your overall health! followup instructions: please follow-up with your primary care physican, dr. , on friday, at 11:10am. provider: , m.d. phone: date/time: 1:00 provider: clinic phone: date/time: 1:00 procedure: non-invasive mechanical ventilation prophylactic administration of vaccine against other diseases diagnoses: urinary tract infection, site not specified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled obstructive chronic bronchitis with (acute) exacerbation pain in joint, lower leg unspecified hereditary and idiopathic peripheral neuropathy other specified vaccinations against streptococcus pneumoniae [pneumococcus] 

Answer: The patient is high likely exposed to