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: ciprofloxacin / penicillins / percocet / meropenem / ativan / depakote attending: chief complaint: lethargy/sob major surgical or invasive procedure: picc line placement g-tube placement history of present illness: ms. is a 78 year old woman with a history of htn and pvd s/p cva (unclear deficits), bipolar who presents after mental status changes, anorexia, & progressive lethargy. per her physician referral, the patient was not eating or drinking at her nh and was found to be lethargic and poorly responsive with oxygen saturations in the upper 80's on room air. there was some concern that was dehydrated. she was then brought to the emergency room. initial ed vs, initial vital signs were: t 97.5, hr 115, bp 133/79, rr 18, pox 95 o2 sat (unclear o2), hypoxic to 77 on ra. physical exam notable for clear lung sounds on inspiration with upper airway noise on expiration with decreased bs in bases. patient was placed on nrb. per ed resident, he confirmed dnr/dni w/ patient. mental status worsened. she then got a head ct, this showed no ich. abg 7.14/119/252. nrb was removed and mental status improved. she was then placed on bipap but reportedly did not tolerate well, was only getting in about 150cc vt. per ed resident, she was fairly lethargic the whole time but not requiring sternal rub to become alert. cxr with infiltrates vs consolidation at the bases. also with decreased breath sounds at the bases. both pen/cipro allergic so getting vanc/cefepime/gent. vs on transfer 96.7, 100, 140/80, 24 and 86%/4l. . on the floor, patient with bipap in place. wakens to loud voice. denies any pain or localizing symptom. breathing mildly difficult. agrees that she does not want to be intubated or resuscitated. . review of sytems: (+) per hpi (-) minimally able to obtain given bipap. patient denies fever, chills or localizing pain. no recent dysuria. past medical history: peripheral vascular disease hypertension bipolar disorder s/p cva (details unknown) degenerative joint disease obesity diverticulosis lower gi bleed, renal insufficiency incontinence s/p tracheostomy in incarcerated hernia repair and failure to wean venous stasis changes in le b/l (incanthosis) social history: she is divorced. she lives in an facility. she has no history of tobacco use. she drinks alcohol socially. family history: her mother died of a myocardial infaraction at age 63. her father died of cancer of unclear type. there is no family history of colon cancer per patient. physical exam: vitals: t: 95.5 bp: 180/96 p: 79 r: 18 o2: fio2 35%, psv 12/peep 8 general: sedated, awakens to loud voice, nodding yes and no. heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: labs on admission: 03:45pm blood wbc-5.5 rbc-5.57*# hgb-15.0# hct-49.9*# mcv-90 mch-26.9* mchc-30.0* rdw-15.6* plt ct-153 03:45pm blood neuts-58.3 lymphs-27.3 monos-8.5 eos-1.7 baso-4.2* 03:45pm blood plt ct-153 03:45pm blood glucose-97 urean-21* creat-0.7 na-142 k-6.9* cl-97 hco3-38* angap-14 03:45pm blood alt-14 ast-68* ld(ldh)-812* ck(cpk)-116 alkphos-57 totbili-0.3 03:45pm blood ck-mb-5 ctropnt-0.04* probnp-1704* 03:45pm blood albumin-3.9 calcium-9.2 phos-5.0* mg-2.3 05:52pm blood type-art po2-252* pco2-119* ph-7.14* caltco2-43* base xs-6 intubat-not intuba 03:55pm blood glucose-98 lactate-1.1 k-6.7* 09:32pm blood hgb-14.7 calchct-44 o2 sat-89 09:32pm blood freeca-1.21 04:25pm urine color-amber appear-cloudy sp -1.021 04:25pm urine blood-lg nitrite-pos protein-150 glucose-neg ketone-tr bilirub-neg urobiln-neg ph-6.5 leuks-mod 04:25pm urine rbc->50 wbc->50 bacteri-many yeast-none epi- 05:49am blood valproa-21* blood gases: 05:52pm blood type-art po2-252* pco2-119* ph-7.14* caltco2-43* base xs-6 intubat-not intuba 06:45pm blood type-art o2 flow-5 po2-73* pco2-114* ph-7.18* caltco2-45* base xs-9 intubat-not intuba comment-nasal 08:42pm blood type-art o2 flow-10 po2-75* pco2-121* ph-7.11* caltco2-41* base xs-4 intubat-not intuba comment-nebulizer 09:32pm blood type-art po2-66* pco2-100* ph-7.17* caltco2-38* base xs-4 05:50am blood type- po2-43* pco2-95* ph-7.24* caltco2-43* base