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 / morphine / clindamycin / dilaudid attending: chief complaint: dyspnea, hypoxemia major surgical or invasive procedure: none history of present illness: 79yo f with h/o copd (gold iv on home o2) and recent admission for pneumonia who presents with dyspnea and hypoxemia. her husband died suddenly last thursday of an intracranial hemmorage and she has not had anything to eat or drink since then. the wake was yesterday and the funeral today. she arrived to the ed from her husbands via limo. she states that she has had worsening dyspnea and increased oxygen requirement. she does not have cough or change in sputum production. she had one fever at home. she has also had nausea and vomiting which has been a chronic problem and vomited the azithromycin she was given. she was recently admitted (discharged on ) with weakness and was treated with 8 day course of vanc/cefepime and azithro x 5 days for hcap. per pcp notes, she has had fradually worsening dyspnea over the past several months with several courses of prednisone initiated in . she was also hospitalized here in . . in the ed, initial vs were: 114 139/71 19 84ra, 100% neb. a cxr showed lul pna. she was given nebs, 4l ns, ceftriaxone, azithomycin, vancomycin, methylprednisolone 125, zofran, kayexylate and tylenol. . vitals on transfer 97.4, 110, 140/54, 28, 96% 4l . on the floor, she is breathing comfortably. she denies chest pain now but did say she had a brief pain at her left costal margin that was associated with coughing. she states that she was improving from her last discharge steadily until her husband passed away and then began to feel dyspneic and very weak with symptoms most noteable with exertion and less with rest. she has had some weight loss of about 15 pounds over the past several months which she attributes to poor appetite from recurrent illnesses. . review of systems: (+) per hpi (-) denies night sweats, diarrhea, dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: # copd on 2l o2 at home: fev1 0.43 l on , fev1/fvc 46% # cad, status post remote inferior mi at age 45 per pt report # hypertension # hypercholesterolemia # hyperglycemia in the setting of steroid use # osteoporosis # lung nodules seen on ct in , which have been followed # restless leg syndrome # insomnia # s/p carpal tunnel release social history: she has 4 children and 4 grandchildren. she is a retired travel . tobacco: quit tobacco 14 years ago, 80-plus-pack-year history. etoh: occasional ethanol. family history: no family history of lung problems. physical exam: admission exam: tmax: 35.9 ??????c (96.7 ??????f) tcurrent: 35.9 ??????c (96.7 ??????f) hr: 101 (101 - 102) bpm bp: 136/58(77) {136/58(77) - 136/58(77)} mmhg rr: 20 (20 - 21) insp/min spo2: 93% general appearance: no acute distress eyes / conjunctiva: perrl head, ears, nose, throat: normocephalic, dry mm cardiovascular: (s1: normal), (s2: normal) peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: present), (left dp pulse: present) respiratory / chest: (breath sounds: wheezes : , diminished: ) abdominal: soft, non-tender, bowel sounds present extremities: right lower extremity edema: absent, left lower extremity edema: absent, no(t) cyanosis, no(t) clubbing skin: warm, no(t) rash: , no(t) jaundice neurologic: attentive, follows simple commands, responds to: not assessed, movement: not assessed, tone: not assessed discharge exam: pertinent results: admission labs: 01:45pm blood wbc-27.0*# rbc-3.83* hgb-10.5* hct-33.9* mcv-89 mch-27.3 mchc-30.8* rdw-20.9* plt ct-355 01:45pm blood neuts-93* bands-2 lymphs-2* monos-3 eos-0 baso-0 atyps-0 metas-0 myelos-0 01:45pm blood glucose-316* urean-16 creat-0.7 na-128* k-6.7* cl-88* hco3-26 angap-21* 01:45pm blood ctropnt-<0.01 08:05pm blood ctropnt-<0.01 02:02pm blood glucose-304* lactate-3.7* na-129* k-6.9* cl-87* calhco3-29 02:26pm blood k-5.4* 05:45pm blood lactate-4.4* 03:20pm urine color-yellow appear-hazy sp -1.012 03:20pm urine blood-neg nitrite-neg protein-100 glucose-1000 ketone-neg bilirub-neg urobiln-neg ph-6.0 leuks-sm 03:20pm urine rbc-1 wbc-5 bacteri-few yeast-none epi-2 transe-<1 03:20pm urine castgr-4* casthy-29* chest x-ray: impression: significantly progressed/new consolidation in the left upper and lower lung worrisome for extensive pneumonia. possible left pleural effusion. brief hospital course: ms. is a 79 year-old woman with a history of copd who presented with dyspnea, hypoxemia, cxr consistent with left multifocal pneumonia. # pneumonia/respiratory distress: patient with marked leukocytosis with bandemia, tachypnea, tachycardia initially thought to be secondary to pneumonia. her oxygen requirement improved with antibiotic treatment with vancomycin, cefepime and ciprofloxacin, however her chest x-ray continued to worsen, concerning for a possible malignancy. with her deteriorating lung function over the past several months and her goals of care, a meeting was held with her daughters and outpatient providers the final decision was made to continue antibiotic treatment for a full 14 day course since we were unable to obtain a sputum culture, along with supplemental oxygen therapy but otherwise to focus on comfort. she was started on an increased dose of klonopin, along with dilaudid 1-2mg q2h prn breathlessness, zyprexa qhs and prn ativan, the dilaudid was the most helpful for her symptoms. her antibiotic course will be completed on . she will also be continued on prednisone 35mg daily and standing nebulizer treatments to help with her breathing. . . #copd: gold stage iv on home o2. patient was treated for copd exacerbation with prednisone 60 mg daily for 5 days, standing nebs and then tapered back to her home