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: patient recorded as having no known allergies to drugs attending: chief complaint: shortness of breath, hypoglycemia major surgical or invasive procedure: s/p laryngoscope history of present illness: cc: present illness: ms. is a 49 year old female with history of hcv, obesity, and esophageal cancer who presents after a family member found her unconscious, and noted a fingerstick blood glucose of 40 mg%. the patient in er received glucagon, glucose, and iv hydration. fbs subsequently normalized in field and transported to er for further management. the patient reports taking her usual "70 mg" (?units) of insluin qd, although her oral intake has been diminshed of late secondary to esophageal pain. she has felt "odd" for approximately 1-2 weeks, noting mild diaphoresis during day, "it might be my sugars..." in er fbs 53 mg%, noted to be tranisently hypoxic with spo2=76%. this episode prompted concern for pe, and cta was attempted. ~60 ml iv contrast dye extravasated into the patient's arm, and a ct noncontrast of the chest was performed. no data regarding the neck / glottis area was obtained. past medical history: pmh: esophageal cancer dx (t2n0) supraglottic, treated with surgical resection and external beam radiation therapy. no chemotherapy was advised given risks of toxicity and comorbid conditions. peg tube placed , replaced for nutritional support morbid obesity, unable to ambulate without wheelchair hepatitis c history of ivda (heroin). last use unknown, remains on methadone osteoarthritis of knees ulnar europathy dm2 on insulin pud / gerd social history: social history (based from chart records): etoh: drinks socially. smoking: 30 p-y hx; now smokes about 4 cigarettes/day. drug use: the patient is an iv heroin abuser who was on methadone for the 2 years prior to last month's hospitalization. the patient is on disability due to her obesity. she is a past victim of domestic violence. she has 4 children and lives with her son, who she reports dose not help out much. family history: one of the patient??????s aunts died of an unknown ca. the patient??????s mother died of an mi, and she states that her father died of ??????diabetes.?????? her two sons have schizophrenia. physical exam: vs: t98.2, bp 101/81, p80, r20, spo2 99% ra. fbs 101 gen: obese female in no distress. pleasant and conversant. clear sleep apnea with coarse, loud "snoring." cv: s1 s2 with no mrg. lungs: distant lung sounds difficult to auscultate secondary to body habitus. no wheezes. abd: overweight, nt/nd, normal bowel sounds. well-healed peg insertion site. ext: no edema. pertinent results: labs: 15.4 > 14.3/44.5 < 224 141 | 4.3 | 97 | 30 | 17 | 1.3 < 78 alt 14, ast 46, ldh 526, alkp 89, tbili 1.0, alb 3.5 lactate 2.4 08:50am %hba1c-4.8# -done -done . urine tox positive for cocaine, opiates, and methadone serum tox negative . 10:24pm urine blood-lg nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-sm urobilngn-1 ph-5.0 leuk-tr 10:24pm urine rbc-21-50* wbc-* bacteria-many yeast-none epi-21-50 . ct chest non-contrast: patchy opacity in the left lower lobe most likely represent early infectious process. . ct neck non-contrast: no definite evidence of pathologic adenopathy. some distortion of intrinsic larynx. this can be evaluated with direct observation. no definite evidence of subglottic extension. . cxr: 1) slight improvement in left basilar opacity. 2) right base atelectasis. . left lower extremity doppler: no evidence of deep vein thrombosis within the common femoral or superficial femoral veins. the popliteal vein demonstrates normal color flow; however, secondary to body habitus, a waveform could not be obtained. as flow proximally to this vessel is normal, if a thrombus exists in the popliteal vein, it is nonocclusive. . brief hospital course: 1. endo -49 year old female with esophageal cancer s/p resection and radiation therapy admitted with hypoglycemia secondary to poor po intake. patient unsure of insulin regimen, but last discharge was 80 u of (70/30) mix. standing insulin regimen was held. blood sugars were relatively well contolled on alone. pt had elevated bs in setting of high dose steroids, but normalized after discontinuation of steroids and didn't require sliding scale insulin. pt's hga1c is 4.8. pt was instructed to check bs at home and to treat with sliding scale as needed. standing dose of insulin was discontinued. . 