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: broken esophageal stent major surgical or invasive procedure: attempted stent removal with stent breakage and migration multiple attempts by ent to remove stent intubation egd history of present illness: 72 year-old female with crest syndrome and barrett's esophagus with dysplasia s/p transhiatal esophagectomy, pyloroplasty and feeding jejunostomy in , with postoperative course complicated by esophageal leak, s/p esophageal stenting, c/b stent migration, s/p repositioning who now presents for removal of the stent. during the removal about 30% of the stent broke off and was removed from the esophagus. the rest of the stent stayed in the hypopharynx and also occluded the airway overlying the epiglottis. a difficult nasal intubation was successfull. subsequent attempt to remove the stent were unsuccessful and only a few small parts were removed. the patient was transferred to the icu. ent was contact. . ros: unable to obtain as patient intubated and sedated. according to husband negative for cough, sob, cp, abd pain or dysuria. pt just started to take full liquids yesterday, otherwise has been fed through the peg-tube. past medical history: crest syndrome (gerd/barrett's esophagitis/raynauds/scleroderma) dilated esophageal stricture right rotator cuff repair left shoulder replacement hysterectomy social history: lives with spouse, retired, no alcohol for 10 weeks, otherwise social etoh, no tobacco, or ivdu family history: not obtained physical exam: vs t 96.0 bp 102/54 hr 86 rr 12 o2sat 100% gen: nad heent: nc/at, perrla, mmm, small bleed in retropharynx, no stent visualized neck: no lad, no jvd, no carotid bruit cor: s1s2, regular rhythm, no r/g, holosystolic murmur over apex > radiating into axilla pulm: cta b/l, no wheezing or rhonchi abd: + bowel sounds, soft, nd, nt, peg tube in place, scar well healed except for small midline lesion skin: warm extremities, no rash, scattered teleangiectasis ext: 2+ dp, no edema/c/c, cool lower extremities, arthritic deformities of hands b/l with ulnar deviation neuro: moving all extremities, following commands, perrla, reflexes 2+ b/l pertinent results: <b>admit labs:</b> 09:14pm blood wbc-9.1 rbc-2.96* hgb-8.7* hct-25.9* mcv-87 mch-29.4 mchc-33.7 rdw-16.6* plt ct-326 09:14pm blood neuts-85.4* bands-0 lymphs-10.4* monos-3.0 eos-0.8 baso-0.4 09:14pm blood pt-11.9 ptt-23.9 inr(pt)-1.0 09:14pm blood glucose-78 urean-22* creat-0.4 na-133 k-4.2 cl-100 hco3-20* angap-17 09:14pm blood calcium-7.9* phos-3.4 mg-2.0 09:14pm blood cortsol-13.3 09:16pm blood type-art temp-35.6 rates-12/ tidal v-450 peep-5 fio2-40 po2-177* pco2-42 ph-7.36 caltco2-25 base xs--1 -assist/con intubat-intubated <br> <b>other labs:</b> 09:14pm blood cortsol-13.3 01:35pm blood type-art temp-36.6 tidal v-450 fio2-100 po2-421* pco2-33* ph-7.38 caltco2-20* base xs--4 aado2-275 req o2-51 intubat-intubated vent-controlled 10:03am blood type-art rates- tidal v-440 fio2-40 po2-174* pco2-36 ph-7.29* caltco2-18* base xs--8 -assist/con intubat-intubated <br> <b>imaging studies:</b> portable abdomen 10:24 am findings: ap portable supine radiograph is obtained. there is residual gastrografin within the colon from previous small-bowel follow through. there is no evidence of obstruction identified. impression: no evidence of obstruction identified. <br> chest (portable ap) 10:24 am findings: on the study, the stent was located in the thoracic area. the proximal edge resided at the t3 level and the distal aspect of the stent resided at approximately the t9 level. on the current study, the stent has migrated proximally. the distal aspect of the stent now resides at the thoracic inlet at approximately the t3 level. the proximal aspect of the stent is not well appreciated on today's study. however, on the film, the proximal aspect of the stent appears to reside at the c6-7 level. the heart is enlarged. retrocardiac opacity likely represents the gastric pullthrough. there is also likely a component of atelectasis. there are two patchy airspace opacities in bilateral upper lung zones, unchanged. this could represent aspiration or pneumonia. postsurgical changes in both shoulders. impression: 1. the stent in question has migrated proximally above the thoracic inlet since the prior study of . please see discussion above. 