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: patient recorded as having no known allergies to drugs attending: chief complaint: cough x3 days, increasing doe x5 days, 2 pillow orhtopnea, and le edema major surgical or invasive procedure: intubation history of present illness: 60 yo female with htn, longstanding smoking hx admitted for hypercapnic and hypoxic respiratory failure. pt presented to clinic with 3 days of cough productive of green sputum, fever, chills, and diarrhea. pt also reported wt gain over the past week, increasing doe over past 5 days, and 2 pillow orhtopnea, and le edema. she was tachypnic with o2 sats of 72 that improved to 92% on 4lnc, so she was sent to ed. pt had bp of 198/121 associated with a ha and lateral st segement depressions. in the ed her vitals were signficant for pulse of 117 and bp of 198/121 with 91% on 4lnc. abg was 7.23/75/82 and pt refused trial of bipap and preferred to be intubated so she was given 60mg po prednisone and salmeterol nebs prior to intubation. chest xray was neg but she had a wbc of 11 with 31%bands so sputum and urine cx's were sent and she was started on azithromycin 500mg po, and given ctx 1g iv. pt initially required a nitro drip which was only used transiently, since her bp normalized with propofol sedation. on admission to floor she remained normotensive and abg improved to 7.31/44/93 on a rate of 20 and tv 500. pt was adequately sedated on propofol. past medical history: none known social history: pt is a counselor and has a doctorate in education. she is divorced. + tobacco x80-100 pyhx. occ etoh family history: father with copd physical exam: pe: 98.2 80's 150's/80's 18 95% 2l gen: nad, a&o x 4, cooperative heent: eomi, l eye peripheralinjection, periorbital edema, perrl, mmm neck: 6-8cm jvp, no lad heart: rrr, +s4. no murmurs. lungs: bibasilar crackles way up thorax, no wheezes abd: soft, nt/nd. nabs ext: 1+ bilateral pedal edema way up leg neuro: non-focal pertinent results: 03:10pm blood wbc-11.0 rbc-5.17 hgb-18.2* hct-52.1* mcv-101* mch-35.2* mchc-35.0 rdw-11.6 plt ct-246 04:18am blood wbc-10.7 rbc-4.43 hgb-15.7 hct-45.1 mcv-102* mch-35.4* mchc-34.7 rdw-11.7 plt ct-228 07:30am blood wbc-11.8* rbc-4.78 hgb-16.5* hct-48.0 mcv-100* mch-34.5* mchc-34.3 rdw-11.9 plt ct-241 03:10pm blood neuts-42* bands-31* lymphs-5* monos-21* eos-0 baso-0 atyps-0 metas-0 myelos-0 plasma-1* 07:23am blood neuts-58 bands-2 lymphs-28 monos-7 eos-3 baso-0 atyps-1* metas-1* myelos-0 04:18am blood hypochr-normal anisocy-1+ poiklo-normal macrocy-1+ microcy-normal polychr-normal 03:10pm blood hypochr-normal anisocy-occasional poiklo-normal macrocy-occasional microcy-normal polychr-occasional 03:10pm blood plt ct-246 07:30am blood plt ct-241 05:01pm blood d-dimer-368 03:10pm blood glucose-196* urean-19 creat-0.5 na-140 k-4.6 cl-99 hco3-27 angap-19 04:18am blood glucose-226* urean-13 creat-0.5 na-142 k-4.5 cl-104 hco3-30* angap-13 07:30am blood glucose-104 urean-9 creat-0.5 na-142 k-3.9 cl-97 hco3-38* angap-11 03:10pm blood ck(cpk)-58 04:18am blood ck(cpk)-43 03:10pm blood ck-mb-notdone ctropnt-<0.01 04:18am blood ck-mb-4 ctropnt-less than 04:18am blood calcium-9.1 phos-3.1 mg-2.1 07:23am blood calcium-8.8 phos-4.3 mg-2.0 04:18am blood vitb12-1721* folate-18.2 04:18am blood tsh-0.31 05:45pm blood type-art po2-82* pco2-75* ph-7.23* calhco3-33* base xs-0 08:19pm blood type-art po2-464* pco2-68* ph-7.25* calhco3-31* base xs-0 07:44am blood type-art temp-37.2 rates-20/ tidal v-500 peep-5 o2-50 po2-105 pco2-59* ph-7.33* calhco3-33* base xs-2 intubat-intubated 08:14am blood type-art po2-90 pco2-67* ph-7.30* calhco3-34* base xs-3 05:45pm blood glucose-220* lactate-1.2 na-137 k-4.7 cl-100 08:19pm blood lactate-0.9 05:30pm blood lactate-1.2 05:45pm blood freeca-1.32 brief hospital course: 60 yo female with htn, longstanding smoking hx admitted for hypercapnic and hypoxic respiratory failure. 1. copd flare: pt with long smoking history and hyperinflated lung volumes worrisome for copd. she required intubation for worsening respiratory failure, but was quickly weaned. she likely had an exacerbation of her stable copd acute h.flu bronchitis. she was treated initially with both azithromycin and ceftriaxone for cap. later, ceftriaxone was d/c'ed as h.flu was the only organism cultured and it was thought that her infection was limited to bronchitis without parenchymal involvment. she was started on steroids with a slow taper and is to continue the taper as an outpatient. she will also require pft's for further evaluation of her pulmonary status. she received frequent nebulizers and was gradually weaned off supplemental oxygen. pt evaluated her and found her o2 sats to drop to 81% on ambulation, son she was discharged with home o2 to be used during periods of activity. 