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: codeine attending: chief complaint: hemoptysis major surgical or invasive procedure: bronchoscopy history of present illness: pt is a 68 y.o. female w/ history of tobacco use transferred from for evaluation of hemoptysis. pt states that afternoon 2 days pta, she coughed up what she thought was phlegm but turned out to be a dark blood clot with a tea spoon of bright red blood. she was symptom free until afternoon pta when she had 4 episodes of hemoptysis, she states each episode showed less than a teaspoon of blood. she decided to go to the ed in . in the ed she underwent a cta chest which showed unchanged pulmonary nodules, no pulmonarty embolism but did show some infection versus bronchitis versus bronchiectasis. given that she was on coumadin with an inr of 1.8 she was also given 5 mg iv vitamin k, 1 unit of ffp and transferred to . she is being admitted to the icu given risk of airway compromise as well as bronchoscopy. past medical history: - a. fib s/p pvi on at - h.o. resolved tachymyopathy in (ef in was 20%, ef in >55%) - a. flutter ablation () - htn - pna () - osteoporosis - tobacco history social history: pt used to smoke 1ppd x 20 years, quit 30 years ago. endorses only intermittent etoh, denies recreational drug use. family history: brother died at age 68 of lung cancer (heavy smoker), father died at age 65 of lung cancer (heavy smoker), brother has emphysema. physical exam: general: caucasian female sitting up in nard. heent: sclera anicteric, mmm, oropharynx shows no blood neck: supple, jvp not elevated, no lad lungs: mild crackles noted lul otherwise ctab. 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 ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: wbc-3.8* rbc-3.75* hgb-11.1* hct-32.6* mcv-87 mch-29.7 mchc-34.2 rdw-13.9 plt ct-264 pt-12.2 inr(pt)-1.0 pt-14.9* ptt-28.0 inr(pt)-1.3* glucose-89 urean-8 creat-0.5 na-141 k-4.2 cl-107 hco3-26 angap-12 glucose-60* urean-9 creat-0.5 na-142 k-3.6 cl-107 hco3-26 angap-13 calcium-9.2 phos-3.5 mg-2.0 urine color-yellow appear-clear sp -1.040* urine blood-neg nitrite-neg protein-neg glucose-neg ketone-15 bilirub-neg urobiln-neg ph-8.0 leuks-neg bal fluid . brochoaveolar lavage : . cell counts: polys-97* lymphs-3* monos-0 . gram stain (final ): 2+ (1-5 per 1000x field): polymorphonuclear leukocytes. 1+ (<1 per 1000x field): gram positive cocci in pairs. 1+ (<1 per 1000x field): gram positive rod(s). . respiratory culture (final ): 10,000-100,000 organisms/ml. commensal respiratory flora. . legionella culture (preliminary): no legionella isolated. . fungal culture (preliminary): no fungus isolated. . acid fast smear (final ): no acid fast bacilli seen on concentrated smear. . acid fast culture (preliminary): . respiratory viral culture (final ): no respiratory viruses isolated. culture screened for adenovirus, influenza a & b, parainfluenza type 1,2 & 3, and respiratory syncytial virus. . respiratory viral antigen screen (final ): insufficient cellular material for evaluation by direct influenza antigen test. . cytology: negative for malignant cells. abundant neutrophils. alveolar macrophages and reactive bronchial epithelial cells. no viral cytopathic effect or fungal organisms identified. afb stain is negative for mycobacteria. gms stain is negative for fungal organisms and highlights background bacterial cocci and rods. . mrsa screen : no mrsa isolated. . cta chest ( ): 1. multiple pulmonary nodules with enlargement of a right lower lobe pulmonary nodule, now measuring 10 x 8 mm. this nodule was not present on and its apparent increase in one month as well as the surrounding peribronchovascular nodular opacities, bronchiolectasis, and tree-in- appearance suggests this is infectious. similar abnormalities seen within the left lingula with also a slight increase in the nodular component here. after the appropriate course of therapy, there should be reimaging in months to insure these are resolving. other nodules described above have not changed significantly since . 2. left lingular and lower lobe scarring and bronchiectasis with other more subtle areas of peribronchiolar nodularity suggests small airways disease. 3. no pulmonary embolism or acute aortic abnormality. 4. mild cardiomegaly, coronary artery atherosclerosis, and aortic atherosclerosis. brief hospital course: 68 yo f with h/o atrial fibrillation (subtherapeutic on coumadin), smoking history, family history of lung cancer presents with 2 days of hemoptysis. 1. hemoptysis: the patient was admitted to the medical intensive care unit, where she was started on azithromycin. as there was no evidence of massive hemoptysis, she was transferred to the medical floor on hospital day 2. the differential diagnosis of the patient's hemoptysis initially included bronchitis/bronchiectasis, chronic infection, and pulmonary hemorrhage syndrome. given the patient's history of tobacco use and her personal history of lung cancer, malignancy was also considered. ua showed no blood or protein, making a pulmonary renal syndrome less likely. the interventional pulmonology service was consulted. bronchoscopy was performed, and the anterior segment of the lingula was felt to be the source of the bleeding. no endobronchial lesion was identified. brochoaveolar lavage was performed, and the fluid was sent for cell counts, microbiology, and cytology. the patient's outpatient providers will need to follow up on the results of these studies. after bronchoscopy, the interventional pulmonology team felt that atypical infection and bronchiectasis in the setting of anticoagulation was the most likely etiology of the patient's hemoptysis. the ip team recommended repeat non-contrast ct in months, as well as the initiation of ppi therapy for bronchoscopic evidence of laryngeal reflux. the patient will complete a 5-day course of azithromycin. 2. atrial fibrillation: the patient has a history of atrial fibrillation and was on anti-coagulation prior to admission. anticoagulation was reversed given hemoptysis and plan for bronchoscopy. 3. hypertension: the patient maintained good blood pressure control on altace and metoprolol. 4. hyperlipidemia: patient continued liptor. 5. osteoporosis: patient continued vitamin d, calcium, and calcitonin. medications on admission: coumadin 10mg qmon, fri coumadin 7.5mg qtu,we,th,sa,sun altace 5mg daily metoprolol xl 50mg daily asa 81mg daily lipitor 40mg daily vit c calcium 600mg + vit d3 125u daily fosamax qweek calcitonin 200u nu daily discharge disposition: home discharge diagnosis: hemoptysis bronchitis coagulopathy gastrolarygneal reflux discharge condition: no further evidence of hemoptysis, hemodynamically stable, with 100% oxygen sat on room air. discharge instructions: you were evaluated for your episodes of hemoptysis and monitored closely in the intensive care unit, treated for infectious causes, and underwent bronchoscopy for further diagnostic work up. please complete your course of azithromycin to treat any infection in your lungs. please stop coumdain and aspirin until you discuss resuming these with your outpatient cardiologist as we discussed. you were also started on omeprazole, a stomach acid suppressor due to changes seen in your larynx consistent with reflux disease. please continue to take this until you discuss discontinuation with your primary care physician. followup instructions: please call you primary care physician to arrange follow up in the next 1-2 weeks. please follow up with your cardiologist as you already have scheduled. please discuss with your pcp if you require any further follow up on the pulmonary nodules that were seen on your ct scan during your stay. it is recommend that you have 6 month follow up for the current nodules but if they are unchanged from prior, this may not be necessary. md, procedure: closed [endoscopic] biopsy of bronchus diagnoses: esophageal reflux unspecified essential hypertension acquired coagulation factor deficiency atrial fibrillation osteoporosis, unspecified acute bronchitis 

Answer: The patient is high likely exposed to