2. unchanged bilateral upper lobe airspace opacities which could represent aspiration or pneumonia. <br> chest (portable ap) 10:51 am findings: the endotracheal tube has been removed. an esophageal stent is present. the tip of the stent terminates just above the clavicles, stable. cardiomediastinal silhouette unchanged. there is a patchy opacity in the left upper lung zone which could represent pneumonia or aspiration. there is also a patchy opacity in the right upper lung zone, and right mid lung zone concerning for the same. these are new since prior study. there is a retrocardiac opacity also concerning for same. again noted is a total left shoulder prosthesis and postsurgical changes in the right shoulder. impression: 1. new patchy opacities left upper lung zone, right, mid and lower lung zones, concerning for aspiration vs. pneumonia. <br> bas/ugi air/sbft 3:35 pm there has been interval migration of the esophageal stent which now is located at the level of upper esophagus and distal pharynx. the gastrografin passes freely through the pharynx and esophagus. there is no retention of the contrast in th e valecula or piriform sinuses. no aspiration or penetration was noted. the esophagogram demonstrated normal appearance of the gastric pull- through with no stricture or leak. impression: 1. interval migration of esophageal stent to the upper esophagus - lower pharyngeal area. 2. no leak or stenosis is noted. no aspiration was visualized. <br> esophagus 10:04 am findings: patient was administered conray orally, no evidence of extravasation was seen. subsequently, barium was administered. the patient is status post esophagectomy with gastric pull-up. there is no stricture at the anastomosis. a metallic stent is seen. impression: status post esophagectomy, gastric pull-up no evidence of extravasation or strictures at the anastomosis. <br> chest (portable ap) 8:13 pm findings: compared to , the esophageal stent has migrated cephalad with its distal most portion now at the thoracic inlet roughly 10.0 cm cephalad to where it was on the prior study. the more superior portion may be just below the upper esophageal sphincter. endotracheal tube is in expected position roughly 6.0 cm above the carina. there is no gas seen within the stomach in the mediastinum. left basilar consolidation persists and there is high- density material overlying the left lung base which could represent retained barium if there has been administered since . consolidation in the left mid lung and right apex are unchanged and may represent slow resolving aspiration versus scarring. there is likely a small left pleural effusion, however, the right pleural effusion appears to have resolved. no new pulmonary opacities. heart size is unchanged. total left shoulder arthroplasty and right chronic rotator cuff tendinopathy changes and post- surgical suture anchors are unchanged. impression: 1. migration of esophageal stent into the cervical esophagus. 2. persistent pulmonary opacities with new high-density material overlying the left lung base which could be barium within the stomach or within the lung. <br> <b>micro data:</b> blood cx (, ) - no growth x 4 c. diff toxin () - negative <br> <b>discharge labs:</b> 10:00am blood wbc-9.3 rbc-3.26* hgb-9.6* hct-28.5* mcv-87 mch-29.6 mchc-33.8 rdw-16.8* plt ct-368 10:00am blood neuts-71.0* lymphs-19.3 monos-6.5 eos-2.8 baso-0.4 10:00am blood glucose-100 urean-23* creat-0.4 na-134 k-4.7 cl-100 hco3-27 angap-12 10:00am blood alt-7 ast-12 alkphos-67 totbili-0.2 10:00am blood albumin-2.9* calcium-8.1* phos-2.7 mg-2.1 10:00am blood triglyc-74 brief hospital course: 1) fractured stent stent was fractured during removal. got laryngoscopy and endoscopy and all but one piece was removed. final piece is approximately 9 cm is adhered to anastamosis. was followed by thoracic surgery as well. gi feels comfortable leaving remaining stent in place as esophagus is patent and stent has migrated distally in past (not