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: history of present illness: the patient is an 80 year old woman with a history of hypertension and peripheral vascular disease who presented to her primary care physician in with a complaint of cough and chest tightness. the symptoms persisted and the patient had a chest x-ray done on , which showed a large right sided in the paratracheal region. on review of systems, the patient reports slow progression of exertional dyspnea, fatigue, anorexia and hemoptysis times several weeks. the patient presented to the emergency room on , with significant worsening of dyspnea, wheezing and cough. ct scan was done which showed a large right upper lobe mass extending into the mediastinum, 7.2 centimeters by 7.7 centimeters, associated with right upper lobe collapse. there was extensive right hilar and sub-carinal lymphadenopathy with an 8 millimeter nodular density in the right posterior middle lobe and small right pleural effusion. the patient was discharged and had an outpatient bronchoscopy performed which showed tumor invasion in the distal tracheal, right main-stem bronchus was patent at that time. unable to do biopsy secondary to patient coughing, discomfort and difficulty visualizing the bronchus. repeat bronchoscopy was done on , which showed complete obstruction of the main stem bronchus. biopsies taken indicated poorly differentiated carcinoma infiltrating bronchial sub-mucosa. the patient was admitted on , to for worsening shortness of breath. the patient was started on solu-medrol which was subsequently changed to prednisone. the patient underwent a staging work-up with abdominal ct scan which showed no metastases. the patient was sent for mapping to initiate xrt to large lung mass. while lying flat, the patient became more dyspneic with increasing coughing and obvious cyanosis. the patient underwent an emergency ct scan which showed progression of disease and compression of the trachea and main bronchus. the patient was sent to for emergent xrt and then sent back to for chemotherapy. the patient received one cycle of carboplatin and taxol on , and has had a total of five cycles of xrt (last cycle on ). the patient reportedly developed increasing cough with periods of bronchospasm and cyanosis despite increasing doses of steroids, nebulizer treatments and heated face mask. the patient was referred to for stenting of her trachea and right main stem bronchus. past medical history: 1. hypertension. 2. severe peripheral vascular disease on coumadin status post bilateral femoral-popliteal bypass in . 3. status post left below the knee amputation in secondary to obstructing clot and left foot ischemia. 4. in , the patient underwent a redo right axillary shunt to lower extremity bypass which was complicated by postoperative pulmonary embolus treated with coumadin and ivc filter placement. 5. non-small cell lung cancer as above. the patient's oncologist is dr. and dr. . her pulmonologist is dr. . medications at home: 1. coumadin 2 mg p.o. q. h.s. 2. maxzide. medications on transfer: 1. diltiazem 60 mg p.o. q. day. 2. albuterol and atrovent nebulizers q. four hours. 3. decadron 4 mg intravenous q. four hours. 4. levaquin 250 mg p.o. q. day. 5. robitussin and tessalon pearls p.r.n. social history: the patient is widowed for seven years. she has three children. she lives independently and ambulates with a cane. she has 40 pack year history of smoking; quit in . physical examination: temperature 98.6 f.; blood pressure 134/60; pulse 110; saturation of 93% on five liters. in general, the patient was alert and oriented times three. cardiovascular: the patient was tachycardic with no appreciable murmurs, rubs or gallops. lungs: bronchial breath sounds, left greater than right. abdomen: obese, nontender, not distended, normal bowel sounds. extremities: left below the knee amputation. no cyanosis, clubbing or edema. laboratory: on admission, white blood cell count 25.0, hematocrit 32.3, platelets 185. sodium 129, potassium 5.1, bun 39, creatinine 0.9, albumin 2.8, calcium 8.5, magnesium 2.1. hospital course: the patient is an 80 year old woman with poorly differentiated non-small cell lung cancer admitted with compression of the trachea and right main stem bronchus by a large right upper lobe tumor. on hospital day one, the patient underwent a rigid bronchoscopy with findings of the right upper lobe occluded by tumor; in addition, distal trachea had a near total obstruction by tumor. the patient underwent placement of a stent to the distal trachea and right main stem bronchus. repeat bronchoscopy was performed on hospital day number two, which showed stents to be patent and in good position. distal airways were patent as well and mild to moderate secretions were noted bilaterally. post-procedure, the patient maintained o2 saturations of 93 to 98% on a 50% face mask (this was her o2 requirement on admission). the patient was subsequently transitioned to shovel mask with three liters nasal cannula, again maintaining her saturations above 93%. the patient did note subjectively improvement in shortness of breath post-procedure. the patient was continued on humidified oxygen, standing albuterol and atrovent nebulizers q. four hours. in addition, the patient was given lidocaine nebulizers to help with continued cough. in addition, the patient was continued on decadron to help decrease inflammation in the bronchus and was continued on prophylactic antibiotics with levaquin and flagyl post-procedure. medications at the time of discharge: 1. diltiazem 60 mg p.o. q. day. 2. heparin 5000 units subcutaneously twice a day. 3. decadron 4 mg intravenously q. four hours. 4. protonix 40 mg p.o. q. day. 5. levaquin 500 mg p.o. q. day. 6. flagyl 500 mg p.o. q. eight hours. 7. albuterol and atrovent nebulizers q. eight hours. 8. lidocaine nebulizers 2.5 cc. of 1% lidocaine q. one hour p.r.n. condition on discharge: stable. discharge status: the patient will be discharged back to for continuing care. discharge diagnoses: 1. non-small cell lung cancer with compression of trachea and main stem bronchus status post stent placement. , m.d. dictated by: medquist36 procedure: fiber-optic bronchoscopy other intubation of respiratory tract diagnoses: unspecified essential hypertension peripheral vascular disease, unspecified malignant neoplasm of upper lobe, bronchus or lung 

Answer: The patient is high likely exposed to