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: soybean attending: chief complaint: pneumonia major surgical or invasive procedure: none history of present illness: 58yo f with copd on 3l at baseline who presented with right sided cp with radiation to the back that began when she woke up this morning. her pain got worse throught the day and pleuritic in nature (worse with inspiration). pt has felt dizzy whenever she attempted to walk today. also reports chills, shivering, and ha. pt called dr who was concerned for pe, ptx, or dissection and sent her to the ed. initial ed vitals: 100.2 110 112/65 18 95%. while in the ed, she became hypotensive to the 80s. initially, pressures did not improve with 2l ivf. bedside fast was negative. a right ij was placed. cvp was measured at and she got another 2l ivf with improvement of pressures to the low 100s (total 4l given in the ed). cta was negative for pe or dissection. given new rll opacities, she was given 750mg of levoflox. she never required pressors. she got morphine x 1 for pain. per the ed, she transiently desatted to 73% on 6l approximately 30mins before icu transfer; per nursing report, this occured in the setting of having recieved 4mg of morphine. currently, t100, 98, 102/68, rr 22, 93% on 6l. on the floor, pt still feels "lousy," but somewhat better than before presentation to the ed. having some cough since volume resucitation in the ed. past medical history: chronic pain - related to low back degenerative changes, cervical spinal stenosis, s/p surgery, and fibromyalgia. systemic lupus erythematosus (severe ophthalmopathy, diffuse arthropathy) depression mitral valve prolapse chronic obstructive pulmonary disease lung nodule osa (on cpap) social history: single (divorced) former nurse who currently works as a receptionist at her local catholic church. she currently lives alone with 2 cats. - tobacco: last cigarette 6m ago, previously smoked for 40+ pack years - alcohol: no significant hx - illicits:denies family history: significant for an uncle with diabetes physical exam: admission exam: t100, 98, 102/68, rr 22, 93% on 6l. general: alert, oriented, no acute distress. cpap in place heent: sclera anicteric, mmm lungs: coarse right basilar crackles cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended ext: warm, well perfused, no clubbing, cyanosis or edema pertinent results: admission labs: 08:40pm blood wbc-13.3*# rbc-4.65 hgb-14.9 hct-42.4 mcv-91 mch-32.2* mchc-35.3* rdw-13.5 plt ct-282 08:40pm blood neuts-92* bands-3 lymphs-5* monos-0 eos-0 baso-0 atyps-0 metas-0 myelos-0 08:40pm blood pt-13.4 ptt-28.3 inr(pt)-1.1 08:40pm blood glucose-160* urean-17 creat-1.2* na-138 k-4.0 cl-101 hco3-25 angap-16 08:40pm blood ctropnt-<0.01 08:40pm blood calcium-9.2 phos-2.2* mg-1.6 08:40pm blood d-dimer-2613* 08:53pm blood lactate-3.0* . cxr : severe emphysema with new bibasilar ill-defined opacities which may reflect infection or aspiration. . echo : the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. the estimated right atrial pressure is 0-5 mmhg. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). the right ventricular cavity is mildly dilated with normal free wall contractility. the aortic arch is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. trivial mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is a small pericardial effusion. the effusion appears circumferential. there are no echocardiographic signs of tamponade. compared with the findings of the prior study (images reviewed) of , pulmonary pressures can now be quantified and are in the mild range. right ventricular size is mildly dilated with preserved systolic function. left ventricular regional and global systolic function is normal. brief hospital course: 58yo f with copd on 3l o2 at home who presents with pleuritic right cp and new rll on chest imaging. . # pna: on presentation, fevers, leukocytosis with left shift, hypoxia, and infiltrates on ct and cxr. she was initially covered with vanc/ceftriaxone/levofloxacin for cap requiring icu admission. vanc was stopped after a few days after pt had become afebrile with no fever spike. urine legionella negative. she completed a 5 day course of levoflox and continued on ctx. prior to discharge, she was switched to cefpodoxime for a planned total 14 day course (to end ). pleuritic chest pain improved; patient not requesting prn pain medication prior to d/c. supplemental o2 was weaned as tolerated, 90-92% on 6l at the time of d/c. . # afib with rvr: pt developed afib with rates in the 140s/150s with chest discomfort, no ischemic ekg changes. required digoxin load, but converted back to sinus and dig was d/ced. felt to be stress of pna. pt in nsr in the 70s-80s at the time of d/c. . # copd: uses 3l o2 at baseline. increased advair to 500-50. iprtroprium nebs q6 hours, held spiriva, can resume this upon d/c. . # flash pulmonary edema: one time occurance. given lasix intermittently. echo did not show any major abnormalities. upon d/c would give lasix prn to keep is and os even, but no need for standing diuresis. . # delerium: pt developed visual hallucinations during her icu stay. does not use etoh, but does take a fair amount of bzds and vicodin at home, particularly at hs. poor sleep during her hospital course. icu delirium vs. benzo withdrawal. mental status at baseline and resolution of hallucinations prior to d/c. pt should resume her home dose of klonopin upon d/c. she may