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: risperdal / ace inhibitors attending: chief complaint: flacid paralysis of lower extremities major surgical or invasive procedure: 1. t8-l2 fusion. 2. multiple thoracic laminotomies. 3. laminectomy of l1. 4. segmental instrumentation, t8-l2. 5. right iliac crest autograft. 6. anterior decompression 7. posterior decompression 8. t11/l1 fusion 9. peg tube placement 10. picc line placement history of present illness: 74f with hx of dementia, schizophrenia and recent t12 compression fx who presented to on with placcid paralysis and found to have cord compression. per notes, pt fell on and since then has had persistent back pain and refuses to move leg. patient was reportedly ambulating with cane prior to fall. lumbarsacral spine and pelvis xray at that point was negative for fracture. patient then noted to have decreased hct and na. given long history of smoking, ct chest done on for malignancy workup. it showed nonpathologic compression t12 fracture. it also showed rll consolidation for which she completed treatment of levaquin for 7 d. on day of admission, pt presented with flaccid paralysis. mr t spine show severe t12 compression fracture with retropulsed fragment causing severe canal stenosis, concerning for cord compression. patient recieved steroids in ed and was admitted to the medicine service. past medical history: dementia schizophrenia history of chronic gi bleed and refused gi workup in the past anemia gerd copd (last pft in : fev1/fvc of 73, fev1 71% of predicted) hypertension benign neoplasm of colon diabetes mellitus osteoarthritis neuropathy, urinary incontinence social history: ms. is a nursing home resident. she worked in the past as a secretary. she is a smoker up to two packs per day. rare alcohol use. family history: there is one sibling with schizophrenia. physical exam: temp 98, bp 151/77, hr 106, r 33, o2 97% on nrb gen: elderly female in moderate resp distress, grunting occasionally, using some accessory muscles heent: mm dry, eomi, pupils dilated, reactive to light cv: heart sounds not heard rhoncherous breath souds chest: no crackles at bases, exp wheezes bilaterally; chest tube in left side abd: hypoactive bowel sounds, nontender, soft sacrum: small 2cm area of erythema ext: 2+ dp, no edema neuro: ao x 2 (not to place), cn 2-12 intact, 4+/5 strength in upper ext, won't move lower ext; ? decreased sensation in lower ext; 1+ dtrs in lower ext, 2+ dtrs in upper ext; babinski neither up nor downgoing pertinent results: cxr: persistent left retrocardiac opacity and left pleural effusion. . echo on : the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy with normal cavity size. regional left ventricular wall motion is normal. left ventricular systolic function is hyperdynamic (ef>75%). 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. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. transmitral doppler and tissue velocity imaging are consistent with grade i (mild) left ventricular diastolic dysfunction. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. . mr l spine scan compression fracture at t12 with severe canal compromise. this is incompletely imaged on this examination and the thoracic spine mr should be obtained. distended bladder could be due to cord compression. . mr contrast gadolin compression of the t12 vertebral body with large retropulsed osseous fragment resulting in marked cord compression and cord edema at the level of compression and in the conus. there are some features of the compression which raise the possibility of this being a pathologic fracture rather than a simple insufficiency fracture. . chest (portable ap) 10:48 pm the endotracheal tube previously in the right main bronchus has been repositioned to standard placement at the level of the sternal notch and, accordingly, the previously collapsed left lung has reexpanded. a pleural tube projects over the base of the left chest. there is no pneumothorax or appreciable pleural effusion. heart is top normal size. there is engorgement of hilar and pulmonary vasculature suggesting borderline cardiac dysfunction or volume overload. tip of the left subclavian catheter projects over the upper svc. nasogastric tube ends in the stomach. . chest port. line placement 9:45 pm total collapse of the left lung secondary to et tube tip in the right main