dose of prednisone 35mg daily. . #cad: continued aspirin. . #htn: continue her home verapamil . #dyslipidemia: discontinued her home lipitor given her goals of care . #osteoporosis: discontinued her home regimen . #diabetes: currently treating with glargine 8units qhs and checking blood sugars in the morning . #seasonal allergies: continued on astelin and montelukast . #insomnia/anxiety/recent stressers: patient recently lost husband. social work was consulted for support, her medication regimen was changed as above and she should be continued to be followed by the palliative care team . transition issues: 1. should be continued to be followed by the palliative care team at the macu 2. patient is dnr/dni medications on admission: -albuterol 90 mcg hfa inhaler 2 puffs qid prn -advair 500mcg/50mcg 1 puff -ipratropium 17mcg hfa inhaler 1 puff q6h -ipratropium/albuterol 2.5mg-0.5mg/3ml nebs q6-8h prn -tiotropium 18mcg inhaled once daily -prednisone taper: currently 35mg once daily, tapering by 5mg every sunday. -bactrim ss 1 tablet po daily -asa 162mg once daily -verapamil xr 120mg once daily -lipitor 80mg once daily -omeprazole 40mg once daily -docusate 100mg -novolog sliding scale: bg 250-299 - 4 units, 300-349 - 6 units, 350-399 - 8 units, >400 - 10 units and md. -metformin 500mg -astelin 137mcg 2 sprays in each nostril -montelukast 10mg qhs -clonazepam 0.5mg (typically in the afternoon and at bedtime) -melatonin otc - dosage unclear. -ascorbic acid 250mg once daily -ferrous sulfate 325mg once daily discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. fluticasone-salmeterol 500-50 mcg/dose disk with device sig: one (1) puff inhalation (2 times a day). 3. sulfamethoxazole-trimethoprim 400-80 mg tablet sig: one (1) tablet po daily (daily). 4. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 7. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 8. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q2h (every 2 hours) as needed for shortness of breath or wheezing. 9. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal (2 times a day). 10. verapamil 120 mg tablet extended release sig: one (1) tablet extended release po q24h (every 24 hours). 11. prednisone 10 mg tablet sig: 3.5 tablets po daily (daily). 12. polyethylene glycol 3350 17 gram/dose powder sig: one (1) dose po daily (daily) as needed for constipation. 13. clonazepam 0.5 mg tablet sig: one (1) tablet po four times a day: hold for sedation, rr<12. 14. lorazepam 0.5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for anxiety: please try dilaudid first . 15. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 16. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 17. olanzapine 5 mg tablet, rapid dissolve sig: 0.5 tablet, rapid dissolve po qhs (once a day (at bedtime)). 18. dilaudid 2 mg tablet sig: 0.5-1 tablet po q2h as needed for shortness of breath or wheezing. 19. heparin, porcine (pf) 10 unit/ml syringe sig: two (2) ml intravenous prn (as needed) as needed for line flush. 20. vancomycin in d5w 1 gram/200 ml piggyback sig: one (1) gram intravenous q 12h (every 12 hours) for 7 days. 21. cefepime 2 gram recon soln sig: one (1) recon soln injection q12h (every 12 hours) for 7 days. 22. ciprofloxacin in d5w 400 mg/200 ml piggyback sig: four hundred (400) mg intravenous q12h (every 12 hours) for 7 days. 23. insulin glargine 100 unit/ml solution sig: eight (8) units subcutaneous hs (at bedtime): have been checking blood sugar with morning labs. 24. ondansetron hcl (pf) 4 mg/2 ml solution sig: four (4) mg injection tid (3 times a day): please offer tid, patient may refuse. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: primary: pneumonia, copd exacerbation, anxiety secondary: hypertension, osteoporosis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: it was a pleasure to participate in your care ms. . you were admitted to the hospital with difficulty breathing and you were found to have a pneumonia. we treated your pneumonia with antibiotics and gave you medications to help your breathing. after a discussion with your family and pulmonologist, dr. we decided to continue treat your pneumonia and give you oxygen but wanted to focus on comfort as the main goal, using medications to help treat your breathlessness. please make the following changes to your medications: 1. add vancomycin for seven more days 2. add cefepime for seven more days 3. add cipro for seven more days 4. add ativan 5. add zyprexa 6. add dilaudid followup instructions: you will follow-up with the doctor at the extended care facility. department: pulmonary function lab when: wednesday at 2:40 pm with: pulmonary function lab building: campus: east best parking: garage department: pft when: wednesday at 3:00 pm department: medical specialties when: wednesday at 3:00 pm with: dr & dr building: sc clinical ctr campus: east best parking: garage md procedure: central venous catheter placement with guidance diagnoses: pneumonia, organism unspecified anemia, unspecified coronary atherosclerosis of native coronary artery unspecified pleural effusion unspecified essential hypertension adrenal cortical steroids causing adverse effects in therapeutic use obstructive chronic bronchitis with (acute) exacerbation personal history of tobacco use other and unspecified hyperlipidemia anxiety state, unspecified long-term (current) use of insulin osteoporosis, unspecified old myocardial infarction other diseases of lung, not elsewhere classified do not resuscitate status insomnia, unspecified other dependence on machines, supplemental oxygen secondary diabetes mellitus without mention of complication, not stated as uncontrolled, or unspecified 

Answer: The patient is high likely exposed to