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: transfer from osh () for evaluation of lll sleeve dehiscence major surgical or invasive procedure: 1. completion left pneumonectomy; tracheostomy tube change 2. flexible bronchoscopy, bal, tracheostomy tube change history of present illness: 50m with reported "stage ii lung ca" s/p lung resection with lll sleeve on at by dr.. patient ventilator dependent immediately post-op. underwent several brochoscopies for mucous plugging. on bronchoscopy, staff noted that lll sleeve site seemed concerning for dehiscence/tissue friability. further bronchoscopies showed worsening progression. he was transferred to for further management. past medical history: copd, htn, anxiety social history: lives with cousin, good social support, social drinker, ex-smoker (35 pack year hx), used to smoke pot family history: mother's side significant for lung ca, breast and uterine ca, father's side has cad, no reported ca physical exam: vs: 98.9 60 105/50 16 91% on cpap 25% psv 12 peep 5 gen: nad, a+ox3, supine on bed, tracheostomy in place heent: eomi, perrl, trachostomy intact, no erythema, no lad felt cv: rrr, 2+ radial and dp pulses resp: expiratory wheezes right lung, little breath sounds on left lung prolonged expiratory phase abd: soft, nt/nd, g-tube in place, no erythema ext: significant for clubbing, left shoulder staples c/d/i, underlying "edema"/bulge is muscle not fluid pertinent results: 09:37pm blood wbc-7.0 rbc-4.14* hgb-11.8* hct-34.1* mcv-82 mch-28.6 mchc-34.7 rdw-18.1* plt ct-231 02:07am blood wbc-21.4* rbc-3.87* hgb-10.9* hct-32.4* mcv-84 mch-28.1 mchc-33.5 rdw-18.4* plt ct-212 03:13am blood wbc-2.0* rbc-3.27* hgb-9.0* hct-27.8* mcv-85 mch-27.5 mchc-32.4 rdw-17.4* plt ct-218 02:55am blood wbc-11.8* rbc-3.08* hgb-8.5* hct-26.3* mcv-86 mch-27.8 mchc-32.5 rdw-18.0* plt ct-268 03:23am blood wbc-5.2 rbc-2.98* hgb-8.6* hct-24.9* mcv-84 mch-29.0 mchc-34.7 rdw-19.1* plt ct-267 02:55am blood pt-13.7* ptt-32.8 inr(pt)-1.2* 02:55am blood plt ct-268 09:37pm blood glucose-106* urean-12 creat-0.4* na-135 k-3.9 cl-95* hco3-34* angap-10 02:07am blood glucose-124* urean-15 creat-0.4* na-132* k-4.3 cl-94* hco3-32 angap-10 03:13am blood glucose-123* urean-10 creat-0.2* na-135 k-4.0 cl-92* hco3-42* angap-5* 02:55am blood glucose-113* urean-14 creat-0.3* na-135 k-4.2 cl-98 hco3-35* angap-6* 02:52am blood glucose-114* urean-12 creat-0.3* na-137 k-4.4 cl-97 hco3-39* angap-5* 02:07pm blood alt-29 ast-18 ld(ldh)-213 alkphos-93 amylase-31 totbili-0.9 03:13am blood caltibc-134* vitb12-766 folate-6.8 ferritn-863* trf-103* 02:50am blood caltibc-182* ferritn-592* trf-140* 09:45pm blood type-art po2-75* pco2-54* ph-7.38 caltco2-33* base xs-4 07:02am blood type-art po2-104 pco2-76* ph-7.28* caltco2-37* base xs-5 03:06pm blood type-art rates-/20 tidal v-300 peep-5 fio2-98 po2-93 pco2-71* ph-7.34* caltco2-40* base xs-8 aado2-560 req o2-89 intubat-intubated vent-spontaneou comment-cpap 50% 1 04:56pm blood type-art temp-37.4 peep-5 fio2-35 po2-73* pco2-67* ph-7.38 caltco2-41* base xs-10 intubat-intubated 04:46am blood type-art rates-/21 tidal v-358 peep-5 fio2-35 po2-82* pco2-66* ph-7.46* caltco2-48* base xs-18 intubat-intubated vent-spontaneou 02:08am blood type-art po2-139* pco2-68* ph-7.33* caltco2-37* base xs-7 11:02am blood type-art po2-56* pco2-64* ph-7.40 caltco2-41* base xs-11 abg on discharge on following settings: cpap 25%, psv 12, peep 5, with sats in 91-97%: ph 7.44 pco2 57 po2 97 hco3 40 basexs 11 ct airway: impression: 1. status post left lower lobectomy with severe narrowing of the proximal left main stem bronchus and distal complete obliteration as it traverses the mediastinum. correlation with bronchoscopy recommended. 2. while evaluation of the operative bed is limited without contrast, there is likely left hilar lymphadenopathy. 3. left upper lobe nodular peribronchial and septal thickening is worrisome for lymphangitic spread of carcinoma. 4. 12 mm right lower lobe solid nodule could represent a neoplastic deposit. 5. diffuse bilateral centrilobular ground- glass opacities and multifocal consolidation could represent diffuse infection. 6. moderate left pleural and small pericardial effusion. 7. slight comminution to posterolateral left fifth rib fracture is in an appropriate location for postsurgical changes, but correlation with surgical history is needed to exclude a metastatic focus. 