bronchus. right basal consolidation. small left basilar pneumothorax. left subclavian line tip in the svc. . t12 vertebral body r/o tumor pathology: bone with focal necrosis, reactive changes, intramedullary fat necrosis and granulation tissue consistent with healing fracture. hyaline cartilage. no osteomyelitis seen. no evidence of malignancy. . bilat lower ext veins port 1:28 am bilateral lower extremity venous ultrasound: scale and doppler son of the bilateral common femoral, superficial femoral and popliteal veins were performed. these demonstrate normal compressibility, flow, augmentation, and waveforms. no intraluminal thrombus identified. impression: no evidence of bilateral lower extremity dvt. . ekg : baseline artifact. rhythm is most likely sinus tachycardia. st segment elevation in leads vi-v2. q waves in leads vi-v3. findings suggest anteroseptal myocardial infarction/injury of undetermined age. there are also lateral st segment depressions suggestive of myocardial ischemia. clinical correlation is suggested. compared to the previous tracing of 7 14-06 anterior and anterolateral abnormalities persist. . echo : the left atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and systolic function (lvef>55%), without regional wall motion abnormalities. tissue velocity imaging e/e' is elevated (>15) suggesting increased left ventricular filling pressure (pcwp>18mmhg). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild to moderate (+) aortic regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is an anterior space which most likely represents a fat pad, though a loculated anterior pericardial effusion cannot be excluded. impression: symmetric lvh with preserved global and regional biventricular systolic function. mild-to-moderate aortic regurgitation. compared with the prior study (images reviewed) of , the findings appear similar. labs: 06:00am blood wbc-9.8 rbc-3.06* hgb-9.3* hct-26.3* mcv-86 mch-30.4 mchc-35.3* rdw-19.0* plt ct-359 02:00pm blood wbc-11.4*# rbc-4.43 hgb-11.4*# hct-34.0* mcv-77*# mch-25.7*# mchc-33.5# rdw-16.8* plt ct-623*# 05:20am blood neuts-85.6* lymphs-6.3* monos-2.6 eos-5.4* baso-0.2 02:00pm blood neuts-79.7* lymphs-12.0* monos-5.4 eos-1.9 baso-1.0 05:20am blood anisocy-2+ macrocy-1+ microcy-1+ 06:00am blood plt ct-359 06:00am blood pt-12.5 ptt-24.3 inr(pt)-1.1 05:50am blood pt-14.9* ptt-26.1 inr(pt)-1.3* 02:00pm blood pt-13.2* ptt-24.0 inr(pt)-1.2* 06:00am blood glucose-97 urean-16 creat-0.4 na-135 k-4.1 cl-97 hco3-27 angap-15 02:00pm blood glucose-119* urean-28* creat-1.0 na-136 k-4.7 cl-97 hco3-27 angap-17 06:00am blood alt-43* ast-31 ld(ldh)-374* alkphos-158* amylase-34 totbili-0.7 04:38pm blood ck-mb-notdone ctropnt-0.10* 01:11am blood ck-mb-19* mb indx-4.3 ctropnt-0.18* 06:00am blood albumin-2.6* calcium-8.3* phos-3.9 mg-1.9 05:20am blood albumin-2.5* calcium-7.8* phos-3.7 mg-1.7 05:55pm blood vanco-19.0* 07:15am blood vanco-13.9* 06:06am blood type-art po2-126* pco2-43 ph-7.43 caltco2-29 base xs-4 06:06am blood freeca-1.19 06:00am blood vitamin d 25 hydroxy-pnd brief hospital course: on , pt was taken to or by ortho spine for a thoracotomy with t12 vertebrectomy with t11-l1 fusion with plans to take her back on for posterior approach. during the operation, pt had left lung collapse requiring a chest tube. at this point, she was started on levo/flagyl. during her stay, pt was noted to have occasional episodes of tachypnea, tachycardic to the 110s and hypertensive to the 190s. she responded well to hydralazine and morphine. lenis were done to rule out dvt and were negative. on day of transfer to icu, pt was found to have a hr in the 120s, rr in the 40s, satting 85% on 50% face mask --> 94% on nrb. (during her stay, she had been 91% on ra --> 99% on 50% face mask.) she was given lasix 20mg iv x 1 and improved somewhat symptomatically. two houws later, she again was found in resp distress and was given 20mg more of lasix. she had put out 1.3l in response to the two boluses of lasix and her saturations had improved to 97% on nrb with a decrease in her resp rate. she was then transferred to the icu for closer monitoring of her resp distress. . initially in icu, pt appeared more comfortable, satting 97-99% on nrb with rr in the mid 20s. she was given 1" of nitropaste and 1mg of morphine to help with agitation. thirty minutes after her arrival to icu, she had another episode of respiratory distress. however, now, pt was noted to have inspiratory stridor asociated with rr to the 40s, diaphoresis and tachycardia. also, of note, the submental area of her neck appeared to be swollen but unclear what her baseline is. she was emergently intubated using fiberoptic bronchoscopy given her difficult airway. on bronchoscopy, she was noted to have a very small airway with diffuse swelling and copious secretions. she was intubated successfully and her heart rate improved to the 80s. her bp also dropped into the 50s so she was started on neosynephrine. . the remainder of her hospital course was complicated by the following issues: . 