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: penicillins / sulfa (sulfonamide antibiotics) / moxifloxacin / metronidazole / cefazolin / iodine / morphine / piperacillin / trimethoprim / avelox attending: chief complaint: dyspnea major surgical or invasive procedure: bronchoscopy with tracheal stent removal history of present illness: history of present illness: 64f with a hx of copd, fibromyalgia, factor v leiden c/b dvt and cva, and tracheobronchomalacia s/p tracheal y-stent on , stent removal for chronic infections and mesh tracheoplasty who presented with 1 day of dyspnea and hypoxia and admitted to the micu for airway monitoring and bipap prior to bronchoscopy. . she states that the woke up and thereafter noticed sob and checked her o2 sat using her husband's pulse ox and was at 85% at rest on ra. she then used some of her husband's o2 by nasal cannula (unclear dose) which brought her o2 to 99%. she ate breakfast and showered and began coughing junky grey and brown material. she then called her pulmonologist, who told her to come to the ed. she otherwise denies fevers, chills, nausea, vomiting, change in appetite, rashes, swelling, or any other symptoms. . of note, patient recently underwent outpatient evaluation for dyspnea by ip who has been following including ct trachea which demonstrated malacic changes in the upper 3-4cm's of her trachea, pft's which demonstrated low lung volumes (tlc 76% predicted, fev1/fvc 104% predicted), and bronchoscopy () with dynamic maneuvers demonstrated severe cervical tracheomalacia, moderate bronchomalacia at the bronchus intermedius, but otherwise no malacia elsewhere. a 15-12-12 y stent cut to a length of 4.5cm was deployed and pt was started on mucinex, albuterol, and mucomyst nebs. two days later she contact the ip office with complaint of dyspnea but denied symptoms of plugging and described using the mucinex and nebs as prescribed but poor compliance of spiriva leading ip to believe her symptoms were more related to her copd. she called the ip office again on the day of admission and felt her symptoms were related to plugging of her stent so she was advised to proceed to the ed for further evaluation. . ed course: in the ed, initial vs were t 99.4, hr 110, bp 135/88, rr 16, 99% on ra. she was evaluated by the ip team in the ed, who expressed concern for possible mucous plugging and recommended taking to the patient to the or for bronchoscopy. cxr wnl's. she received nebs with albuterol and racemic epinephrine as well as 80 mg iv solumedrol and zofran 4 mg iv for nausea. icu admission was recommended as patient may require bipap as well as close monitoring post-bronchoscopy. transfer vitals were t 98.4 ??????f, hr 89, rr 20, bp 121/67, o2 sat 98% on ra. . on arrival to the micu, patient's vs: 99.6, 101, 146/83, 14, 100%3lnc. she confirms the above history and denies significant symptoms other than some discomfort with breathing and a moderate headache which she often has. past medical history: - tracheomalacia s/p tracheal y-stent on , stent removal for chronic infections - s/p pfo closure , - factor v leiden deficiency with h/o dvt and cva - migraine - fibromyalgia - asthma - copd, bronchiectasis - glaucoma - c. difficile () social history: social history: retired social worker. married and lives with her husband. a history of alcoholism but quit drinking almost 30 yaers ago. former smoker, quit . no recreational drugs. family history: father (d) depression, copd. mother alcoholism. physical exam: vitals: 99.6, 101, 146/83, 14, 100%3lnc general: alert, oriented, no acute distress, not using accessory muscles heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad, soft submandibular fullness that seems to be adipose rather than edema cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-distended, bowel sounds present, no organomegaly, no tenderness to palpation, no rebound or guarding gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation pertinent results: 02:50pm blood wbc-7.8# rbc-5.08# hgb-13.4# hct-44.9# mcv-89 