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: heparin agents / percocet attending: chief complaint: chief complaint:respiratory distress major surgical or invasive procedure: intubation and mechanical ventilation history of present illness: 67f with extensive cardiac history and copd with post-intubation tracheal stenosis, s/p tracheal decannulation and tracheocutaneous fistula. discharged from ent service after tracheocutaneous fistula closure; her hospital course was complicated by respiratory failure requiring intubation, mrsa bacteremia/rll pna completed a course of vancomycin, discharged home with bipap at night on a course of bactrim. has history of pseudomonas pna. overnight on evening of admission had acute sob after getting up oob to use bathroom. reports feeling very anxious, put on cpap, able to sleep for an our, awoke again with severe sob and presented to osh ed. reports jaw pain is her anginal equivalent but did not experience this during the episode. no chest pain. has been coughing, producing white sputum, though no more than prior to last discharge. subjective fevers this afternoon. no chills. slight right hip pain although not new. on 2l 02 at home, able to ambulate and climb stairs without difficulty. no note of le swelling or recent weight gain. initially presented to hospital, found to have rll pna on cxr and new leukocytosis, transfered to ed. in our ed, tried off bipap, desatted to 80s on nrb. got ctx, azithromycin lasix and 500ns at osh at was flown here. in our ed, initial vs 98.5 hr 80s bp 95/44 20 98% bipap, given 1 dose of levaquin. past medical history: -coronary artery disease s/p cabg in and "recent" pci -chf, last tte ef 60% with mild lvh and some focal hypokinesis at base. -osa -dyslipidemia -htn -left total hip replacement-, elective. complicated postoperative course with post-operative atrial fibrillation wtih rvr requiring cardioversion, sepsis, pseudomonas vap, vre ut, and prolonged intubation leading to trach/peg. discharged to chronic wean facility but unable to decannulate. bronchoscopy revealed tracheomalacia of subglottic region. -supraglottic edema from gerd -bipolar disorder -depression -chronic atrial fibrillation, developed postop from thr, not anticoagulated -chronic constipation -hit during fragmin therapy social history: married. very supportive husband. when she is not hospitalized/in rehab, she lives with him. no etoh or current smoking. has 35 pack year smoking history, quit 13 years ago. family history: depression physical exam: vitals: t:96.3 bp:94/51 p:83 r:17 sao2: 100 bipap 100% fi02, peep/ps 6/6 tvs 400s. general: awake, alert, mildly anxious, tachypneic. heent: ncat, mm dry. hoarse voice neck: supple, inspiratory wheeze on ascultation of trachea (louder than in lungs), + jvd with hjr. s/p tracheocutaneous fistula repair with bandage c/d/i, incision still partially open with sm amount white drainage. no surrounding erythema. no crepitus. pulmonary: no crackles, inspiratory wheeze. decreased at right base. cardiac: distant. rr, nl s1 s2, no murmurs, rubs or gallops appreciated abdomen: soft, nt, nd, normoactive bowel sounds, no masses or organomegaly noted extremities: no edema, 2+ radial, dp pulses b/l neurologic: alert, oriented x 3. able to relate history without difficulty. cranial nerves ii-xii intact. normal bulk, strength and tone throughout. no abnormal movements noted. no deficits to light touch throughout. per ent note: foe: nasopharynx unremarkable. moderate supraglottic edema at the level of the false cords. no erythema or exudates. bilat true vocal folds with no edema, movement is symmetric. good approximation. scant pooling of thick mucus in the pyriform sinuses bilat. pertinent results: wbc 19.3 normal diff (52% neutrophils, no bands) hct 41.8 platelets 631 na 140 k 5.3 cl 101 co2 26 bun 14 cr 1.34 glucose 276 cpk 135 7.28/52/74 ua negative bnp 340 (nl <100) trop i 0.05 . imaging: . cxr: persistent rll infiltrate. fluid overload worse than prior () . tte : the left atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is grossly normal (lvef 60%). however, the basal inferior wall is dyskinetic and tha posterior wall is hypokinetic. right ventricular chamber size and free wall motion are normal. the number of aortic valve leaflets cannot be determined. the aortic valve is not well seen. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. . ekg: sinus rhythm at 92 nl axis, nl intervals. q waves in ii, iii, avf. twi v4-v6. early r-wave progression. no change from prior. brief hospital course: micu course: pt was transferred from osh ed on in respiratory distress on bipap. bipap was weaned off during the first hospital day. cta negative for pe. she was initially treated with vanc/levo/zosyn for ?pna; these were discontinued on as no clinical evidence of infection. she was also initially treated with iv steroids per ent for upper airway edema. on the patient developed sudden onset respiratory distress and desatted into the 50s. she was emergently intubated. this was thought to be due to flash pulmonary edema vs mucous plug. she subsequently did well, and was taken to the or for bronchoscopy on ; no upper airway etiology of her respiratory failure was found. she was extubated for the procedure but reintubated