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: morphine / haldol attending: chief complaint: dyspnea major surgical or invasive procedure: intubation history of present illness: 67 yo female with chf/copd d/c'd on after hospitalization for chf and uti who presented to ed on with flash pulmonary edema likely secondary to hypertensive emergency requiring intubation for hypoxic respiratory failure and found to have a persistent uti. the patient denied cp, f/c, n/v. no home 02 requirement. . at presentation in the , pt was persistently hypoxic to the 70s despite increasing oxygenation. she was placed on nitro gtt for inital bps >200 medication noncompliance. max bp in ed 257/108. she was also given ctx/levaquin for question of pna on cxr along with + ua, iv steroids, nebs, and lasix. her bnp was elevated at ~7000. after stabilization, the patient was transferred to the micu. . micu course. captopril and hydralazine were added to her home bp regimen, and nitro drip was weaned off on . she was diuresed 2l over length of stay with iv lasix. she was extubated on . she was found to have an e.coli uti. she was continued on ceftriaxone. there was concern regarding her mental status while intubated. a head ct was performed and was unremarkable. . at time of micu call-out, she denied sob, chest pain, nausea, vomiting, diarrhea. no orthopnea or pnd. she reported feeling as though her respiratory status was at baseline. past medical history: cardiac risk factors: + diabetes, + dyslipidemia, + hypertension . cardiac history: cabg: none . percutaneous coronary intervention (): 1. one vessel coronary artery disease --> lcx (90% lesion), lad modest diffuse dz, rca 50% stenosis 2. successful ptca/stent of the proximal and distal lcx. 3. normal left ventricular function. (ef 60%) 4. resting hemodynamics showed mild pulmonary hypertension and a low-normal cardiac output. . other past medical history: cad: nstemi s/p pci w/ des to proximal and distal lcx. chf (diastolic dysfunction w/ ef >55%, 1+ ar and trivial mr, 2+ tr) dm 2, diet controlled hypercholesterolemia hypertension pulm htn- moderate h/o rheumatic heart disease w/ mild ar chronic renal insufficiency lung disease: ? copd vs. restrictive pattern on spirometry in and pulmonary nodules. history of pulmonary embolus in , while taking oral contraceptives, s/p ivc "interruption procedure") schizoaffective disorder h/o thyroiditis h/o seizure disorder from infancy to age of 17 social history: she lives alone. her daughter, , lives nearby and visits her frequently and helps her managing her medications. currently uses walker for walking. has home nurse her regularly for daily activity as well; tobacco abuse: 30 pyrs, still smoking, social drinker; no illicit drugs currently in rehab, s/p r total knee replacement family history: cad in mother at age 68. no history of coagulation problems in her family. physical exam: vs: 99.4 (99.8) 146/60 81 12 94% on 5l fsbs 111 gen: pleasant female eating breakfast in bed, nad, asking to go home heent: perrl, eomi, ncat, mmm and i neck: no jvd, no bruits cv: no mrg, nl s1, s2, rrr chest: cta bl abd: soft, nt/nd, +bs ext: no cce skin: intact, no rashes or jaundice neuro: cn2-12 grossly intact, moving all 4 extremities, sensation intact, oriented to person, place and time rectal and bladder foleys inplace and draining pertinent results: 10:07am plt count-386# 10:07am neuts-72.9* lymphs-20.3 monos-5.3 eos-1.3 basos-0.3 10:07am wbc-5.6 rbc-3.44* hgb-10.8* hct-33.7* mcv-98 mch-31.5 mchc-32.1 rdw-17.2* 10:07am ck-mb-notdone probnp-7233* 10:07am ctropnt-0.02* 10:07am ck(cpk)-64 10:07am glucose-105 urea n-9 creat-1.0 sodium-143 potassium-3.3 chloride-106 total co2-28 anion gap-12 11:39am urine rbc-0-2 wbc-21-50* bacteria-many yeast-none epi-0-2 11:39am urine blood-neg nitrite-pos protein-500 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-sm 11:39am urine color-yellow appear-clear sp -1.017 11:39am urine gr hold-hold 11:39am urine hours-random 02:20pm type-art po2-62* pco2-46* ph-7.40 total co2-30 base xs-2 08:06pm urine mucous-rare 08:06pm urine hyaline-10* 08:06pm urine rbc-41* wbc-39* bacteria-none yeast-none epi-<1 08:06pm urine blood-mod nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.5 leuk-mod 08:06pm urine color-yellow appear-hazy sp -1.014 08:06pm ck-mb-notdone ctropnt-0.01 