mch-26.3*# mchc-29.8* rdw-16.9* plt ct-316 07:53pm blood wbc-6.7 rbc-4.63 hgb-12.1 hct-40.5 mcv-88 mch-26.1* mchc-29.8* rdw-16.9* plt ct-239 02:50pm blood neuts-75.7* lymphs-18.0 monos-3.2 eos-2.6 baso-0.4 02:50pm blood plt ct-316 07:53pm blood pt-11.1 ptt-31.0 inr(pt)-1.0 07:53pm blood plt ct-239 07:53pm blood glucose-287* urean-21* creat-0.6 na-143 k-4.2 cl-108 hco3-23 angap-16 07:53pm blood calcium-9.1 phos-2.3*# mg-1.8 02:50pm urine color-yellow appear-clear sp -1.014 02:50pm urine blood-neg nitrite-neg protein-neg glucose-300 ketone-neg bilirub-neg urobiln-neg ph-6.0 leuks-sm 02:50pm urine rbc-1 wbc-8* bacteri-none yeast-none epi-0 02:50pm urine mucous-rare time taken not noted log-in date/time: 6:09 pm mrsa screen source: nasal swab. mrsa screen (pending): chest (portable ap) study date of 2:14 pm impression: no acute cardiopulmonary abnormality, and no significant interval change from prior. ekg: nsr @ 97, lad which is old, ni, poor r-wave progression, otherwise similar to prior from brief hospital course: assessment and plan: 64f with a hx of copd, fibromyalgia, factor v leiden c/b dvt and cva, and tracheobronchomalacia s/p s/p mesh tracheoplasty and y-stent who presented with 1 day of dyspnea and hypoxia and admitted to the micu for airway monitoring and bipap prior to bronchoscopy. . # hypoxia/concern for stent plugging/possible copd exacerbation: pt with extensive tracheomalacia history on top of mild-moderate copd without home o2 requirement presenting with repeated episodes of dyspnea following tracheal stent placement concerning for mucous plugging. on exam, she is without significant stridor or upper airway sounds and without wheezes. while she does not currently have frank fevers, cxr infiltrates, or lung exam findings c/w pneumonia she does report history of productive cough that is different from her baselime sputum, temperatures are elevated, and she is somewhat diaphoretic raising possibility of copd exacerbation. unfortunately she has multiple antibiotic allergies which would make therapy selection more difficult. interventional pulmonology took the patient to the or for bronchoscopy and removed the stent. they noted granulation tissue around the stent with mucous which was the likely cause of her dyspnea. they also removed some fo the granulation tissue. she was observed in the icu for 4 hours after the procedure with o2 sat of 98 while ambulating on ra. patient received methyl prednisolone while in the icu and was discharged on 4 days of 40mg prednisone per ip recommendations. she will follow up with both ip and thoracic surgery for eventual surgical repair of her tracheomalacia. . # copd: patient on no home o2, without wheezes on exams, only home med is spiriva. patient's o2 saturation was monitored continously while in the icu and was placed on prn nebulized albuterol and ipratropium without issue. . # gerd: stable. perhaps a causative factor in her tracheomalacia. patient was continued on ranitidine and omeprazole and tums. . # fibromyalgia/migraines: stable. patient was continued on her home gabapentin, citalopram, cyclobenzaprine. medications on admission: medications: confirmed with rite-aid pharmacy (237 , , ma; phone: ) - sodium chloride 3% 3ml via nebulizer q8h 20 minutes after albuterol nebs (this was in lieu of acetylcysteine nebs, which could not be obtained by pharmacy; script filled ) - xbenzonatate 100 mg 2 capsule q8h x 10 days prn cough (script filled ) - xclonazepam 1 mg po tid prn vertigo (script filled ) - xlidoderm patch 5% 12 hours on/12 hours off (script filled ) - promethazine with codeine syrup, 240 ml, 1 tsp q4h prn cough (script filled ) - xcyclobenzaprine 10 mg po qhs x 30 days (script filled ) - xvicodin 10-325 mg tab po tid prn pain #50 (script filled ) - xtramadol 50 mg tab po tid prn pain #50 (script filled ) - xranitidine 300 mg po qhs (script filled ) - xpromethazine 25 mg po qid prn #50 (script filled ) - acetylcysteine nebs 20% 5ml q8h to be used 20 minutes after albuterol nebs (prescribed but not filled as unavailable at pharmacy; saline nebs substituted) . old scripts not filled in months: - fiorcet 50 mg-325 mg-40 mg tablet(s) by mouth every six (6) hours as needed for headache (script last filled ) - gabapentin 200 mg po bid (script last filled ) - hydromorphone 2 mg tab q3h prn pain #60 (script filled ) - lorazepam 0.5 mg q6h prn (script last filled ) - nifedipine 10 mg po q8h (script last filled ) - metformin 500 mg po qhs (script last filled ) - spiriva 18 mcg 1 cap inhaled daily (script last filled ) - citalopram 20 mg po daily (script last filled ) . meds per omr record, but no record at pharmacy: - dozolamide-timolol eye drops, dose unknown - no record at rite-aid - simvastatin 20 mg po daily - no record at rite-aid - omeprazole 40 mg po, frequency unknown - no record at rite-aid (? otc) - colace 100 mg po, frequency unknown - no record at rite-aid (? otc) - mucinex er multiphase 1,200 mg by mouth twice a day #60 (prescribed , no record at rite-aid, ? otc) . discharge medications: 1. prednisone 20 mg tablet sig: two (2) tablet po once a day for 4 days. disp:*8 tablet(s)* refills:*0* 2. clonazepam 1 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for vertigo. 3. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). 4. cyclobenzaprine 10 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for spasm. 5. hydrocodone-acetaminophen 5-500 mg tablet sig: 1-2 tablets po once (once) for 1 doses. 6. ranitidine hcl 150 mg tablet sig: two (2) tablet po hs (at bedtime). 7. benzonatate 100 mg capsule sig: two (2) capsule po every eight (8) hours as needed for cough for 5 days. 8. tramadol 50 mg tablet sig: 1-2 tablets po three times a day as needed for pain for 7 days. 9. promethazine 25 mg tablet sig: one (1) tablet po four times a day for 10 days. 10. acetylcysteine sig: 20% 5ml nebs inhalation every eight (8) hours as needed for shortness of breath or wheezing for 7 days: use 20min after albuterol nebs. 11. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) nebs inhalation q6h (every 6 hours) as needed for sob/wheezes. discharge disposition: home discharge diagnosis: tracheomalacia mucous plugging tracheal stent with granulation tissue causing airway narrowing discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mrs. , you were admitted to for shortness of breath. our interventional pulmonologists removed your tracheal stent. you had formed some scar tissue around the stent and had mucous plugging which likely lead to your shortness of breath. we gave you steroids in the icu to help with inflammation. please take 4 more days of prednisone, a steroid, as prescribed. followup instructions: dr. () and dr. () offices are making appointments for you. if they do not contact you by , please call their offices. the following appointments have already been scheduled: provider: , md phone: date/time: 3:30 provider: , md phone: date/time: 9:00 provider: scan phone: date/time: 8:30 md, procedure: laryngoscopy and other tracheoscopy endoscopic excision or destruction of lesion or tissue of bronchus removal of intraluminal foreign body from trachea and bronchus without incision diagnoses: polymyalgia rheumatica esophageal reflux diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled personal history of tobacco use other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other late effects of cerebrovascular disease mechanical complication due to other implant and internal device, not elsewhere classified primary hypercoagulable state chronic obstructive asthma, unspecified bronchiectasis without acute exacerbation myalgia and myositis, unspecified migraine, unspecified, without mention of intractable migraine without mention of status migrainosus other diseases of trachea and bronchus inhalation and ingestion of other object causing obstruction of respiratory tract or suffocation other abnormal granulation tissue other musculoskeletal symptoms referable to limbs foreign body in trachea 

Answer: The patient is high likely exposed to