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: dyspnea. major surgical or invasive procedure: tracheostomy tube change. bronchoscopy x 2 + trach revision. history of present illness: this is a 69 year old woman with metastatic papillary thyroid cancer s/p resection complicated by tracheal stenosis, s/p tracheostomy with t-tube placement, admitted for respiratory distress with lll pneumonia. subsequently found to have tracheal stenosis proximally requiring revision. . underwent co2 laser ablation/partial r arytenoidectomy, t-tube removal and tracheostomy tube placement. , pt developed acute respiratory distress, with o2 sats to 78% + sbp in 200's. o2 sats increased to 100% on ambu-bag. respiratory rate -tube interrogated with no apparent blood oozing seen. pt suctioned with a little blood return. she was placed on cpap at 12/5 and rr decreased to 32 with bp in 140's. transferred to icu. . patient initially admitted after she developed cough with increased secretions and stridor. taken to ed where lll infiltrate was discovered on cxr. wbc 14.2. pt was afebrile saturating 100% on 40% trach mask. bp 95/64 with hr 90-99. pt started empirically on cefepime and vancomycin. pt also noted to be hyperkalemic to 5.6, kayexelate was given. she was subsequently admitted to icu for pneumonia and possible need for bronchoscopy. in the icu, antibiotic therapy was continued and pt underwent bronchoscopy on . the bronch showed t-tube prox. limb w/ 98%occlusion, distal limb patent, some supraglottic edema. pt was then transferred back to the floor awaiting re-bronchoscopy for stenosis on . underwent ent procedure, as outlined above. now admitted to micu for respiratory monitoring past medical history: 1. mult episodes of cardiac and respiratory arrest prompting inpatient hospitalizations here and ; most recently s/p vap with respiratory difficulties and cardiac arrest at osh 2. thyroid cancer dx in - papillary cancer with positive nodes status post sternotomy and partial right and total left 3. thyroidectomy on . 3. iddm 4. htn 5. hiatal hernia 6. b12 defic 7. b cell lymphoma-s/p chemo 8. h/o acinetobacter and enterobacter pneumonias at 9. a flutter 10. tracheomalacia, subglottic stenosis, and infra and superior glottic swelling seen on bronch social history: the pt has six children living in the area, 2 children living in . she is from and speaks cambodian. she understands some english. apparently she was independent with mobility and basic adl prior to her last hospitalization. her functional capacity recently has been the need for maximal assistance to total dependency in most areas family history: noncontributory physical exam: per admitting intern: vs: hr 84, 100% o2 on % fio2, tv's 534-546 gen: no acute distress, breathing comfortably on vent support heent: mmm, sclerae anicteric neck: t-tube in trach, no blood oozing cor: normal s1/s2, rrr, no m/r/g appreciated pulm: lungs clear b/l. no focal ronchi or wheezes abd: soft, nt, nd +bs. +gtube in place ext: no edema neuro: sleepy but arousable to voice, following commands pertinent results: 06:26pm potassium-5.4* 03:27pm urine color-yellow appear-clear sp -1.007 03:27pm urine blood-neg nitrite-neg protein-neg glucose-1000 ketone-neg bilirubin-neg urobilngn-neg ph-7.0 leuk-neg 01:29pm type- comments-not specif 01:29pm na+-129* k+-5.7* 12:16pm comments-green top 12:16pm lactate-2.4* 11:45am glucose-330* urea n-19 creat-1.0 sodium-122* potassium-5.2* chloride-87* total co2-22 anion gap-18 11:45am probnp-349 11:45am wbc-14.2*# rbc-3.91* hgb-11.5* hct-33.6* mcv-86 mch-29.4 mchc-34.1 rdw-15.7* 11:45am neuts-91* bands-3 lymphs-2* monos-3 eos-0 basos-0 atyps-0 metas-0 myelos-1* 11:45am hypochrom-normal anisocyt-occasional poikilocy-occasional macrocyt-occasional microcyt-normal polychrom-1+ ovalocyt-occasional schistocy-occasional teardrop-occasional 11:45am plt count-318 radiology preliminary report chest (portable ap) 5:45 am chest (portable ap) reason: please evaluate for cause of hypoxia. medical condition: 69 year old woman with subglottic stenosis, who had tracheal tube change today, now with stridor, desaturation. reason for this examination: please evaluate for cause of hypoxia. study: single portable ap chest. indication: 69-year-old female with trach change, now with desaturation. comparison: single ap view of the chest, . findings: sternotomy wires and trach tube identified in a normal position. cardiomediastinal silhouette is unchanged. no new pleural effusions or pneumothoraces identified. the lungs are clear. impression: no acute cardiopulmonary process identified. dr. dr. brief hospital course: this is a 69 year old woman with metastatic papillary thyroid cancer s/p resection complicated by tracheal stenosis, s/p tracheostomy with t-tube placement, admitted for respiratory distress with lll pneumonia. subsequently found to have tracheal stenosis proximally requiring revision on . now admitted to micu for intermittent tracheal occlusion requiring revision. . patient initially admitted after she developed cough with increased secretions and stridor. taken to ed where lll infiltrate was discovered on cxr. wbc 14.2. pt was afebrile saturating 100% on 40% trach mask. bp 95/64 with hr 90-99. pt started empirically on cefepime and vancomycin. pt also noted to be hyperkalemic to 5.6, kayexelate was given. she was subsequently admitted to icu for pneumonia and possible need for bronchoscopy. in the icu, antibiotic therapy was continued and pt underwent bronchoscopy on . the bronch showed t-tube prox. limb w/ 98%occlusion, distal