08:06pm ck(cpk)-65 cultures: urine - : urine culture (final ): escherichia coli. >100,000 organisms/ml.. sensitivities: mic expressed in mcg/ml _________________________________________________________ escherichia coli | ampicillin------------ =>32 r ampicillin/sulbactam-- =>32 r cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 16 i ciprofloxacin--------- =>4 r gentamicin------------ <=1 s meropenem-------------<=0.25 s nitrofurantoin-------- <=16 s piperacillin---------- 32 i piperacillin/tazo----- 8 s tobramycin------------ <=1 s trimethoprim/sulfa---- =>16 r imaging: ekg : sinus rhythm. short p-r interval. mild q-t interval prolongation. since the previous tracing of atrial premature beats are no longer seen. cxr : the exam is technically limited by patient rotation. however, the left hemidiaphragm is obscured by a region of increased opacity at the left lung base, which could reflect atelectasis. overall, the pulmonary vasculature is engorged, with diffusely increased parenchymal opacity, consistent with mild-moderate edema. the cardiomediastinal silhouette remains markedly enlarged, overall unchanged. there is no pneumothorax. cervical spine fusion hardware is stable. soft tissue and bony structures are otherwise unremarkable. impression: moderate pulmonary edema. ct head : there is no evidence of hemorrhage, edema, masses, mass effect or infarction. the ventricles and sulci are normal in caliber and configuration. no fractures are identified. conclusion: normal study. : the patient has been extubated. the film is less rotated and in a slightly more lordotic position. there is no focal consolidation and the lateral cp angles are sharply delineated. pulmonary vascular markings are normal. mild cardiomegaly is demonstrated. some prominence of the right paratracheal soft tissues may be related to tortuous vessels. impression: no obvious radiographic explanation for fever spikes. brief hospital course: 67f with diastolic chf, copd, htn, ra transferred out of the micu after brief intubation for respiratory failure due to hypertensive emergency also found to have resistant e.coli uti. . ## respiratory failure: acute onset hypoxic respiratory failure. pna unlikely with lack of sputum production, cough, clear cxr. pe unlikely despite remote history of pe as patient is not hypotensive or tachycardic. history most consistent with flash pulmonary edema in the setting of known diastolic dysfunction. the patient was diuresed, her bp controlled with multiple meds including a nitro drip and she was successfully extubated morning of . she was weaned off oxygen and tolerated sats in the low 90s on room air. . ## hypertension: bp meds were adjusted to create the easiest dosing schedule. initially, the patient was on nitro gtt with prn hydralazine and home bb and ccb. she was weaned off and placed on tid isordil which was transitioned back to imdur prior to d/c home. captopril was added as an afterload reducer and titrated to patient bp. this was converted to lisinopril for easier dosing schedule. she was continued on her home bb and ccb, amlodipine. amlodipine dosage was increased from 5 to 10 mg. . ## uti: initially treated with cipro but patient demonstrated fevers and sensitivities returned showing resistance to cipro but sensitivity to ctx. patient was switched to ctx and thereafter to cefpodoxime for a total 7 day course to be completed as an outpatient. . ## copd:no evidence on exam for copd exacerbation. patient maintained on home albuterol prn and advair with prn nebs. . ## chf:as above, was treated with diuresis, bp control, and afterload reduction. . ## pulmonary artery hypertension: severe per last tte . no evidence for pe on cta done at same time. unclear etiology due to left heart failure vs pt's ra. consider repeating tte as an outpatient after stabilized to evaluate interval change in , may need rhc in future. . ## dm2: diet controlled at home. patient was maintained on sliding scale with minimal insulin needs. . ## : etanercept held due to acute illness. home sulfasalazine and plaquenil were continued. . ## cad: history of nstemi in s/p des, per omr, no longer on plavix. cardiac enzymes negative and ecg unchanged. no evidence of acs. patient was continued on home statin and aspirin. . ## hypercholesterolemia: home statin was contined. . ## schizoaffective