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: sulfonamides / penicillins / decongestant sinus attending: chief complaint: 75 y/o woman with a history of moderate asthma, and recent mediastinal mass, who presents with dyspnea and chest discomfort. major surgical or invasive procedure: mediansternotomy for excision of mediastinal mass. history of present illness: mrs. is a 75 year old woman with history of asthma, allergies and hypertension. one week ago (), she noticed a worsening dry, non productive cough she had an xray on which did not demonstrate evidence of pneumonia. her cough worsened and she noticed chest tightness. she noticed that the pain was persistent and did not flucuate with breathing. she localized the pain to the center of her chest. her cough and discomfort progressed to the point that she requested that her daughter stay with her because her condition made her feel unsafe alone. she noted that on that she had vomitted in the setting of her cough (non bloody). she noted blurry vision, tingling in the hands and feet, bouts of chills, an elevated temp at 99.6, five pound weight loss (over 1 month). the night before admission, ms had a particularly sever episode of coughing with chest pain. she requested that her son take her to the er. ros: postive for vomiting, negative for diarrhea, diplopia ed course: vitals: t 97.5 bp 173/87 rr 20 o2 98 ddimer: 438 cta: negative ekg sinus rhythm, 1st degree heart block, consistent with baseline past medical history: asthma diagnosed at age 50, treated at , previously hospitalized, never intubated. allergies gerd post nasal drip diabetes: treated a year ago with metformin, but pt experienced nausea and stopped use. hypertension social history: lives alone in . dresses and cooks for herself. no history of tobacco or alcohol use. cantonese speaking woman with a very involved family. family history: no known family history of cancer physical exam: gen: patient was found in bed, in gown, alert and attentive, nad vitals: 99.6 bp 120/70 hr 84 o2 98 3l heent: normocephalic, eomi, perrl, no exopthalmus, moist mucous membranes neck: no cervical or supraclavicular lad, no palpable thyroid nodules pulm: bilateral rhonchi right greater than left, no wheezes apprecriated, no dullnes to percussion cor: heart sounds distant, normal s1 and s2 no appreciable murmurs rubs or gallops abodomen: non distented, nontender, ruq tenderness, no involuntary guarding, no hepatosplenomegaly extemities: equivocal reduced vibration sense below the knees, palable pedal and popilteal pulses neuro: aox3, no fatigability of eyelids pertinent results: labs: wbc 5.8 hct 34.2 na 117 serum osm 260 urine osm 144 glu 161 peak flow today; 200, 200, 250 peak flow: 250 to 300 studies: cxr : anterior mass unchanged from , no new opacities or nodules ct chest : anterior mediastinal mass 9x6x7 well circumscribed, non invasive, without calcification, likely thymoma swallow-study mrs. presents with a mild pharyngeal dysphagia at this time primarily characterized by impaired airway closure from left vocal cord immobility/paresis with resulting aspiration of liquids. when a chin tuck maneuver was combined with smaller sips of liquids, aspiration of thin liquids was easily prevented. however, the pt requires larger sips of thin liquids to swallow pills. as such, i am recommending that pills be taken whole with purees for the time being. follow up video swallow study can be completed in the next 2-3 months to monitor status of the pt's dysphagia, either here as an outpatient or at rehab/other facility. recommendations: 1. advance to regular texture po diet with thin liquids. pills may be given whole with liquids. 2. aspiration precautions, including: a. tuck your chin to your chest when drinking liquids. b. take small sips of liquids!! 3. repeat video swallow study in the next 2-3 months to monitor dysphagia and pending ent intervention. cxr: heterogeneous opacity in the right upper lung has progressed since following removal of the pleural tube. the apical component is conceivably atelectasis or hemorrhage related to retraction during surgery, but a more focal region in the axillary portion of the right upper lobe developed between and and has grown slightly since. there is also progressive left perihilar and basal consolidation. overall findings are concerning for bilateral pneumonia and/or severe atelectasis at the left base. small right apical pneumothorax is new or newly apparent. there is no left pneumothorax, but there is a small and slightly increased left pleural effusion, following removal of the left pleural tube. mediastinal caliber is comparable to that on , but there is vascular engorgement, and the heart is top normal size. brief hospital course: mediastinal mass: likely thymoma lymphoma, teratoma, thyroid/parathyroid tumor ruled out with history, exam, and normal tsh, pth, ionized ca, and phos. neurology evaluated for myasthenia, negative for fatigability. ms. a resection of her anterior mediastinal mass on . for details of the procedure please see the operative report. of note