1) resp distress: in consideration of stridor which precipitated previous respiratory failure, it is possible that pt had laryngeal edema from prior intubation (during first surgery). then she also had either pneumonia or diastolic heart failure (or both) that caused some resp distress. her resp distress may have then exacerbated her pre-existing edema. in addition, the increased negative pressure from her resp distress through a narrowed airway may have caused some pulm edema. patient was intubated for resp. distress and found to have laryngeal edema during intubation. neck ct showed some edema of laryngeal soft tissues around ett. no new medications were on board; however it was considered that this may have been angioedema from acei. her ace-i was thus discontinued. pt was extubated successfully on . sputum from grew out mrsa, now s/p 10 day course of vancomycin. cxr during episode of desaturation on reveals worsening pulmonary edema. ace inhibitor was held due to questionable adverse reaction in context of respiratory difficulty. patient was diuresed to maintain negative fluid balance and urine output was adequate. she did not have further episodes of desats and remained stable on room air. patient produced adequate secretions with deep suctioning and sputum gram stain was negative and preliminary culture had no growth. she was taken off contact precautions since she was not actively infected with mrsa. she received muciprocin x 5 days for mrsa positive nasal swab. . 2) t12 compression fracture with cord compression: patient was status post anterior and posterior decompression surgeries, performed by dr . the chest tube from prior surgery was removed and a drain was placed. steroids were discontinued on . drain was removed . patient continued to remain paralyzed in her bilat les. cultures taken of wound during or proceedings negative for organisms. pain control with iv morphine, tylenol was adequate. . 3) hypertension: necessary to control pain in order to control bp. bp stabilized, back on bb, holding acei. . 4) diastolic heart failure: on recent echo (), ef hyperdynamic with evidence of diastolic heart failure. beta blocker was resumed once bp was stable. patient has had slightly elevated cardiac enzymes likely from chronic left ventricular strain in context of chf. decision was made not to heparinize since ekg did not reveal st changes lowering concern for infarct. patient had a repeat echo on to evaluate for worsening chf given pulmonary edema and revealed ef 55% with similar findings to prior study. . 5) anemia: baseline hct in low 30's ( is last documented), now in mid 20's but stable; she was transfused 1 unit prbcs on due to low hct and it remained around 27. patient had hemolysis workup with haptoglobin, ldh, and t bili which were all within normal limits. she was guiaic negative. . 6) schizophrenia- haldol im q month, remeron, zyprexa, and trazodone 50 mg qhs. patient had episodes of sun-downing as she was disoriented in the evenings to self and time. it was not clear whether this was her baseline mental status. lfts were checked to evaluate delirium and showed mild elevation in alt. patient's lipitor dose was decreased by half. . 7) diabetes mellitus: very low insulin need; continue riss . 8) hoarseness: patient with new hoarseness s/p extubation, now improving. per ent consult, continue ppi and she will need to be scheduled for outpatient follow-up. . 10) fen: patient failed s&s on and subsequently removed her own ngt. she was at that time without nutrition source. gi placed peg on and tolerated tube feeds well with no evidence of aspiration on deep suctioning. patient was started on calcitonin for regulation of pth's activity on bone resorption. levels of pth and vitamin oh-d were pending on discharge and will be followed up by pcp. . 