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: hypoxic respiratory distress major surgical or invasive procedure: none history of present illness: the patient is a f with hx of rheumatoid arthritis, osteroarthritis, malnutrition, recently admitted to with diffuse esophageal spasm with subsequent recent admission to with gib, who recent finshed a course of abx for uti, and is currently undergoing treatement for clostridium difficile infection. she is brought to the ed today by her family, as she's had a 7 day course of progressive lethargy, anorexia, cough productive for clear sputum, & pleuritic chest pain. there are no reported fevers or chills, nausea, vomiting, aspiration events, recent travel, or smoking. the family does report that she's had increasing erythema at the sacrum and worsening of her lower extremity skin tears. they also report that she's had dependent edema without changes in her urinary habits. ed course: she was found to be slighly unresponsive and in no apparent distress, and vital signs were remarkable for an oxygen saturation in the mid-80's. she had a cxr done that revealed infiltrates vs effusions bilaterally, and her labs were notable for a wbc count of 17 with 92% pmns. she was subsequently given iv ctx/flagyl/azithromycin. given her clinical findings and ongoing hypoxia she was admitted to the for observation. past medical history: 1. rheumatoid arthritis for 2. osteoporosis. 3. hiatal hernia. 4. intermittent cognative impariment of unclear cause, 5. failure to thrive 6. urinary incontinence. 7. intermittent leg edema social history: patient resided at the nursing home in past; however, daughter and granddaughter took the patient home after discharge on . her daughter is very involved with her care. on last admission, the did not want to send her to rehab. etoh: none. tobacco: none. illicits: none. family history: noncontributory physical exam: tmax: 36.2 ??????c (97.2 ??????f) tcurrent: 36.2 ??????c (97.2 ??????f) bp: 143/119(125) {133/68(85) - 143/119(125)} mmhg rr: 20 (20 - 30) insp/min heart rhythm: sr (sinus rhythm) peripheral vascular: (right radial pulse: 1+), (left radial pulse: 1+ (right dp pulse: not assessed), (left dp pulse: not assessed) skin: sacral skin breakdown with surrounding erythema, dressed bilateral skin tears neurologic: responds to: voice, movement: maew, tone: increased upper extremity tone heent: at/nc, patient did not open eyes, dry mm, poor dentition, no jvd cardiac: irregular rhythm, s1/s2, holosystolic murmur @ rusg lung: decreased air movement bilaterally, without wheezes, rales, or rhonci abdomen: nondistended, +bs, nontender in all quadrants, no rebound/guarding m/s: moving all extremities well, no cyanosis, clubbing o pertinent results: cxr portable ap semi-upright chest radiograph: the cardiomediastinal silloutte is stable, however partially obscured by large bilateral pleural effusions that are unchanged. there is no pulmonary edema or evidence of pneumonia cxr impression: pulmonary edema with enlarging bilateral pleural effusions significantly worse since . kub impression: paucity of bowel gas component, which could be seen with obstruction. if clinically indicated, either a repeat study or a ct may be obtained for better characterization tte the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is unusually small. left ventricular systolic function is hyperdynamic (ef 70-80%). right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the supporting structures of the tricuspid valve are thickened/fibrotic. moderate to severe tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. impression: hypertrophic, hyperdynamic left ventricle with very small cavity size; at least moderate mitral regurgitation and moderate-to-severe tricuspid regurgitation brief hospital course: 1. aspiration pneumonia - patient was maintained on vancomycin and zosyn - aspiration precautions were continued - family declined peg - geriatrics were consulted 2. c. difficile colitis - patient was maintained on flagyl - plan was for 2 weeks post cessation of vanco/zosyn - serial toxin assay 3. severe malnutrition - no ngt or peg per family - continous aspiration 4. sacral decubitus - vascular consultation - wound care consult - wound care 5. coagulopathy - nutritional # goals of care: patient was extensively consulted on by palliative care and geriatrics. lengthy discussions with the family. patient was cmo/dnr/dni with plans to discharge to hospice on , however she expired prior to discharge medications on admission: docusate 100mg po bid lidocaine patch 5% on 12 hrs, off 12 hrs daily megestrol 40mg qhs miconazole 2% topical daily mirtazapine 15mg qhs omeprazole 40mg daily sucralfate 1gm q6h boutreaux butt past daily oxycodone prn (rarely takes) senna 2 tabs daily prn discharge disposition: expired discharge diagnosis: aspiration pneumonia c. diff colitis septicemia pressure ulcers severe malnutrition coagulopathy discharge condition: expired discharge instructions: you are going home with hospice services. they will be your primary contact for symptom management. followup instructions: provider: , md phone: date/time: 1:00 provider: , md phone: date/time: 12:00 procedure: venous catheterization, not elsewhere classified diagnoses: acidosis anemia of other chronic disease other chronic pain esophageal reflux acute kidney failure, unspecified unspecified septicemia unspecified protein-calorie malnutrition other persistent mental disorders due to conditions classified elsewhere diaphragmatic hernia without mention of obstruction or gangrene pneumonitis due to inhalation of food or vomitus cardiac arrest osteoporosis, unspecified pressure ulcer, other site intestinal infection due to clostridium difficile osteoarthrosis, unspecified whether generalized or localized, site unspecified pressure ulcer, lower back rheumatoid arthritis hypoxemia encounter for palliative care hyperosmolality and/or hypernatremia backache, unspecified other and unspecified coagulation defects barrett's esophagus urinary incontinence, unspecified adult failure to thrive hip joint replacement anorexia personal history, urinary (tract) infection edema unspecified persistent mental disorders due to conditions classified elsewhere 

Answer: The patient is high likely exposed to