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 / oxycontin / percocet attending: chief complaint: unresponsive, hypoglycemic major surgical or invasive procedure: intubation and mechanical ventilation x 2 picc line placement and removal history of present illness: 65 y/o female with a h/o t2dm, htn, and pvd who was found down by home health aid. ems was called and patient's blood sugar was found to be 12. she had an iv placed in her left shin and received glucagon and 1 amp d50 as well as thiamine. her bs increased to 202 and patient became more responsive. when she arrived to the ed, she had copious secretions and was satting 100% on ra but she was intubated in the ed because it was felt she could not protect her airway. cxr was done which was consistent with asymetric chf vs. an infectious process such as aspiration pna. patient received a dose of vanc/flagyl/levo in the ed. . in the icu, she was extubated on hod #2 but re-intubated several days later for hypoxemic respiratory failure, possibly from bilateral upper-lobe pna vs boop. she was treated with steroids and received a course of vanc/zosyn and was extubated approx 2 days later. at time of transfer to the floor, her o2 sats were 99% on 2l. bp had been difficult to control and was on ntg gtt briefly. she also became hyperglycemic requiring an insulin gtt but was transitioned to sc insulin. . she was transferred to the medical floor hemodynamically stable. past medical history: gout t2dm since , using insulin since . osteoarthritis hypertension "temporary paralysis", ? tia vs cva left parietal lacunar stroke in causing right hemiparesis cholecystectomy cervical cancer, s/p tah chronic renal failure (baseline creatinine 1.8-2.0) diabetic retinopathy planum sphenoidale meningioma social history: she does not smoke cigarettes or drink alcohol. family history: nc physical exam: upon arrival to micu: t 99.8 bp 161/68 hr 78 rr 30 ac 500x14 peep 5 fio2 100% gen: sedated heent: ett and and og tube in place lungs: vent airway noise cardiac: rrr s1/s2 no murmurs abd: obese, soft, +bs ext: left io iv in place neuro: sedated pertinent results: labs: . micro: multiple blood cultures - negative urine cultures - negative c. diff - negative x 4 c. diff toxin b assay pending at time to discharge to rehab . imaging: : ct head - no cranial hemorrhage, shift of normally midline structures, or evidence of acute major vascular territorial infarct is apparent. mild-to-moderate periventricular white matter hypodensity predominates in the frontal lobes and is likely the sequelae of chronic small vessel infarction. sulcal and ventricular prominence is likely related to age-related atrophy. mucosal thickening involving several ethmoid air cells and the sphenoid sinus is noted. surrounding osseous structures are unremarkable and no fracture is seen. . : tte - the la is normal in size. there is mild symmetric lvh. the lvcavity size is normal. overall lv systolic function is normal (lvef 70%). tissue doppler imaging suggests an increased lvfilling pressure (pcwp>18mmhg). transmitral doppler and tissue velocity imaging are consistent with grade ii (moderate) lv diastolic dysfunction. there is no vsd. rv chamber size and free wall motion are normal. the av leaflets (3) are mildly thickened but as is not present. no aortic regurgitation is seen. the mv leaflets are mildly thickened. there is no mv prolapse. trivial mr is seen. there is moderate pa systolic hypertension. there is no pericardial effusion. . : ct chest - 1. diffuse bilateral airspace disease, upper lobe predominant, concerning for pneumonia. 2. mediastinal lymphadenopathy, which may be reactive. 3. left picc line distal tip at the level of the left brachiocephalic vein. 4. stable left adrenal thickening. 5. no acute inflammatory process within the abdomen or pelvis. 6. heterogeneous thyroid, correlation with thyroid ultrasound is recommended in a nonemergent basis . ct abdomen and pelvis w/o contrast no specific ct finding to explain patient's abdominal pain. unchanged appearance of left adrenal thickening. unchanged appearance of age-indeterminate compression deformity of the superior endplate of t12. . wbc-6.8 rbc-4.00* hgb-10.4* hct-31.7* mcv-79* mch-25.9* mchc-32.6 rdw-16.7* plt ct-170 wbc-10.3 rbc-3.30* hgb-8.5* hct-26.2* mcv-79* mch-25.6* mchc-32.3 rdw-18.3* plt ct-438 glucose-132* urean-57* creat-1.8* na-140 k-4.2 cl-107 hco3-24 angap-13 glucose-132* urean-33* creat-1.7* na-143 k-4.4 cl-109* hco3-26 angap-12 alt-29 ast-42* ld(ldh)-300* alkphos-104 totbili-0.1 calcium-9.1 phos-4.2 mg-1.6 brief hospital course: 65 y/o female with a h/o t2dm, pvd, and hypertension who was found down at home with a blood sugar of 12 complicated by aspiration pna. she was initially intubated for airway protection with rapid extubation. however her intensive care course was further complicated by progressive respiratory distress thought secondary to hospital acquired pneumonia. she was subsequently transferred to the medical floor after improvement in her respiratory status. the following issues were addressed during this hospitalization. . 