proximally). barium swallow showed no perforation. was started on steroids for airway edema. was intubated for airway protection but was extubated within a day. respiratory status remained stable. she will have follow-up x-rays done as an outpatient (on and ) to assess to location of the stent. these will be reviewed by her gastroenterologist, dr. . she will subsequently follow up with dr. and dr. . <br> 2) aspiration pna patient was hypotensive and hypothermic in setting of multiple scopes, patient likely aspirated. cxr is consistent with aspiration pna. patient was subsequently hemodynamically stable. she was intially treated with vanco/zosyn, but was switched to iv flagyl/levo. ultimately changed to cefpodox and flagyl, wich she will take to complete a full course. blood cultures were negative. <br> 3) crest nifedipine held (not on her med list). she was given viscous lidocaine to help with her throat pain. also given percocet liquid for pain. <br> 4) hypertension after initially being held, her metoprolol was restarted. medications on admission: medications from last discharge summary: 1. oxycodone-acetaminophen 5-325 mg/5 ml : 5-10 mls po q4h prn. 2. metoprolol tartrate 25mg 3. tube feed replete at 55 cc/hr continuous 4. lactulose 10 g/15 ml 30mls'or" prn via feeding tube. 5. colace 50 mg/5 ml liquid sig 10mls prn 6. polyethylene glycol 3350 17g 1 packet po daily 7. lansoprazole 30mg delayed release via j tube 8. levofloxacin 500 mg tablet for 7 days . last medication list per husband: prevacid metoprolol 12.5mg discharge medications: 1. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po once a day. disp:*15 tabs* refills:*2* 2. lidocaine hcl 2 % solution sig: twenty (20) ml mucous membrane tid (3 times a day) as needed for sore throat. disp:*500 ml(s)* refills:*2* 3. lactulose 10 g/15 ml syrup sig: thirty (30) ml po q8h (every 8 hours) as needed for constipation. 4. cefpodoxime 100 mg/5 ml suspension for reconstitution sig: ten (10) ml po twice a day for 9 days. disp:*180 ml* refills:*0* 5. flagyl 500 mg tablet sig: one (1) tablet po twice a day for 9 days. disp:*18 tablet(s)* refills:*0* 6. oxycodone-acetaminophen 5-325 mg/5 ml solution sig: ml po every four (4) hours as needed for pain. disp:*500 ml* refills:*0* 7. sodium chloride 0.65 % aerosol, spray sig: two (2) spray nasal tid (3 times a day). disp:*1 inhaler* refills:*2* 8. lansoprazole 30 mg susp,delayed release for recon sig: thirty (30) mg po once a day: via j-tube. discharge disposition: home with service facility: area vna discharge diagnosis: primary: esophageal stent fracture likely aspiration pneumonia secondary: crest syndrome barrett's esophagus (s/p transhiatal resection w/ anastamotic leak w/ stent placement and stent migration and repositioning) dilated esophageal stricture discharge condition: afebrile, vital signs stable. discharge instructions: please take all medications as presribed. you will need to complete the course of antibiotics. the last dose is to be taken on . you will need to have neck/upper chest x-rays taken to evaluate the stent location. this should be done at in on and (as arranged). dr. will follow up with you regarding these results. . return to the emergency room or call your primary doctor for: shortness of breath chest pain nausea/vomiting/abdominal pain fever followup instructions: dr. (ct surgery) - (please follow up next week as scheduled) dr. (gastroenterology) - (please follow up as scheduled or call to confirm) pcp: . . please call for follow up appointment. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours other gastroscopy other endoscopy of small intestine insertion of endotracheal tube enteral infusion of concentrated nutritional substances laryngoscopy and other tracheoscopy diagnoses: acidosis unspecified essential hypertension hyposmolality and/or hyponatremia atrial fibrillation pneumonitis due to inhalation of food or vomitus mechanical complication due to other implant and internal device, not elsewhere classified barrett's esophagus status of other artificial opening of gastrointestinal tract systemic sclerosis 

Answer: The patient is high likely exposed to