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: penicillins attending: chief complaint: stridor major surgical or invasive procedure: mechanical ventilation extubation history of present illness: ms. is a 45f with schizoaffective disorder, polysubstance dependence, and sah s/p coiling l mca aneurysm and repeat coiling for recannalization on , who initially presented to osh ed with sore throat x 1 week. neck x-ray was performed and revealed possible thickened epiglottis but she left the ed ama prior to finalized . she then returned to the osh ed at approximately 10pm with new onset stridor and hoarseness. she was also noted to be altered with slurred speech and there was concern for intoxication. she was intubated with a 7-0 ett for airway protection with emesis noted post-intubation. ct neck reportedly revealed thickened epiglottis and ct head was negative for acute process. she received ceftriaxone, decadron 10mg iv, and was transferred here by . she received pancuronium, 4mg iv versed, 4mg iv ativan at osh. labs there remarkable for abg 7.40/53/75, wbc 4.6. in ed, initial vs were: 98.6 77 101/76 16 96%. she was given propofol for sedation. cxr confirmed ett placement. ent was consulted and epiglottis was visualized and felt to be slightly inflamed. they recommended continuing dex 10mg iv q8 and antibiotics and plan for extubation when has cuff leak. neurosurgery was also notified. vs prior to transfer: 98.6 113/74 72 16 100% on ac fio2 100% vt500 rr16 peep 5. on the floor, she is intubated and sedated. past medical history: - asthma - h/o polysubstance abuse - adhd - depression/anxiety vs bipolar disorder - schizoaffective disorder - s/p overdose c/b respiratory failure - sah s/p coiling l mca aneurysm with recannalization on mri and repeat coiling social history: - originally from ; has a son and a daughter but no contact info at time of admission - tobacco: denied at osh - per her nephew, she was a heavy smoker in past - alcohol: denied at osh after extubation here, denied any substance use, reported only taking prescribed medications family history: unable to otbain at time of admission physical exam: physical exam on arrival to icu: vs: tcurrent: 36.2 ??????c, hr: 79, bp 104/70, rr 18, o2sat 98% on cmv/assist. peep 5, fio2 50%, rr 18, abg: 7.51/41/205//9 general: intubated, sedated heent: sclera anicteric, mmm, oropharynx clear, perrl, 2mm neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally with crackles r base, no wheezes or ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: foley draining clear yellow urine ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema skin: no lesions or rashes. pertinent results: 02:05am blood wbc-11.1* rbc-3.59* hgb-11.4* hct-34.4* mcv-96 mch-31.9 mchc-33.2 rdw-13.3 plt ct-279 05:52am blood wbc-9.3 rbc-3.65* hgb-11.8* hct-35.4* mcv-97 mch-32.3* mchc-33.3 rdw-13.1 plt ct-281 05:52am blood neuts-91.1* lymphs-7.1* monos-1.0* eos-0.3 baso-0.5 04:37am blood wbc-15.7*# rbc-3.67* hgb-11.6* hct-35.0* mcv-95 mch-31.8 mchc-33.3 rdw-12.8 plt ct-286 02:05am blood pt-12.7 ptt-24.1 inr(pt)-1.1 04:37am blood pt-12.6 ptt-123.1* inr(pt)-1.1 02:05am blood fibrino-335 05:52am blood glucose-167* urean-10 creat-0.6 na-141 k-4.1 cl-101 hco3-29 angap-15 03:00am blood alt-12 ast-18 ld(ldh)-157 alkphos-75 totbili-0.2 02:05am blood lipase-22 05:52am blood calcium-9.5 phos-2.7 mg-2.1 iron-66 05:52am blood caltibc-326 ferritn-21 trf-251 03:00am blood vitb12-393 folate-9.5 07:36pm blood vanco-5.2* 02:05am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-pos tricycl-neg 03:14am blood type-art temp-37.0 rates-/16 tidal v-500 fio2-100 po2-205* pco2-41 ph-7.51* caltco2-34* base xs-9 aado2-488 req o2-80 -assist/con intubat-intubated comment-green top 01:54pm blood type-art rates-/16 tidal v-450 peep-5 fio2-40 po2-137* pco2-48* ph-7.39 caltco2-30 base xs-3 intubat-intubated vent-controlled 12:13pm blood lactate-4.4* 01:54pm blood lactate-2.2* history: epiglottitis with intubation, to assess for acute abnormality. findings: in comparison with the study of , the endotracheal and nasogastric tubes have been removed. the atelectatic streak in the left mid zone has cleared. at the current time, there is no evidence of acute pneumonia or vascular congestion or pleural effusion. brief hospital course: assessment and plan: 44 year old woman with schizoaffective disorder and sah s/p coiling l mca aneurysm transferred from osh with with epiglottitis and resp distress now intubated. . #. epiglottitis/hypercarbic respiratory failure: patient initially presented to osh with sore throat and was found to have imaging (neck x ray and ct per report) consistent with epiglottitis. abg also consistent with hypercarbia and respiratory acidosis with concomitant metabolic alkalosis. she left osh ed and subsequently presented with stridor and was intubated for airway protection. epiglottitis can be caused by thermal or inhalational injury but is more commonly caused by infection. the most common bacterial causes include h flu, strep pneumo, beta hemolytic strep and staph aureus but viral causes are also possible. patient was intially treated with decadron and empiric ceftriaxne. she was on insulin ss while on steroids. rapid resp viral panel sent, antigen was negative, viral