1. hypoglycemia/t2dm the trigger to the pt's initial hypoglycemia was most likely an medication error as patient has a long standing h/o t2dm and takes insulin at home. her blood sugars responded to glucagon and 1 amp d50. with monitoring the patient improved and slowly nph was added. it was titrated up as tolerated to maintain excellent glycemic control. . 2. respiratory distress the patient intubated in the ed for copious secretions and it was felt she would be unable to protect her airway. she was diuresed with lasix to improve pulmonary function. patient was extubated successfully on . she was treated for 5 days with levo/flagyl for aspiration pna. the patient continued to have episodes of hypertension and flash edema. with cpap and lasix she initially responded and her blood pressure meds were increased to prevent flash pulmonary edema. she required aggressive diuresis given her fluid overload. however, on she continued to have worsening respiratory status and presumed ards secondary to hap. she was intubated and treated with vanc/zosyn. given ct scan, she completed 10 days total of vanc/zosyn. she was initially started on steroids for concern of boop, however these were rapidly tapered. pulmonary was consulted and felt that her clinical picture was most consistent with pneumonia. she was changed to levofloxacin on and will complete a five day course. pulmonary recommended an outpatient pulmonary follow up, ct chest 4-6 weeks, outpatient sleep study, and outpatient echocardiogram to assess for pulmonary hypertension. she will need continued pulmonary toilet upon discharge to acute rehab. . 3. anemia patient's anemia is to iron deficiency anemia along with anemia of chronic disease. she had no evidence of bleeding. her blood count was monitored and was stable. . 4. htn the patient had persistently elevated blood pressures requiring a nitroglycerine drip initially. she continued on her outpatient anti-htn medications: metoprolol, amlodipine, hydralazine, imdur at increased doses where able. her diuretic was held with regard to her acute on chronic renal failure as below. . 5. cad/chest pain patient had chest pain that seemed msk given reproducibility but upsloping of st in iii and avf was intially concerning for ischemia. however, she completed a rule-out for mi. . 6. gout patient has a history of gout. the patient remained on her allopurinol. she did experience a gout flare in her left foot and colchicine was added with success. she will be discharged to rehab on colchicine but it will be stopped once her flare resolves. . 7. cri with arf patient admitted at baseline creatinine, which is most likely secondary to diabetic nephropathy. she developed arf, with a normal renal us and lytes consistent with intrinsic renal failure. the patient's renal function worsened and was likely related to diuresis. she received ivf and improved. she is currently at baseline. . 8. diffuse abdominal pain/diarrhea the pt developed some diffuse abdominal discomfort. she also developed some diarrhea. she was treated empirically for c.diff infection with flagyl. diarrhea resolved. abdominal discomfort persisted. gi was consulted and agreed with treating for c. diff. she will finish her course of flagyl at rehab. she has a known h/o gastroparesis to her t2dm. she was started on reglan with good effect. ct abdomen/pelvis were unrevealing and did not explain a cause for her abdominal discomfort on 2 different studies. . 9. thyroid heterogeneity this was an incidental finding on a ct torso. tfts were consistent with sick euthyroid. these imaging abnormality should be followed up as an outpatient with ultrasound and consideration for biopsy. . 10. code: full . 11. comm: medications on admission: allopurinol 100 mg po daily, amlodipine 10 mg po daily, aspirin 81 mg po daily, cacitriol 0.25 mcg po daily, colace 100 mg po twice daily, folic acid 1 mg po daily, humulin-n 45 units q a.m. and 25 units q bedtime, sliding scale humulin-r during the day, hydralazine 50 mg po 4 times daily, hctz 25 mg po daily, imdur 30 mg po daily, lipitor 20 mg po daily, methotrexate 10 mg po weekly, metoprolol 50 mg po daily, multivitamin 1 tab po daily, neurontin 400 mg po 3 times daily, prilosec 40 mg po twice daily, paxil 30 mg po daily, sorbitol po daily, tramadol 50 mg po q 4 to 6 hours po prn. discharge medications: 1. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 2. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 4. calcitriol 0.25 mcg capsule sig: one (1) capsule po daily (daily). 5. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 6. hydralazine 50 mg tablet sig: 1.5 tablets po q6h (every 6 hours). 7. isosorbide dinitrate 20 mg tablet sig: two (2) tablet po tid (3 times a day). 8. atorvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 9. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). 10. hexavitamin tablet sig: one (1) cap po daily (daily). 11. paroxetine hcl 30 mg tablet sig: one (1) tablet po daily (daily). 12. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid w/meals (3 times a day with meals). 13. clonidine 0.2 mg tablet sig: one (1) tablet po tid (3 times a day). 14. duloxetine 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 15. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 16. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 17. albuterol sulfate 0.083 % (0.83 mg/ml) solution sig: one (1) nebulizers inhalation q4h (every 4 hours). 18. ipratropium bromide 0.02 % solution sig: one (1) nebulizer inhalation q4h (every 4 hours). 19. hydroxychloroquine 200 mg tablet sig: one (1) tablet po bid (2 times a day). 20. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 21. loperamide 2 mg capsule sig: one (1) capsule po tid (3 times a day) as needed for diarrhea. 22. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 3 days. 23. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 2 weeks. 24. insulin nph human recomb 100 unit/ml suspension sig: forty (40) units subcutaneous qam (in the morning. 25. insulin nph human recomb 100 unit/ml suspension sig: fourteen (14) units subcutaneous qpm (in the evening). 26. insulin regular human 300 unit/3 ml insulin pen sig: as per attached sliding scale units subcutaneous three times a day. 27. metoclopramide 10 mg tablet sig: 0.5 tablet po qidachs (4 times a day (before meals and at bedtime)). 28. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed for cough. 29. colchicine 0.6 mg tablet sig: one (1) tablet po daily (daily): until resolution of acute gout attack in left foot. discharge disposition: extended care facility: - discharge diagnosis: hypoglycemia type ii diabetes chronic renal failure acute renal failure bilateral pneumonia hypoxic respiratory failure requiring intubation/ventilation diarrhea, possible c.diff infection ? gastroparesis discharge condition: the patient was discharged hemodynamically stable afebrile with appropriate follow up. discharge instructions: you were diagnosed with hypoglycemia, severe aspiration pneumonia, and presumptive c.dif colitis. you were treated with 2 weeks of zosyn/vancomycin(antibiotics) for your pneumonia and are being treated with flagyl for presumed c.diff colitis (intestinal infection). you had an abnormality on the imaging of your thyroid. please work with your primary care doctor to have a thyroid ultrasound arranged. take your medications as below. if you develop chest pain, shortness of breath, fever, chills, or any other concerning symptoms, please contact your rehab doctor or report to the nearest er. while you were in the hospital, the pulmonary team evaluated you for your cough and pneumonia. you will need to have a ct scan of your chest in weeks, have a sleep study, and have a follow up appointment with pulmonology. the rehab facility and your pcp will help to arrange the above issues. followup instructions: please make an appointment to see your pcp . 1 month after discharge. call to schedule your appointment. please call the pulmonary clinic at ( to schedule an outpatient pulmonary follow up in weeks. they would like to have a repeat chest ct in weeks, outpatient echo, and outpatient sleep study arranged as an outpatient. your previously scheduled appointments: provider: mri phone: date/time: 11:30 provider: , m.d. phone: date/time: 11:00 md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified diagnostic ultrasound of heart insertion of endotracheal tube transfusion of packed cells diagnoses: end stage renal disease congestive heart failure, unspecified acute kidney failure, unspecified hyposmolality and/or hyponatremia gout, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute respiratory failure pneumonitis due to inhalation of food or vomitus diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled intestinal infection due to clostridium difficile iron deficiency anemia, unspecified atherosclerosis of native arteries of the extremities, unspecified personal history of malignant neoplasm of cervix uteri diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy diabetes with peripheral circulatory disorders, type ii or unspecified type, not stated as uncontrolled other specified alveolar and parietoalveolar pneumonopathies unspecified disorder of stomach and duodenum 

Answer: The patient is high likely exposed to