8. linear densities around the tracheostomy may represent secretions, though disruption of the tracheostomy tube cannot be excluded. cxr s/p pneumonectomy impression left pneumonectomy space is almost completely air filled with only a small amount of fluid. cardiomediastinal contours are shifted towards the left. left subclavian catheter terminates in superior vena cava and tracheostomy tube terminates in expected location of trachea. within the right hemithorax, a new band-like opacity has developed in the right mid lung region, probably due to a combination of atelectasis and intrafissural fluid. subcutaneous emphysema is present in the left chest wall. larger gas collection is noted in the lower left chest wall adjacent to an indwelling left-sided chest tube. cxr (discharge cxr): no evident change in the appearance of the left thorax status post pneumonectomy with minimal residual air overlying the left apex. left picc and tracheostomy tube are in expected and unaltered positions. right lung is unchanged with minimal basilar atelectasis. micro: sputum: contaminant bal: klebsiella ( , gent, bactrim) bal: 2+ gpc, gnr sparse growth pleural fluid: nothing on gs, ngtd intercostal muscle flap: klebsiella ( , gent, bactrim) sputum: no growth final ucx: no growth final mrsa: negative cmv: negative rsv negative bcx: no growth final mrsa negative findings: bronchial stump from previous operation was completely dehisced. chest was irrigated thoroughly with betadiene, bacitracin, copious amounts of irrigation. intercostal muscle flap was used to cover the bronchial stump and fibrin glue was used to cover all stumps (bronchial, pa, pulm vein). did not require any blood intraop new bronchial resection margin was sent to pathology . path () l 5th rib: no carcinoma seen completion pneumonectomy: no carcinoma seen new bronchial margin: no carcinoma seen brief hospital course: the patient was admitted to the thoracic surgery service on and had a completion left pneumonectomy and tracheostomy tube change on . the patient tolerated the procedure well and was transferred to the surgical icu for further management. neuro: post-operatively, the patient received a hydromorphone/bupivacaine epidural with good effect and adequate pain control. on pod#1 the patient was given enteric tube feeds via g tube. on pod#3, the epidural was discontinued and the patient was started on hydromorphone iv. the patient was subsequently transitioned to oral pain medications on pod#12. cv: a phenylephrine drip was initiated due to hypotension experienced in pod#0. it was titrated to maintain a map>60. once the patient was weaned off the pressor, metoprolol was given to control his heart rate. the patient was otherwise stable from a cardiovascular standpoint; vital signs were routinely monitored as per icu protocols. pulmonary: postoperatively, the patient was transferred to the icu from the pacu. intraoperative findings included a bronchial stump from a previous operation that was completely dehisced. an intercostal muscle flap was used to cover the bronchial stump and fibrin glue was used to cover all stumps (bronchial, pa, pulm vein). a chest tube was inserted into the left chest and put to water seal. a follow-up cxr showed postoperative changes: left pneumonectomy space almost completely air filled; cardiomediastinal contours are shifted towards the left. on pod#2 the chest tube was removed. follow-up chest xray showed no acute changes. on pod#3; the tracheostomy tube was changed due to a cuff leak. on pod#7, the patient had an acute episode of respiratory distress leading to an 02 desaturation into the 70s during physical therapy. his respiratory secretions were immediately suctioned and the fi02 settings were increased to 100%. chest xray showed atelectasis vs aspiration pneumonitis. also on pod#7, the patient developed another air leak around his trach. the interventional pulm service performed a flexible bronchoscopy and changed the patient's tracheostomy tube ( #8). the patient has been doing well since the last trach tube change. the patient continues to be weaned from the ventilator. his settings before d/c to rehab is cpap 25% fio2, psv 12 peep 5 with sats in thhe 90-95%. gi/gu: post-operatively, the patient was given iv fluids until tolerating peg tube feeds. the patient's diet was advanced when appropriate, which was tolerated well. the patient has a foley to accurately monitor urine output while in the icu setting. intake and output were closely monitored as per icu protocol. the patient received diuretic therapy as needed. heme: on admission, the patient's wbc was 7.0. on pod#4, a cbc revealed a wbc of 1.7; with 43% neutrophils and 1% bands. the granulocyte count was 790. over the ensuing two days, the patient's wbc remained at 2.0. the decision was made to start the patient on filgastrim. the patient responded to the filgrastrim therapy and at the time of discharge his wbc is near his baseline level. id: during the hospital course, the patient had the following positive cultures: bronchoalveolar lavage postive for klebsiella (sensitive to meropenem); bronchoalveolar lavage with 2+ gram positive cocci on gram stain and gram negative rods (rare growth) in culture; intercostal muscle flap culture that grew klebsiella (sensitive to meropenem). the patient was given two-week courses of meropenem and vancomycin for the infections. to date no other microbiologic specimen have been positive for microbes. prophylaxis: the patient was ordered for sequential compression devices and subcutaneous heparin for dvt prophylaxis. he was given ppi therapy for gastric ulcer prophylaxis. the patient was also encouraged to get up and ambulate as early as possible. at the time of discharge, the patient was doing well, afebrile with stable vital signs, tolerating a diet via tube feeds, and pain was well controlled. medications on admission: proventil 2 puffs qid prn, advair 500/50 , spiriva 1 puff, lisinopril 5 mg po qd discharge medications: 1. paroxetine hcl 20 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). disp:*30 tablet,rapid dissolve, dr(s)* refills:*2* 3. ipratropium bromide 17 mcg/actuation aerosol : two (2) puff inhalation qid (4 times a day). disp:*qsuff qsuff* refills:*2* 4. fluticasone 110 mcg/actuation aerosol : two (2) puff inhalation (2 times a day). disp:*qsuff qsuff* refills:*2* 5. albuterol 90 mcg/actuation aerosol : six (6) puff inhalation q2h (every 2 hours) as needed. disp:*qsuff qsuff* refills:*0* 6. oxycodone-acetaminophen 5-325 mg/5 ml solution : 5-10 mls po q4h (every 4 hours) as needed. disp:*500 ml(s)* refills:*0* 7. lorazepam 0.5 mg iv q6h:prn 8. colace 100 mg capsule : one (1) capsule po twice a day: crushed and via g-tube. capsule(s) 9. senna 8.6 mg tablet : one (1) tablet po twice a day: crushed via g-tube. tablet(s) 10. metoprolol tartrate 25 mg tablet : one (1) tablet po bid (2 times a day): crushed via g-tube. disp:*60 tablet(s)* refills:*2* 11. heparin (porcine) 5,000 unit/ml solution : one (1) injection tid (3 times a day). 12. vancomycin in dextrose 1 gram/200 ml piggyback : one (1) intravenous q 8h (every 8 hours) for 2 days. 13. meropenem 500 mg recon soln : one (1) recon soln intravenous q6h (every 6 hours) for 1 days. disp:*4 recon soln(s)* refills:*0* 14. lisinopril 5 mg tablet : one (1) tablet po once a day: crushed via g-tube. discharge disposition: extended care facility: radius discharge diagnosis: left bronchial anastomotic dehiscence with mediastinitis and pneumonia discharge condition: stable discharge instructions: call dr. office at ( if you experience: -fever >101 or chills -increased cough, shortness of breath or sputum production -chest pain -difficulties breathing -incision develops drainage -you may sponge bathe the first day. afterwards you may shower. no bathing/soaking/swimming for 6 weeks after the operation -no driving while taking any form of narcotics. followup instructions: follow up with dr. in 2 weeks. please call his office at ( to schedule an appointment. procedure: venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus replacement of tracheostomy tube replacement of tracheostomy tube other and unspecified pneumonectomy diagnoses: pneumonia, organism unspecified unspecified essential hypertension chronic airway obstruction, not elsewhere classified personal history of malignant neoplasm of bronchus and lung other respiratory complications neutropenia, unspecified mediastinitis other tracheostomy complications 

Answer: The patient is high likely exposed to