cultures pending at the time of discharge; blood cx sent and were no growth. patient was evaluated by ent with laryngoscopy while intubated and again after extubation. initial impression was that epiglottis was mildly inflamed. after she was extubated, she had another endoscopic exam and was noted to have some vocal cord dysfunction, improved with relaxation techniques and no obvious epiglottitis. patient was transferred to the floor on and continued to do well. still had a sore throat, but no wheezing or shortness of breath, no dysphagia. ent also recommended increasing omprazole to 40 mg daily. have scheduled outpt ent follow-up . # pea cardiac arrest- this occured while in icu, patients pulse returned after 1 minute or so of chest compressions. etiology was felt to be possibly secondary to biting the tube versus related to propofol. patient had some pleuritic chest pain related to chest compressions later in hospital course, treated with ibuprofen, tylenol and one dose oxycodone. patient has oxycodone at home still for headaches and continue to take these as needed for chest pain as well. #. anemia: hct at current baseline 30-32 with high normal mcv. . #. h/o sah and mca aneurysm s/p coiling and repeat coiling : neurosurgery aware. no current active issues - continue aspirin 325mg po daily , has f/u scheduled with neurosurgery. . #. asthma: continue albuterol prn (mdi while intubated) although no current wheezing on exam . #. schizoaffective disorder: - continued home seroquel - restarted home benzos, trazodone and gabapentin . #. h/o polysubstance abuse: had urine tox positive for benzos (gets these rx), amphetamines (on adderal) and barbiturates (on butalbital for migraines). denied current substance use. #. adhd: held adderal in icu, restarted prior to discharge. medications on admission: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain fever. 2. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. gabapentin 300 mg capsule sig: one (1) capsule po hs (at bedtime). 5. clonazepam 1 mg tablet sig: two (2) tablet po bid (2 times a day). 6. lorazepam 1 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for anxiety. 7. trazodone 50 mg tablet sig: three (3) tablet po hs (at bedtime). 8. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for wheeze. 9. amphetamine-dextroamphetamine 5 mg tablet sig: four (4) tablet po bid (). 10. quetiapine 100 mg tablet sig: one (1) tablet po qam (once a day (in the morning)). 11. quetiapine 100 mg tablet sig: three (3) tablet po qhs (once a day (at bedtime)). discharge medications: 1. quetiapine 50 mg tablet sig: two (2) tablet po qam (once a day (in the morning)). 2. quetiapine 50 mg tablet sig: six (6) tablet po qhs (once a day (at bedtime)). 3. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: six (6) puff inhalation q6h (every 6 hours) as needed for wheezing. 4. clonazepam 1 mg tablet sig: two (2) tablet po bid (2 times a day). 5. lorazepam 1 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for anxiety. 6. acetaminophen 500 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 7. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). disp:*60 capsule, delayed release(e.c.)(s)* refills:*2* 8. ibuprofen 400 mg tablet sig: two (2) tablet po q8h (every 8 hours) as needed for pain. 9. amphetamine-dextroamphetamine 5 mg capsule, sust. release 24 hr sig: four (4) capsule, sust. release 24 hr po bid (). 10. oxycodone 5 mg tablet sig: one (1) tablet po every hours. 11. trazodone 50 mg tablet sig: three (3) tablet po once (once). 12. gabapentin 300 mg capsule sig: one (1) capsule po hs (at bedtime). discharge disposition: home discharge diagnosis: vocal cord dysfunction epiglottitis cardiac arrest discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted with wheezing and difficulty breathing and required intubation. you also had a cardiac arrest which lasted a short period with return of your heart beat with cpr/chest compressions. the likely cause of the wheezing was vocal cord dysfunction, although a viral illness and or gastric reflux may have been contributing. there was initially concern about epiglottitis (inflammation of the epiglottis), but this only mildly inflamed when they looked with a camera in your throat. you will need to take a higher dose of omeprazole (40mg) and will need to follow-up with ent and pcp as scheduled. you should continue your other outpatient medications as you did previously followup instructions: name: , v. md address: ,, , phone: appointment: friday 1:30pm name: , location: family practice address: , , phone: appointment: wednesday 2:00pm procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours laryngoscopy and other tracheoscopy cardiopulmonary resuscitation, not otherwise specified diagnoses: hyperpotassemia abnormal coagulation profile anemia, unspecified esophageal reflux adrenal cortical steroids causing adverse effects in therapeutic use asthma, unspecified type, unspecified cardiac arrest other postprocedural status attention deficit disorder with hyperactivity leukocytosis, unspecified schizoaffective disorder, unspecified painful respiration other diseases of vocal cords acute epiglottitis without mention of obstruction 

Answer: The patient is high likely exposed to