2. epiglottitis/supraglottitis: a few days into hospital course, pt was noted to be strigorous and short of breath, while maintaining o2 sats of mid 90s. pt was seen by ent who was consulted to perform a laryngoscope to look for a structural etiology of aspiration. at this point, ent noted a significantly compromised airway. pt's baseline 50% narrowed airway was decreased to 33% secondary to epiglotitis/supraglottisi. pt was also noted to be somnolent. abg was performed which showed acute respiratory acidosis secondary to co2 retention (7.26/78/73). pt was transferred to the unit for close respiratory monitoring. she was started on high dose steroids and iv unasyn with significant decrease in supraglottis on serial scopes. abg normalized. mental status and respiratory status normalized. after a few days in the , pt was transferred back to the floor where she continued to have q2h o2 sat checks while her steroids were tapered to off. pt's respiratory status remained stable. pt will be followed up by her ent doctor within one week of discharge. pt received around 5 days of unasyn and is to complete a 14 day course of augmentin for treatment of epiglottitis/supraglottitis. . 3. aspiration - she is clearly aspirating, noting that she always coughs after drinking water. at this visit, the patient took a sip of water and demonstrated aspiration, likely with abnormal swallowing secondary to pain and surgical procedure / radiation. pt was evaluated by speech and swallow who performed a video swallow and recommeded nectar thick liquids, ground solids, meds crushed in puree. pt was put on aspiration precautions. . 4. osa: pt may have underlying osa in setting of morbid obesity. pt should obtain a sleep study as an outpatient. . 5. id - pt had evidence of aspiration pna in lll. pt was started on levo/flagyl, which were discontinued after initiation of unasyn. pt remained afebrile with minimal symptoms. serial cxrs showed improvement in lll opacity. pt also has uti, which was adequately treated with antibiotics. blood and urine cultures were negative. . 6. formication: pt describes a several month history of feeling hair falling on her skin. she describes the sensation as tingling. ddx includes cocaine (positive tox screen), other drug use (i.e. heroin), pschiatric disorder. none of her current medications are likely to cause such an adverse reaction. . 7. polysubstance use: pt was continued on home dose of methadone for hx of heroin use. she was seen by substance abuse social work consult. . 8. le swelling: pt was noted to have asymmetric left foot swelling associated with pain. pt reported a prior hx of dvt. le ultrasound was negative for dvt. . 9. loose stools: pt had negative cdiff x2. medications on admission: methadone 90mg qd insulin 70/30 70-30 80u hydromorphone hcl 4 mg tablet sig: 1-2 tablets po q3-4hrs as needed for 4 days. (prescribed ) protonix 40mg po qd discharge medications: 1. augmentin 875-125 mg tablet sig: one (1) tablet po twice a day for 14 days. disp:*28 tablet(s)* refills:*0* 2. methadone hcl 40 mg tablet, soluble sig: two (2) tablet, soluble po daily (daily). 3. methadone 10 mg/ml concentrate sig: one (1) po once a day. 4. oxycodone-acetaminophen 5-500 mg capsule sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. disp:*30 tablet(s)* refills:*0* 5. lorazepam 1 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 6. insulin lispro (human) 100 unit/ml cartridge sig: one (1) subcutaneous twice a day: in am and before dinner. 7. lancets misc sig: one (1) miscell. twice a day. disp:*60 60* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: epiglottitis/supraglottitis aspiration pneumonia hypoglycemia osa discharge condition: stable o2 saturations, breathing comfortably discharge instructions: if you develop fevers, chills, difficulty breathing, lightheadedness, dizziness, or any other concerning symptoms call your doctor or return to the emergency room immediately. followup instructions: follow up with dr. , m.d. on at 3:45pm.(call ( to reschedule) . follow up with your primary care doctor dr. have your primary care doctor follow up on your blood sugars. we are stopping your insulin for now because your blood sugars have been under good control. . provider , md where: lm center phone: date/time: 11:00 procedure: laryngoscopy and other tracheoscopy diagnoses: urinary tract infection, site not specified acute kidney failure, unspecified unspecified viral hepatitis c without hepatic coma candidiasis of mouth cocaine abuse, unspecified opioid type dependence, continuous disturbance of skin sensation pneumonitis due to inhalation of food or vomitus long-term (current) use of insulin insulins and antidiabetic agents causing adverse effects in therapeutic use other diseases of pharynx, not elsewhere classified unspecified sleep apnea obesity, unspecified personal history of irradiation, presenting hazards to health adult failure to thrive personal history of malignant neoplasm of esophagus swelling of limb diabetes with other coma, type ii or unspecified type, not stated as uncontrolled supraglottitis unspecified, without obstruction acute epiglottitis without mention of obstruction 

Answer: The patient is high likely exposed to