there was a thoracic duct injury noted intraop which was later clipped. a jp drain was left in place at the level of the thoracic duct injury to assess for a chyle leak postop. two chest were left in place postoperatively as well. preliminary pathology at the time of the procedure was significant for a fibrous tumor and not thymoma. postoperatively she was transferred extubated to the sicu. both chest tubes were left to suction and no air leak was noted. her sodium was noted to be 131 postop. she remained npo overnight. on pod1 her diet was advanced and her pain was controlled with a dilaudid pca now controlled with percocet. both chest tubes were removed on pod2, however the jp drain was left in place until she was taking a significant amount of oral intake. over the first few postoperative days she was noted to have a significantly hoarse voice and difficulty swallowing. ent was consulted out of concern for a recurrent laryngeal nerve injury. she had an foe exam on pod3 which confirmed an immobile left true vocal cord. seen by speech and swallow pathology and cleared for regular diet with thin liquids and chin tuck. (see report in result section). hyponatremia: likely euvolemic hyponatremia due to siadh considering mediastinal mass. serum osm of 260 is less ooncentrated than normal, while urine osm of 144 is inappropriatedly concentrated. this is consistent with euvolemic hyponatremia. the sodium should be corrected slowly (by half per day). she has been getting fluid restriction to 1000 cc per day. her mental status has been perfect, and her sodium levels have been improving. we are holding her hctz, which could have contributed. after the procedure her her hyponatremia was stable at around 130 and the hctz was restarted without further lowering her sodium. cough/chest pain: while originally thought to be an asthma exacerbation an intraop bronchoscopy showed significant purulent drainage from the right middle lobe. a bal was positive for mssa which was treated with vancomycin for 3 days and then was changed to levaquin and course was completed upon discharge from the hospital. uti: a preop ua was noted to be positive and the urine culture was positive for pansensitive e.coli. the patient was complaining of dysuria and hesitency. the uti was treated with 3 days of ciprofloxacin/levofloxacin and a repeat urine culture was negative. activity: the patient was seen by physical therapy and rehab was recommended. she was discharged to rehab on . medications on admission: singlair 10 mg qd 25 mg 2 puff tid hctz 25 mg daily diovan 320mg mg daily ventolin 2puff tid atrovent 2 puff tid flovent 2-3 puffs prn serevent 50 mcg flonase 50 mcg protonix 40 mg daily discharge medications: 1. salmeterol 50 mcg/dose disk with device sig: one (1) disk with device inhalation q12h (every 12 hours). 2. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 3. fluticasone 50 mcg/actuation aerosol, spray sig: one (1) spray nasal daily (daily). 4. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 5. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 6. albuterol sulfate 0.083 % (0.83 mg/ml) solution sig: one (1) inhalation q6h (every 6 hours). 7. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 9. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed. 10. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 11. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 12. fexofenadine 60 mg tablet sig: one (1) tablet po bid (2 times a day). 13. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po daily (daily). 14. valsartan 160 mg tablet sig: two (2) tablet po daily (daily). 15. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 16. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed for pain. discharge disposition: extended care facility: - discharge diagnosis: asthma, htn, dm, gerd, s/p tah excison of mediastinal mass with pneumonia, uti discharge condition: deconditioned requiring rehab discharge instructions: call dr. office if you develop increased pain in your chest, shortness of breath, fever, chills, redness or drainage from your incision site. you may shower but no tub bathing or swimming for 4 weeks. the steri-strips will fall off within 1-2 weeks. follow sternal precautions: no lifting or pushing greater than 10 pounds for 6 weeks and no vigorous upper extremity exercise or work for 6 weeks. continue to take pain medication and stool softner. followup instructions: call dr. office for an appointment after discharge from rehab. follow up with your pcp as needed. you have an appointment on 3:15pm with ent dr. in the building, suite 6e, procedure: biopsy of lymphatic structure transfusion of packed cells thymectomy, not otherwise specified 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 asthma, unspecified type, unspecified hypotension, unspecified methicillin susceptible pneumonia due to staphylococcus aureus other disorders of neurohypophysis anemia in neoplastic disease unilateral paralysis of vocal cords or larynx, partial malignant neoplasm of thymus 

Answer: The patient is high likely exposed to