2. bronchitis: the patient has + sputum cultures for h.flu and no opacity, suggestive of acute bronchitis. her habitus is that of a "pink puffer" however, she may have a component of chronic bronchitis as well. in any case, she will be treated for 10 days of azithromycin for this infection. on discharge she had completed 7/10 days. 3. hypertension: patient presented with a bp of 198/121 assiciated with a ha and lateral st segment depressions. this hypertensive emergency was likely induced by stress response from respiratory failure and her bp became controlled when she was sedated. once patient was brought to the floor, her antihypertensive requirements increased to metoprolol 50mg po bid and hydralazine 50 q6hours. her medication regimen was further adjusted to hctz 25qd, lisinopril 10 qd, and atenolol 50 qd. as her bp has likely been elevated for some time, her goal sbp was 130s-140s, which was achieved on the outlined regimen. 4. cad: pt had lateral st depressions with bp of 198/121. denied cp. cyclic cardiac enzymes were negative. tte showed no regional wall motion abnormalities to suggest ongoing ischemia or past infarcts. she most likely does have cad given these lateral depressions and may benefit from outpatient exercise risk stratification. 5. erythrocytosis: pt's last hgb 15.5. likely a secondary polycythemia due to chronic hypoxia from smoking. no s/s myeloproliferative disorder. 6. acid/base: pt presented with a pco2 of 7.23/75/82 and a hco3 of 27. she either is not a co2 retainer and had an acute respiratory acidosis (with normal hco3). or, she is a c02 retainer and had acute on chronic resp acidosis plus a metabolic acidosis (with a normal hco3). her repeat abg 7.30 / 67 / 90 with a hco3 of 32 implies that she still has a respiratory acidosis with partial metabolic compensation. upon treatment on her infection, with cxr evidence of clearing, her ph quasi-normalized with a high hco3, suggesting that she is a co2 retainer. 7. code: full medications on admission: none discharge medications: 1. albuterol sulfate 0.083 % solution sig: one (1) neb inhalation every 4-6 hours as needed for shortness of breath or wheezing. disp:*30 neb* refills:*1* 2. oxygen home oxygen. use with activity at 2 liters/minute by nasal cannula. 3. azithromycin 250 mg capsule sig: one (1) capsule po q24h (every 24 hours) for 3 days. disp:*3 capsule(s)* refills:*0* 4. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po qd (once a day). disp:*30 tablet(s)* refills:*2* 5. prednisone 5 mg tablet sig: one (1) tablet po qd (once a day) for 2 days: . disp:*2 tablet(s)* refills:*0* 6. prednisone 20 mg tablet sig: 2.5 tablets po qd (once a day) for 2 days: . disp:*5 tablet(s)* refills:*0* 7. prednisone 20 mg tablet sig: two (2) tablet po qd (once a day) for 2 days: . disp:*4 tablet(s)* refills:*0* 8. prednisone 10 mg tablet sig: three (3) tablet po qd (once a day) for 2 days: . disp:*6 tablet(s)* refills:*0* 9. prednisone 20 mg tablet sig: one (1) tablet po qd (once a day) for 2 days: . disp:*2 tablet(s)* refills:*0* 10. prednisone 10 mg tablet sig: one (1) tablet po qd (once a day) for 2 days: . disp:*2 tablet(s)* refills:*0* 11. atenolol 50 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 12. salmeterol xinafoate 50 mcg/dose disk with device sig: one (1) inh inhalation q12h (every 12 hours). disp:*1 inh* refills:*2* 13. fluticasone propionate 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). disp:*1 inhaler* refills:*2* 14. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). disp:*30 cap(s)* refills:*2* 15. lisinopril 10 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: copd hypertension discharge condition: stable discharge instructions: please call your doctor and return to the hospital for shortness of breath, fever, chills, nausea, vomiting, or any other questions you may have. please follow-up with out-patient pulmonary rehab. please use home oxygen when doing activities or if you are short of breath. followup instructions: provider: breathing test where: phone: date/time: 7:45 provider: exam room is (no charge) where: is (no charge) date/time: 8:00 provider: , m.d. where: phone: date/time: 8:00 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnostic ultrasound of heart insertion of endotracheal tube diagnoses: coronary atherosclerosis of native coronary artery tobacco use disorder unspecified essential hypertension obstructive chronic bronchitis with (acute) exacerbation acute respiratory failure influenza with other respiratory manifestations 

Answer: The patient is high likely exposed to