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: history of present illness: this is a 73 year old woman, with a remote history of tuberculosis, status post wedge resection in , and history of bronchoalveolar lung cancer, status post right upper lobe lung lobectomy and xrt in of this year. she presented to an internist in three to four weeks prior to admission, with a complaint of non productive cough. no fevers or shortness of breath above baseline. cough was also associated with chest pain on the right side that was sharp and pleuritic, occurring with coughing. no sick contacts. international travel. the patient was started on a five day course of azithromycin for treatment of bronchitis versus viral pneumonia. the patient reports that she has had viral pneumonia six times in the past 40 years. she received pneumo-vax immunization two years ago. the patient flew from to about five days prior to admission and worsening non productive cough on antibiotics. she developed low grade fevers to 100 to 100.5 and worsening dyspnea on exertion. chest pain was unchanged. she saw her local physician. x-ray done per husband reports a right lower lobe pneumonia and pleural effusion. white count of 14.8. the patient was then started on moxifloxicin. one day prior to admission, the patient's symptoms worsened and she spiked a temperature to 102 and had shaking chills. she presented to . outside hospital temperature was 98.4. pulse was 104. respiratory rate of 20. oxygen saturation 94%. blood pressure 120/54. chest x-ray showing worsening pneumonia in right middle lobe and right lower lobe. white blood cell count of 25. the patient was started on vancomycin and ceftazidime. the patient underwent ultrasound guided thoracentesis for small pleural effusion, with only 3 cc of fluid aspirated, which was hazy, yellow pleural fluid; however, ph was 6.89; glucose of 46; total protein of 4.5; ldh of 388. white count to 600; red count of 20,000 with 92 neutrophils, 4 lymphs, 4 monos. pleural fluid culture was sent and did not grow any organisms. infectious disease was consulted and the patient's antibiotics were changed to vancomycin and ciprofloxacin. given low ph of pleural fluid and concerns for empyema, patient was transferred to for thoracic surgery evaluation. on admission, ct scan of chest obtained showed one moderate sized, multi-loculated right pleural effusion with slight thickening of pleural rind, concerning for empyema. patchy, peripheral consolidation of right lower lobe, as well as more diffuse ground glass opacity, consistent with pneumonia. right hilar lymphadenopathy as well as slightly enlarged nodes in the zygoesophageal recess, may be reactive peripheral ground glass opacities in left upper lobe. two small left lower lobe lung nodules. one contains component of calcification and an empyema. of note, the patient reports a ct of chest was obtained , prior to head surgery, and was normal. the patient underwent pig tail catheter into right thoracic space with 100 cc of straw-colored fluid removed. catheter was maneuvered in an attempt to direct as many loculations as possible. gram stain showing 3+ pnm's, no micro-organisms. fluid was sent for culture. allergies: no known drug allergies. medications: hydrochlorothiazide 12 mg p.o. q. day. zestril 10 mg p.o. q. day. multi-vitamins. calcium 150 mg p.o. q. day. -pro times 20 years for osteoporosis prevention. past medical history: hypertension. history of tuberculosis in , treated for two years with streptomycin and pf. status post wedge resection with phrenic nerve injury in . history of spondylosis, status post spinal fusion in . hospital course complicated by meningitis and spinal leak. bronchoalveolar lung cancer, status post right upper lobe lobectomy, , followed by xrt for three months, finished in , with reported negative chest ct on . bilateral hip replacements for osteoarthritis in and . cutaneous porfira tarda, diagnosed in , treated with phlebotomy. status post appendectomy. social history: lived in , . moved to about five years ago. patient lives with husband who is a retired family physician. have four children. 30 year tobacco history, quit in . ethanol, 14 glasses of wine a week. had walked two miles a day prior to hip surgery. the patient reports six episodes of pneumonia over the last 30 years, although one was viral. physical examination: on admission, the patient was afebrile, temperature 99.1; heart rate 89 to 102; blood pressure 120 to 160 over 63 to 90; respiratory rate 20 to 22; oxygen saturation 97% on two liters. weight is 43 kilograms. general: awake, alert, breathing comfortably, in no apparent distress. pupils are equal, round, and reactive to light and accommodation. extraocular movements intact. oropharynx moist. no buccal lesions. neck supple. heart regular rate, tachycardia at 100, no murmurs, rubs or gallops. lungs: positive bronchial breath sounds and egophony at right breast. pigtail catheter in place on the right side. left diffuse sub crackles. abdomen: soft, nontender, non distended, positive bowel sounds. extremities: no edema or clubbing. neurologic: cranial nerves 2 through 12 intact. strength 5/5 proximally and distally. sensation grossly normal to light touch. laboratory data: white count of 20. hematocrit of 29. platelets of 637. 