xs-8 02:36pm blood type- temp-36.7 fio2-40 po2-63* pco2-65* ph-7.21* caltco2-27 base xs--3 intubat-not intuba 05:17pm blood type-art po2-57* pco2-107* ph-7.18* caltco2-42* base xs-7 intubat-not intuba 07:15pm blood type-art rates-/26 peep-5 fio2-35 po2-62* pco2-78* ph-7.29* caltco2-39* base xs-7 intubat-not intuba vent-spontaneou 11:18pm blood type-art po2-68* pco2-87* ph-7.22* caltco2-38* base xs-4 02:28am blood type-art po2-67* pco2-77* ph-7.32* caltco2-42* base xs-9 10:46am blood type-art fio2-50 po2-61* pco2-77* ph-7.28* caltco2-38* base xs-5 intubat-not intuba 03:51pm blood type-art temp-36.4 o2 flow-50 po2-75* pco2-91* ph-7.27* caltco2-44* base xs-10 intubat-not intuba comment-simple fac 06:35pm blood type-art temp-36.1 tidal v-260 fio2-35 po2-64* pco2-65* ph-7.35 caltco2-37* base xs-6 intubat-not intuba 02:24am blood type-art po2-78* pco2-68* ph-7.33* caltco2-37* base xs-6 12:43pm blood type-art po2-95 pco2-86* ph-7.14* caltco2-31* base xs--2 11:06pm blood type-art temp-35.5 rates-/27 tidal v-250 peep-8 fio2-35 po2-64* pco2-70* ph-7.32* caltco2-38* base xs-6 intubat-not intuba vent-spontaneou 08:16am blood type-central ve temp-36.9 rates-/23 peep-8 fio2-35 po2-46* pco2-63* ph-7.35 caltco2-36* base xs-6 intubat-not intuba vent-spontaneou comment-ps 12 06:13pm blood type-central ve temp-36.5 rates-/28 fio2-35 po2-54* pco2-81* ph-7.29* caltco2-41* base xs-9 intubat-not intuba vent-spontaneou comment-cool mist 04:47am blood type-art po2-79* pco2-67* ph-7.39 caltco2-42* base xs-11 01:01pm blood type-art po2-92 pco2-105* ph-7.17* caltco2-40* base xs-5 02:53pm blood type-art po2-89 pco2-81* ph-7.32* caltco2-44* base xs-11 03:27am blood type-art po2-79* pco2-72* ph-7.32* caltco2-39* base xs-7 06:53am blood type-art po2-86 pco2-78* ph-7.32* caltco2-42* base xs-9 04:03am blood type-art temp-36.4 po2-79* pco2-73* ph-7.33* caltco2-40* base xs-8 labs on discharge: micro: stool clostridium difficile toxin a & b test-final inpatient urine legionella urinary antigen -final inpatient sputum gram stain-final; respiratory culture-final {yeast} inpatient urine urine culture-final inpatient blood culture blood culture, routine-final inpatient blood culture blood culture, routine-final inpatient blood culture blood culture, routine-final emergency ammonia levels 02:13am blood ammonia-122* 04:29am blood ammonia-26 brief hospital course: 78f htn, cva c r hemiplegia, pvd, bipolar d/o admitted with acute-on-chronic hypercarbic respiratory failure and probable uti, pna with increasingly productive cough, on nppv much of the time. # hypercarbic respiratory failure: multifactorial, acute on chronic. chronic hypercarbia at baseline (baseline hco3 ~30) with contributions from copd, osa and likely ohs. acute component of respiratory failure due to primarily to aspiration pneumonia. no evidence of pe on cta. fluid status difficult to assess but appears to not have been significant driver of respiratory failure. patient with history of difficulty weaning with a prior tracheostomy in in the setting of an incarcerated hernia repair and failure to wean. # pna, aspiration: -treated with course of linezolid and aztreonam. # nutritional status: failed repeat speech and swallow evaluations including a video eval. patient stated express desire to not have any nasal or oral feeding tube, but - f/u peg placement with general surgery # lethargy/ams: intermittently somnolent and disoriented but consistently arousable. overall mental status improved across admission. original ams likely multifactorial including infectious, hypercarbic. now resolved. high ammonia level on admission thought depakote, resolved with stopping of medication. overall mental status improved with improvement in respiratory status. - continue zydis; will not give ativan. - continue home risperdal dose given occasional anxiety - continue to hold depakote given ms changes and elevated ammonia level - dc ativan and added to allergy list # atrial fibrilation: new af v. pacs on on telemetry although not captured on ekg. no history of af per documentation. on iv dilt 10 q6 if hr > 160 prn. was given lopressor, however may have contributed to worsening respiratory status. ce negative. tsh normal. no observed recurrances. of note, briefly started on beta blocker but appeared to have increased sob. chads = 5 (previous cva, no documented chf). - plan to restart po dilt once peg tube in place - given history of strokes, consider anticoagulation, holding off in context of lack of po access # uti/hematuria: hematuria had improved, but now continues. completed antibiotic course. likely needs outpatient follow up for work up of possible urinary malignancy - f/u urine cytology - potential outpatient workup # low urine output: patient had tntermittent low urine output initially thought hypovolumia but relatively unresponsive to fluid boluses but consistently responsive to lasix. # rash: patient developed a diffuse erythematous rash across her upper torso during her admission which was felt likely a drug reaction. the time course was most consistent with her use of meropenem. this was stopped and added to her drug allergy list. of note, her rash resolved completely within 4-5 days of stopping her meropenem. # hypertension: on diltiazem as outpatient, initially held on admission, and then held with concern for aspiration with intermittent use of a dilt gtt in the setting of af as previously described. - restart po dilt once peg tube is in # peripheral vascular disease: patient known chronic venous stasis changes and proteus wound infections in lower extremities. le wounds were treated with moisturizing lotion and improved during admission. # bipolar disorder: admitted on risperdal and depakote as outpatient. depakote stopped due to concern for high ammonia levels and added to her allergy list. intermittent agitation managed with zydis (sl zyprexa) prn. # diverticulosis: patient h/o lgib in . no c/o of pain at this time to indicate inflammation, no e/o lgib during this admission. # s/p cva: per family, unable to move r arm and not ambulatory. neuro exam limited to known deficits. # urinary incontinence: at baseline. ***on she had been weaned successfully to 3-4 l nc, however on the evening of she had worsening saturations and was placed back on bipap with good effect. over the course of she continued to have desaturations that were not improved with bipap. she alternated between the bipap and nrb and her tachypnea continued to increase to 40s and 50s. her symptoms improved for several hours on morphine and lasix drip. her tachypnea returned at about 17:30 and her o2 sat dropped into the 70s despite bipap, she became unresponsive and efforts to suction and assist her with bvm and high flow o2 remained unsuccessful. she was dnr/dni and expired at 18:20 medications on admission: asa 81 mg daily diltiazem cr 180 mg daily risperidone 0.25 qam, 0.5 qpm lasix 20 mg qam, 40 mg qpm loratadine 10 mg qday loperamide 2mg prn loose stool calcium carbonate 1200 daily + 800u vitamin d salsalate 500 tylenol prn multivitamin with minerals depakote 250 mg ferrous sulfate 1 tab po daily discharge medications: pt. expired discharge disposition: expired discharge diagnosis: hyperarbic respiratory failure discharge condition: pt. expired discharge instructions: pt. expired followup instructions: pt. expired md procedure: venous catheterization, not elsewhere classified diagnoses: obstructive sleep apnea (adult)(pediatric) urinary tract infection, site not specified unspecified essential hypertension chronic airway obstruction, not elsewhere classified atrial fibrillation peripheral vascular disease, unspecified acute and chronic respiratory failure pneumonitis due to inhalation of food or vomitus dermatitis due to drugs and medicines taken internally personal history of venous thrombosis and embolism hypovolemia other specified antibiotics causing adverse effects in therapeutic use hematuria, unspecified diverticulosis of colon (without mention of hemorrhage) other bipolar disorders other urinary incontinence anorexia late effects of cerebrovascular disease, hemiplegia affecting dominant side 

Answer: The patient is high likely exposed to