limb patent, some supraglottic edema. pt was then transferred back to the floor awaiting re-bronchoscopy for stenosis on . underwent co2 laser ablation/partial r arytenoidectomy, t-tube removal and tracheostomy tube placement. . had episode of acute desaturation to 58%, with tachypnea. bag ventilation was difficult until trach was re-positioned, at which time o2 sats quickly recovered to 100% on 35% trach collar. total time of desaturation about one minute. abg done at that time was 7.39/34/58. ent seen and evaluated on floor. trach noted to have granulation tissue at tip of trach superiorly with patency below, once past the granulation tissue, patent to carina. also noted to have supraglottic edema with b/l mobile vocal cords with patent airway between vocal cords. she was admitted to micu for respiratory monitoring and trach revision by ip. trach was changed to a fr. tts 6mm trach. pt. satting well after trach revision, bps, hr wnl. . *tracheostomy tube to be fully inserted at all times.* . # desaturation: likely in setting of sedation post-op vs transient mucus plug (although bronch negative). improved oxygen saturation immediately after transfer with brief ambu-bag ventilation. now stable respiratory status on trach mask, although continues to saturate >94% when pulls trach mask off. monitor trach site for blood oozing, secretions. . # lll pneumonia. finished 11day course of vancomycin and cefepime (d1 ). continue atrovent bronchodilator therapy . # tracheal stenosis: visualized on bronch . after discussion w/ ip and ent, underwent co2 laser ablation/partial r arytenoidectomy, t-tube removal and tracheostomy tube placement on . will need further outpatient sessions with ent for continued ablation (has appointment with dr. ent) . # papillary thyroid ca: h/o papillary thyroid carcinoma s/p thyroid resection. cont thyroid hormone replacement. patient to follow-up with endocrine as outpatient (dr. . # diabetes, well controlled with insulin sliding scale. . # communication: daughter ; medications on admission: 1. guaifenesin 600 mg tablet sustained release sig: two (2) tablet sustained release po bid (2 times a day). 2. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 3. docusate sodium 150 mg/15 ml liquid sig: one (1) po bid (2 times a day) as needed. 4. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours) as needed. 5. calcium carbonate 1,250 mg (500 mg) tablet sig: one (1) tablet po bid (2 times a day). 6. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po bid (2 times a day). 7. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 8. acetaminophen 325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 9. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 10. insulin regular human 100 unit/ml solution sig: sliding scale injection asdir (as directed). 11. metoprolol tartrate 25 mg tablet sig: one (1) tablet po q6h (every 6 hours). 12. lansoprazole 30 mg susp,delayed release for recon sig: thirty (30) mg po once a day. discharge medications: 1. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 2. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 3. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). 4. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po bid (2 times a day). 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po q6h (every 6 hours). 6. lansoprazole 30 mg susp,delayed release for recon sig: one (1) po daily (daily). 7. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 8. docusate sodium 150 mg/15 ml liquid sig: one (1) po bid (2 times a day) as needed. 9. levothyroxine 137 mcg tablet sig: one (1) tablet po daily (daily). 10. insulin sliding scale. discharge disposition: extended care facility: academy manor of - discharge diagnosis: primary - tracheal stenosis secondary - diabetes - thyroid cancer - hyponatremia - pneumonia discharge condition: patient with tracheal mask. stable condition, will need trach care. **keep trach fully inserted at all times** discharge instructions: please take all your medications as prescribed. please seek immediately medical attention if you experience shortness of breath or other concerning symptoms. please see all your appointments below. please choose a primary care doctor an appointment as soon as possible. you will not be able to be followed-up with endocrine without having seen a primary care physician. will need to an appointment with dr. for the first week of (). one week before the appoinment, you will need to get following labs drawn at your primary care doctor: tsh, free t4, thyroglobulin, anti-thyroglobulin. followup instructions: wednesday 1:15 pm dr. ent () please make an appointment with primary care physician of your choice as soon as possible. please see above for appointment with endocrine service. procedure: enteral infusion of concentrated nutritional substances bronchoscopy through artificial stoma replacement of tracheostomy tube replacement of tracheostomy tube other partial laryngectomy tracheoscopy through artificial stoma diagnoses: hyperpotassemia unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia atrial flutter other b-complex deficiencies acute and chronic respiratory failure pneumonitis due to inhalation of food or vomitus long-term (current) use of insulin personal history of irradiation, presenting hazards to health personal history of malignant neoplasm of thyroid mechanical complication of tracheostomy edema of larynx other postablative hypothyroidism nonspecific abnormal results of pulmonary function study 

Answer: The patient is high likely exposed to