92 neutrophils, 3 lymphs, 3 monos, 3 eosinophils. sodium of 134; potassium of 4.4 and chloride of 103. bicarbonate of 22. bun of 9. creatinine of 0.7. hospital course: the patient was initially admitted to the medical service, with the history as described above. however, she was then transferred to the medical intensive care unit on because of an episode of tachypnea and respiratory distress, in the context of an examination showing diffuse wheezing and prolonged inspiratory to expiratory ratio. initial impression: the initial impression was that the patient was having some component of reactive airway disease, which responded to a combined treatment. low on the differential was a possible congestive heart failure. the patient was treated for both. she received lasix and nitrates and had some relief of symptoms. she also was treated with nebulizers. the patient ultimately stabilized of the neonatal intensive care unit day one on . later in the day, the patient had worsening respiratory distress, requiring intubation. her arterial blood gases at the time was 6.95, 76 and 102. the patient then received a bronchoscopy. it was felt that the patient had significant secretions and may have had an episode of mucus plugging and causing her desaturations and hypocarbic arrest. the patient was noted to have a very small airway and a #6 endotracheal tube was placed. results of bronchoscopy on revealed patent trachea, main right stem and right upper lobe bronchus are patent; right bronchus intermedius was patent and there were no masses visible. right middle lobe was patent. minimal to moderate amounts of white secretion. right upper lobe bronchus was patent and visualized with anterior apical and post bronchial right lower lobe was also patent. the patient was transiently on dopamine for an episode of hypotension, though she had a brief episode of atrial fibrillation on transfer to the intensive care unit. she remained hemodynamically stable and out of atrial fibrillation. the patient was weaned to pressure support ventilation by but had increased tachypnea with decreased pressor support. chest x-rays showed persistent middle and right lower lobe infiltrates; no significant effusion and also left upper lobe infiltrate. culture data revealed positive strep milleri from her pleural fluid. antibiotics were changed to ceftriaxone for coverage of strep milleri. by , however, the patient had increased respiratory distress, after being extubated on . the thought was that she likely had another episode of mucus plugging. examination was consistent with reactive airways. she was intubated again on , after discussing with the patient and her husband, who is her health care proxy. from a cardiac standpoint, the patient remained hemodynamically stable, slightly hypotensive, but ruled out for a myocardial infarction, with only some "t" wave inversions on electrocardiogram. overall picture and impression of team at this time was that the patient had underlying poor pulmonary reserve, in the context of remote tuberculosis history and wedge resection on the left; recent bronchoalveolar carcinoma on the right, status post resection, with a concurrent empyema and probably some component of restrictive disease with fibrosis, as well as an active pneumonia, requiring repeat intubation. over the next two days, the patient remained stable but then requiring continued treatment for strep milleri with continuous ceftriaxone. vancomycin was added for mersa which grew from a bronchoalveolar lavage done on . after extensive discussion with family and the patient's husband, who is her health care proxy, consent was achieved between the patient's family and the team regarding the fact that the patient's overall prognosis for recovery was limited and moreover, the patient and her husband had strong feelings against undergoing a tracheostomy and a prolonged wean. given this wish not to have a tracheostomy, it was felt that the patient would be unlikely to have any significant improvement over the next several days and would ultimately require a tracheostomy and require very prolonged intensive care unit and then rehabilitation course, should she recover at all. at this point, the patient's husband and family reached consensus on that the patient's care should focus on comfort care. the patient was extubated on with her family present. she remained comfortable. the patient had respiratory failure and died at 4:07 p.m. on . the patient's husband requested a post mortem examination. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis arterial catheterization closed [endoscopic] biopsy of bronchus diagnoses: unspecified pleural effusion atrial fibrillation personal history of malignant neoplasm of bronchus and lung asthma, unspecified type, unspecified acute respiratory failure postinflammatory pulmonary fibrosis other emphysema empyema without mention of fistula pneumonia due to other streptococcus 

Answer: The patient is high likely exposed to