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: nifedipine / amlodipine attending: chief complaint: shortness of breath major surgical or invasive procedure: none history of present illness: ms. is a 69 year old woman with a history of copd on 2l nc, cad (ef >55% ) s/p aaa repair complicated by ischemic bowel, with subsequent colostomy complicated by ischemia s/p multiple abdominal surgeries, most recently colectomy and end ileostomy who presents with several days of dyspnea on exertion and 2 episodes of acute shortness of breath. reports recent dry cough but denies sputum production, fevers/chills, sick contacts; reports more frequent use of albuterol nebulizer at home over the last several days and has required constant o2 via nasal cannula which she had previously used only at night. has not yet been able to obtain her prescribed fluticasone and symbicort. denies chest pain, nausea/vomiting, abdominal pain, increased ostomy output. reports improving lower extremity edema since discharge last week and stable 3 pillow orthopnea for many years. has spent most of the time since recent discharge in bed. she initially presented to , found to have a negative troponin, bnp 379; given nitrates and lasix without much relief. in the ed, initial vs were: 97 92 141/75 22 96% 2l. cxr demonstrated hyperinflation, ekg with nsr. exam with faint bibasilar crackles on examination, prominent end expiratory wheezing bilaterally. surgery saw her in the ed and recommended admission to medicine for possible copd flare and agreed with steroids if medically indicated. she recieved 500mg azithromycin, 60mg prednisone, as well as albuterol/ipratropium nebs for a presumed copd exacerbation. past medical history: - cad (tte w ef 60%) - dm2 - htn - copd on home o2 - recurrent pna - h/o interstitial lung disease of hypersensitivity pneumonitis s/p prednisone ~ s/p wedge resection of rml - gerd - hx thyroid dz - previous smoker - l thalamic ich w residual mild rle weakness () - concern for cryptogenic cirrhosis - lactose intolerance - s/p tah/bso unknown - s/p appy unknown - tonsillectomy unknown - l lumpectomy - s/p lung biopsy - s/p open infrarenal aaa repair w/ dacron (kechejian-) - s/p sigmoid colectomy end colostomy (-) - s/p hartmann's reversal, sbr, bladder repair, liver bx (-) - s/p take down of the ileostomy in social history: - lives at home with boyfriend, - does not report a substance use history - says that she is a social drinker and does not drink very often - had long smoking history but stopped smoking 5 years ago family history: father died age w/complications of alzheimer's. mother is aged 97 w/mild memory issues and is retired rn. physical exam: admission physical exam: vs 98.1 hr 95 bp 186/92 r 22 o2 97% 2l nc gen cachectic female, alert, oriented, no acute distress heent ncat dry mucous membranes eomi sclera anicteric, op clear neck supple, jvp @ 10cm, no lad pulm distant lung sounds, + rales to mid lung fields posteriorly, no wheezes cv rrr normal s1/s2, no mrg abd ostomy in place with surrounding erythema c/d/i, midline surgical incision dressing c/d/i, soft nt nd normoactive bowel sounds, no r/g ext wwp 2+ pulses palpable bilaterally, mild pitting edema bilateral lower extremities to mid shin neuro cns2-12 intact, motor function grossly normal skin no ulcers or lesions pertinent results: 07:42pm wbc-5.1 rbc-3.41* hgb-9.1* hct-28.6* mcv-84 mch-26.5* mchc-31.7 rdw-17.2* 07:42pm plt count-337 07:42pm pt-11.7 ptt-35.2 inr(pt)-1.1 10:30am glucose-118* urea n-8 creat-0.6 sodium-139 potassium-3.9 chloride-98 total co2-37* anion gap-8 10:30am estgfr-using this 10:30am alt(sgpt)-11 ast(sgot)-17 ld(ldh)-182 alk phos-137* tot bili-0.3 10:30am ck-mb-2 ctropnt-<0.01 probnp-4293* 10:30am albumin-2.5* calcium-8.2* phosphate-3.7 magnesium-1.5* 10:30am wbc-5.4 rbc-3.18* hgb-8.6* hct-26.6* mcv-84 mch-27.0 mchc-32.3 rdw-17.2* 10:30am neuts-92.3* lymphs-4.8* monos-2.8 eos-0.1 basos-0.1 10:30am plt count-325# 04:05am blood wbc-6.7 rbc-3.44* hgb-8.9* hct-28.9* mcv-84 mch-26.0* mchc-30.8* rdw-17.2* plt ct-372 03:20am blood wbc-6.2 rbc-3.27* hgb-8.9* hct-27.4* mcv-84 mch-27.1 mchc-32.4 rdw-17.2* plt ct-363 09:00am blood wbc-8.5# rbc-3.17* hgb-8.3* hct-26.4* mcv-83 mch-26.3* mchc-31.5 rdw-17.2* plt ct-336 04:05am blood plt ct-372 03:20am blood plt ct-363 03:20am blood pt-11.1 ptt-35.3 inr(pt)-1.0 09:00am blood plt ct-336 04:05am blood glucose-93 urean-10 creat-0.7 na-136 k-3.9 cl-96 hco3-36* angap-8 09:00am blood glucose-96 urean-11 creat-0.6 na-137 k-3.6 cl-96 hco3-36* angap-9 09:00am blood alt-12 ast-20 alkphos-151* totbili-0.2 04:05am blood calcium-8.6 phos-3.3 mg-2.1 09:00am blood calcium-8.0* phos-3.5 mg-2.4 05:12am blood type-art temp-36.8 po2-87 pco2-48* ph-7.48* caltco2-37* base xs-10 05:12am blood glucose-106* lactate-0.8 05:12am blood o2 sat-96 brief hospital course: ms. is a 69 year old woman with copd, aaa repair c/b ischemic bowel s/p multiple abdominal surgeries including recent colectomy and end ileostomy who presents with several day h/o progressive doe and 2 episodes of acute sob and evidence of small subsegmental pe on cta who experienced a hemorrhagic stroke of the pons and transferred to the neurology service. . #pontine stoke- on the patient had sbp- from 150-180, asymptomatic, no neurologic deficits, denied headache, chest pain, dyspnea or vision changes with normal mental status and orientation. standing labetalol was increased to 300mg tid and she was given 100mg extra dose twice for asymptomatic sbp of 180 the night of . early am on the patient experienced acute mental status change and right sided weakness. she was transferred to the neuro icu after a code stroke was called. once in the icu she developed left sided weakness as well with a dilated right pupil and began having extensor posturing. ct scan showed a pontine hemorrhage. it was thought that her hemorrhage was most likely attributed to coagulopathy attributed to the use of lmwh for her pulmonary embolism. she was intubated and given mannitol. the following morning the patient's exam was very poor, indicating compression of the midbrain. the poor prognosis was communicated to the family. they decided to make the patient cmo in accordance with her clearly stated wishes and the patient was extubated on . she passed during the night. . # shortness of breath: high suspicion for pe on admission given recent surgery and subsequent immobilization as well as acute nature of sob episodes. cta chest this showed small subsegmental pe lul and worsening bilateral effusions. deconditioning and bibasilar atelectasis related to recent surgery and immobilization also likely contributing factors.was treated with heparin drip and was transition ed to lovenox and coumadin bridge with normal renal function. . # bilateral pleural effusions: likely exacerbating current sob. chf possible given pro-bnp elevation to the 1000s although tte earlier this month showed no abnormality. diuresed with good symptomatic effect with 2 bolus's of 20mg iv lasix until the stroke per above. . # copd: on 2l home o2. - continued home tiotropium, flovent, albuterol nebs; symbiot non formulary . # recent colectomy/ileostomy: - pain control with oxycodone # cad: - continued asa and simvastatin # depression: - continued home celexa medications on admission: the preadmission medication list is accurate and complete. 1. aspirin 81 mg po daily 2. citalopram 10 mg po daily 3. simvastatin 20 mg po daily 4. tiotropium bromide 1 cap ih daily 5. acetaminophen (liquid) 650 mg po q6h 6. fluticasone propionate 110mcg 2 puff ih 7. labetalol 250 mg po tid 8. oxycodone liquid 2.5-5 mg po q4h:prn pain 9. omeprazole 20 mg po daily 10. symbicort *nf* (budesonide-formoterol) 160-4.5 mcg/actuation inhalation tid 11. vitamin d 1000 unit po daily 12. ferrous sulfate 160 mg po daily 13. albuterol 0.083% neb soln 1 neb ih q6h:prn sob discharge medications: n/a discharge disposition: expired discharge diagnosis: pontine hemorrhage discharge condition: deceased discharge instructions: the patient was initially admitted for a pulmonary embolism. she was started on blood thinners for this. in the middle of the night on she suddenly had right sided weakness. she was found to have a bleed in her brainstem. she was intubated and brought to the icu but unfortunately there were signs that the blood was significantly compressing the brain stem. the patient's family made her wishes clear that she did not wish to be rescusitated or have a prolonged intubation. in accordance with her wishes she was made cmo. followup instructions: n/a md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux congestive heart failure, unspecified unspecified essential hypertension cirrhosis of liver without mention of alcohol diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified acute on chronic diastolic heart failure personal history of tobacco use depressive disorder, not elsewhere classified intracerebral hemorrhage personal history of other diseases of circulatory system other late effects of cerebrovascular disease other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation postinflammatory pulmonary fibrosis iatrogenic pulmonary embolism and infarction bell's palsy dysarthria do not resuscitate status other and unspecified coagulation defects aphasia ileostomy status hemiplegia, unspecified, affecting unspecified side intestinal disaccharidase deficiencies and disaccharide malabsorption acquired absence of both cervix and uterus colostomy status other musculoskeletal symptoms referable to limbs acquired absence of intestine (large) (small) acquired absence of organ, genital organs 

Answer: The patient is high likely exposed to