11) healthcare proxy: patient is not competent with baseline dementia and psychiatric condition. healthcare proxy and legal guardian is , ( at advoguard, inc. pcp . has been in touch with guardian regarding treatment goals and code status. . 12) dispo: continue pt. she will be discharged to . . 12) code status - full code. medications on admission: * levofloxacin 500 mg iv q24h * metronidazole 500 mg iv q8h * lisinopril 20 mg * atenolol 100 mg po daily * insulinss * ipratropium bromide neb 1 neb ih q6h * albuterol 0.083% neb soln 1 neb ih q4-6h:prn * fluticasone propionate 110mcg 2 puff ih * acetaminophen (liquid) 650 mg ng q6h * miconazole powder 2% 1 appl tp tid:prn * mirtazapine 30 mg po hs * benztropine mesylate 1 mg po bid * dexamethasone 4 mg iv q6h * morphine sulfate 1-2 mg iv q4h * docusate sodium 100 mg po bid * multivitamins 1 cap po daily * famotidine 20 mg iv q12h * nicotine patch 14 mg td daily * guaifenesin 15 ml ng q4h * heparin 5000 unit sc tid discharge medications: 1. therapeutic multivitamin liquid sig: one (1) cap po daily (daily). 2. benztropine 1 mg tablet sig: one (1) tablet po bid (2 times a day). 3. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 4. olanzapine 2.5 mg tablet sig: three (3) tablet po daily (daily). 5. mirtazapine 15 mg tablet sig: two (2) tablet po hs (at bedtime). 6. insulin lispro (human) 100 unit/ml solution sig: one (1) ssi subcutaneous asdir (as directed). 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 8. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed. 9. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 10. docusate sodium 150 mg/15 ml liquid sig: one (1) po bid (2 times a day). 11. nicotine 14 mg/24 hr patch 24hr sig: one (1) patch 24hr transdermal daily (daily). 12. lactulose 10 g/15 ml syrup sig: thirty (30) ml po tid (3 times a day). 13. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 14. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 15. albuterol sulfate 0.083 % solution sig: one (1) inhalation q6h (every 6 hours). 16. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 17. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 18. calcitonin (salmon) 200 unit/actuation aerosol, spray sig: one (1) nasal daily (daily). 19. haldol decanoate 50 mg/ml solution sig: one (1) 1 intramuscular once a day as needed for agitation. 20. ativan 0.5 mg tablet sig: one (1) tablet po every 4-6 hours as needed for anxiety. 21. morphine 30 mg tablet sustained release sig: one (1) tablet sustained release po every 4-6 hours as needed for pain. discharge disposition: extended care facility: - discharge diagnosis: main diagnosis: t12 burst fracture and paraplegia s/p t8-l2 fusion on respiratory distress other diagnosis: dementia schizophrenia history of chronic gi bleed and refused gi workup in the past anemia gerd copd (last pft in : fev1/fvc of 73, fev1 71% of predicted) hypertension benign neoplasm of colon diabetes mellitus osteoarthritis neuropathy, urinary incontinence discharge condition: fair. discharge instructions: please take all medications. followup instructions: pcp . for further management. . pt has an ortho appointment with dr. () at 10:30 on , 2 orthopedics, and will require transportation for this. procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] dorsal and dorsolumbar fusion of the anterior column, anterior technique excision of bone for graft, other bones transfusion of packed cells dorsal and dorsolumbar fusion of the posterior column, posterior technique repair of vertebral fracture insertion of interbody spinal fusion device fusion or refusion of 2-3 vertebrae fusion or refusion of 4-8 vertebrae diagnoses: anemia, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified infection with microorganisms resistant to penicillins other persistent mental disorders due to conditions classified elsewhere pulmonary collapse methicillin susceptible pneumonia due to staphylococcus aureus unspecified accident angioneurotic edema, not elsewhere classified acute diastolic heart failure closed fracture of t7-t12 level with unspecified spinal cord injury edema of larynx abnormal involuntary movements schizophrenic disorders, residual type, unspecified parasympathomimetics [cholinergics] causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to