due to lethargy/sedation post procedure. she was then extubated on . of note, she developed a small troponin leak in the setting of her respiratory distress. she was continued on her home cardiac medications. medical floor course: ## respiratory distress: patient was stable on xfer to the floor. her o2 requirement was weaned and she was back to baseline 2l nc prior to discharge. . ## arf:ddx includes pre-renal in setting of possible infection vs atn/ain from meds given during last hospitalization. stabilized prior to discharge. . ## cad: no evidence for ischemia on ecg. had slight trop leak in setting of acute resp decompensation in the icu. thought not acs. continued home meds. . ## chf:clinically and by cxr and bnp pt appeared moderately volume overloaded on presentation. she was diuresed and discharged on home meds. . ## copd:treated for exacerbation . ## depression/anxiety: -ativan needed to be scheduled given her severe anxiety. -continued home lamotrigine, quetiapine, sertraline . ## osa: -bipap or cpap at night . ## hyperlipidemia: -continued statin . ## code status: full code medications on admission: 1. lactulose prn 2. sertraline 100 mg daily 3. docusate 4. senna 5. lamotrigine 25 mg tablet 6. quetiapine 25 mg tid 7. quetiapine 100 mg qhs 8. albuterol sulfate q 6 hours prn 9. ipratropium-albuterol q4 prn 10. aspirin 81 mg tablet daily 11. simvastatin 40 mg daily 12. lisinopril 5 mg tablet daily 13. furosemide 40 mg daily 14. potassium chloride 20 meq daily 15. metoprolol tartrate 12.5mg daily 16. vicodin 5-500 mg tablet 17. guaifenesin 18. bactroban 2 % ointment sig 19. bactrim ds 160-800 mg tablet sig: one (1) tablet po twice a day for 7 days: please take all pills on time and finish entire course. disp:*14 tablet(s)* refills:*0* discharge medications: 1. please use 2-3 liters oxygen and keep saturation > 90% at all times 2. quetiapine 25 mg tablet sig: one (1) tablet po tid (3 times a day). 3. quetiapine 100 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 4. lamotrigine 25 mg tablet sig: one (1) tablet po bid (2 times a day). 5. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 6. sertraline 100 mg tablet sig: one (1) tablet po daily (daily). 7. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 9. hydrocodone-acetaminophen 5-500 mg tablet sig: 1-2 tablets po q8h (every 8 hours) as needed for hip pain. 10. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 11. lorazepam 1 mg tablet sig: one (1) tablet po qid (4 times a day). 12. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po q6h (every 6 hours) as needed. 13. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 14. ipratropium bromide 0.02 % solution sig: one (1) inhalation qid (4 times a day) as needed. 15. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 16. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed. 17. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation prn (as needed). 18. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po daily (daily). 19. outpatient physical therapy pt for 1-2 visits. discharge disposition: home with service facility: discharge diagnosis: primary: -possible aspiration pneumonia -acute respiratory distress secondary: -coronary artery disease -congestive heart failure -obstructive sleep apnea -copd -depression -hyperlipidemia discharge condition: afebrile, satting >90% on 2l nc, ambulating discharge instructions: you were admitted for respiratory distress. you stayed in the icu and stabilized, at which point you were transferred to the general medicine floor. you are discharged home on your usual home oxygen therapy. your lisinopril is held because of concerns that it would cause your blood pressure to be too low. please follow-up with your primary care provider next week regarding whether or not to restart lisinopril. 1. please take all medications as prescribed - we made no changes other than holding your lisinopril. 2. please attend all follow-up appointments 3. if you develop fevers, chills, chest pain, severe shortness of breath, nausea, vomiting, or any other concerning symptoms, please contact your primary provider or report to the emergency room. followup instructions: please follow-up with your primary care provider next week regarding whether or not to restart lisinopril. dr. office number is . please see physical therapy for 1-2 visits during your first week after discharge. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube other bronchoscopy non-invasive mechanical ventilation diagnoses: obstructive sleep apnea (adult)(pediatric) acute kidney failure, unspecified atrial fibrillation obstructive chronic bronchitis with (acute) exacerbation acute on chronic diastolic heart failure aortocoronary bypass status percutaneous transluminal coronary angioplasty status other specified forms of chronic ischemic heart disease acute respiratory failure pneumonitis due to inhalation of food or vomitus bacteremia infection with microorganisms without mention of resistance to multiple drugs foreign body accidentally entering other orifice hip joint replacement other diseases of trachea and bronchus foreign body in larynx edema of larynx carrier or suspected carrier of other specified bacterial diseases 

Answer: The patient is high likely exposed to