d/o: home cymbalta and seroquel were contined. on , the patient was felt stable for discharge as her blood pressure was well-controlled on her new regimen and she was tolerating room air without difficulty. she was therefore discharged in good condition with scheduled follow up. medications on admission: albuterol amlodipine 10mg daily atorvastatin 80mg qhs duloxetine 20mg daily enteracept 50mg sc qweek fludrocortisone 0.1mg daily fluticasone/salmeterol 250/50 folic acid furosemide 20mg daily vicodin hydroxychloroquine 200mg daily isosorbide mononitrate 30mg daily lisinopril 5mg daily metoprolol tartrate 50mg pantoprazole 40mg daily quetiapine 50mg sulfasalazine 1g daily asa 81mg daily ferrous sulfate 325mg daily mvi discharge medications: 1. famotidine 20 mg tablet : one (1) tablet po q24h (every 24 hours). 2. atorvastatin 80 mg tablet : one (1) tablet po hs (at bedtime). 3. quetiapine 25 mg tablet : two (2) tablet po bid (2 times a day). 4. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 5. duloxetine 20 mg capsule, delayed release(e.c.) : one (1) capsule, delayed release(e.c.) po daily (daily). 6. sulfasalazine 500 mg tablet : two (2) tablet po qam (once a day (in the morning)). 7. sulfasalazine 500 mg tablet : one (1) tablet po qpm (once a day (in the evening)). 8. hydroxychloroquine 200 mg tablet : one (1) tablet po bid (2 times a day). 9. amlodipine 5 mg tablet : two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 10. furosemide 40 mg tablet : one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 11. fluticasone-salmeterol 250-50 mcg/dose disk with device : one (1) disk with device inhalation (2 times a day). 12. cefpodoxime 100 mg tablet : two (2) tablet po q12h (every 12 hours) for 3 days. disp:*12 tablet(s)* refills:*0* 13. lisinopril 20 mg tablet : two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 14. metoprolol tartrate 50 mg tablet : one (1) tablet po twice a day. discharge disposition: home with service facility: caregroup vna discharge diagnosis: hypertensive crisis with flash pulmonary edema e.coli urinary tract infection acute on chronic diastolic heart failure discharge condition: good discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: please attempt to restrict fluids to 2 liters daily to minimize your risk of fluid overload. you were admitted to the hospital because your blood pressure was very high. this placed strain on your heart. because of the heart strain, fluid backed up in your lungs. this caused you to be unable to oxygenate properly and resulted in your intubation. you were aggressively diuresed with extra lasix to get the extra fluid off of your lungs and your blood pressure medications were changed to better manage your blood pressure. you have a follow up appointment on with dr. at which time there may be additional changes to your medication regimen. until that time, you should take the medications as indicated on this discharge paperwork. in addition, you were found to have a urinary tract infection. you were treated with antibiotics and should complete the course of oral antibiotics as prescribed. you expressed interest in additional home services while in the hospital and dr. thought you may benefit from assistance with meal provision such as via meals on wheels. someone will contact you on with details on how this can be arranged. please call your pcp or come to the hospital if you experience severe headache, chest pain, increased shortness of breath, decreased urination, or any other symptoms of concern. followup instructions: 10:00am , md phone: 12:30pm (rheum lmob) phone: 11:50 , m.d. phone: md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia tobacco use disorder urinary tract infection, site not specified congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified acute on chronic diastolic heart failure other chronic pulmonary heart diseases percutaneous transluminal coronary angioplasty status chronic kidney disease, unspecified acute respiratory failure old myocardial infarction rheumatoid arthritis personal history of venous thrombosis and embolism hyperosmolality and/or hypernatremia schizoaffective disorder, unspecified hypertensive chronic kidney disease, malignant, with chronic kidney disease stage i through stage iv, or unspecified 

Answer: The patient is high likely exposed to