continue zyprexa at hs prn. . # osa: cpap at night with home settings. . # cad: con't simvastain . # smoking cessation: continue nicotine replacement. . # htn: held lisinopril in the setting of diuresis, can resume upon d/c. . # chronic pain: continued home gabapentin. held home vicodin given ams and hallucinations. . dnr/dni (confirmed with pt, she has discussed this with her psychiatrist) medications on admission: albuterol sulfate - 90 mcg hfa aerosol inhaler - 2 puffs orally up to qid for asthma flare as directed clonazepam - (prescribed by other provider) - 1 mg tablet - tablet(s) by mouth diazepam - (prescribed by other provider) - 5 mg tablet - 0.5 (one half) tablet by mouth in the am and 1 tab in the pm duloxetine - (prescribed by other provider; dose adjustment - no new rx) - 20 mg capsule, delayed release(e.c.) - 4 capsule(s) by mouth once a day fluticasone - 50 mcg spray, suspension - 2 sprays(s) in each nostril once a day pharmacy please deliver fluticasone-salmeterol - 250 mcg-50 mcg/dose disk with device - 1 actuation(s) orally once or twice a day gabapentin - (prescribed by other provider) - 800 mg tablet - 4 (four) tablet(s) by mouth at bedtime hydrocodone-acetaminophen - 5 mg-500 mg tablet - tablet(s) by mouth every six (6) hours as needed for pain limit 4 tabs per day lisinopril - 10 mg tablet - 1 tablet(s) by mouth once a day naproxen sodium - 550 mg tablet - 1 tablet(s) by mouth twice a day omeprazole - 20 mg capsule, delayed release(e.c.) - 2 (two) capsule(s) by mouth once a day please deliver oxygen - - 2l/min cont flow at night via cpap; 2l/min cont flow with exertion at home; evaluate for pulse dose 02 with exertion outside home; dxs: copd; osa simvastatin - 20 mg tablet - 1 tablet(s) by mouth once a day tiotropium bromide - 18 mcg capsule, w/inhalation device - 1 capsule inhaed orally once a day cetirizine - (prescribed by other provider; otc) - 10 mg tablet - 1 (one) tablet(s) by mouth once a day as needed for allergy symptoms nicotine - (prescribed by other provider; dose adjustment - no new rx) - 14 mg/24 hour patch 24 hr - 1 patch daily daily nicotine (polacrilex) - 4 mg gum - chew 1 piece as directed at each significant urge to smoke discharge medications: 1. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 2. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) capsule inhalation once a day. 3. nicotine (polacrilex) 2 mg gum sig: one (1) gum buccal q2h (every 2 hours) as needed for craving. 4. guaifenesin 100 mg/5 ml syrup sig: ten (10) ml po q4h (every 4 hours). 5. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch transdermal once a day. 6. duloxetine 60 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po once a day. 7. fluticasone-salmeterol 500-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 8. gabapentin 400 mg capsule sig: six (6) capsule po hs (at bedtime). 9. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 10. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 11. cefpodoxime 200 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 6 days. 12. zyprexa 5 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. 13. lisinopril 10 mg tablet sig: one (1) tablet po once a day: hold for sbp < 100. 14. klonopin 0.5 mg tablet sig: one (1) tablet po once a day: hold for sedation. 15. klonopin 2 mg tablet sig: 1-2 tablets po at bedtime: hold for sedation. 16. fluticasone 50 mcg/actuation spray, suspension sig: two (2) sprays nasal once a day. 17. cetirizine 10 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: primary: community-aquired pneumonia . secondary: copd sleep apnea atrial fibrilation, resolved discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: ms. , . it has been a pleasure taking care of you here at . you were admitted to the icu with a pneumonia. we treated you with antibiotics and were slowly able to decrease the amount of oxygen you needed. your heart went into an abnormal rhythm (atrial fibrilation), likely from the stress of the pneumonia. your heart was back in normal sinus rhythm before discharge. . we made the following changes to your medications: - please start taking cefpodoxime for 6 more days - please change your advair to 500-50, 1 puff twice a day - please stop taking vicodin for now. as you might remember, you were confused for a few days in the icu. you appeared comfortable without this medication. - you may take guaifenasin as needed for cough - you may take zyprexa (olanzipine) 5mg at bedtime as needed to help you sleep followup instructions: department: medical specialties when: tuesday at 11:00 am with: rrt/dr. building: sc clinical ctr campus: east best parking: garage . department: neurology when: wednesday at 4:00 pm with: drs. & building: sc clinical ctr campus: east best parking: garage . department: when: tuesday at 3:30 pm with: , md building: campus: east best parking: garage procedure: central venous catheter placement with guidance diagnoses: pneumonia, organism unspecified systemic lupus erythematosus obstructive sleep apnea (adult)(pediatric) other chronic pain coronary atherosclerosis of native coronary artery unspecified essential hypertension chronic airway obstruction, not elsewhere classified atrial fibrillation personal history of tobacco use acute respiratory failure do not resuscitate status lumbosacral spondylosis without myelopathy acute edema of lung, unspecified psychophysical visual disturbances 

Answer: The patient is high likely exposed to