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: rectal prolapse major surgical or invasive procedure: suture rectopexy rigid bronchoscopy and stent placement history of present illness: ms. is a year old female who presented to -ed on from an osh for treatment of a recurrent rectal prolapse. she is s/p an altmeier procedure by dr. , she was admitted to the surgical service for further management. past medical history: rectal prolapse s/p recent surgery ppm placement, unclear reason hypertension chf cad s/p mi (per ed, but patient denies) s/p broken hip and repair s/p tah social history: lives alone in . widowed (husband died at age 82). denies tobacco, etoh, or drug use family history: non-contributory physical exam: upon admission: 97.3 61 112/53 16 94% room air gen: uncomfortable appearing cv: regular rate and rhythm abd: soft, non-distended rectum: prolapsed, irreducible, globular appears bright red, edematous, frank blood pertinent results: operative note : respiratory failure secondary to severe cervical tracheomalacia. procedure: rigid bronchoscopy, flexible bronchoscopy, metallic covered stent placement and balloon dilatation. gyn porcedure note; procedures: estrace cream applied to prolpased vault, gellhorn pessary placed without difficulty echo : impression: symmetric left ventricular hypertrophy with normal global and regional systolic function. mild aortic regurgitation. moderate tricuspid regurgitation. moderate pulmonary hypertension. mildly dilated thoracic aorta. persantine mibi/ stress test: impression: there is a small, mildly severe reversible perfusion defect in the anteroapical wall. there is normal left ventricular wall motion and cavity size. impression: no anginal type symptoms or ischemic ekg changes. nuclear report sent separately. chest x-ray : impression: 1) no acute cardiopulmonary process identified. cardiology report ecg study date of 2:36:32 pm baseline artifact. atrial paced rhythm with a rate of about 64 beats per minute with a-v interval of about 210 milliseconds. native qrs shows left ventricular conduction delay with left axis deviation. compared to the previous tracing of no diagnostic change. chest ct : 1) moderate layering non-hemorrhagic bilateral pleural effusions, with secondary bibasilar atelectasis and retained secretions in occluded right basilar segmental bronchi. 2) focal tracheomalacia in the upper trachea. 3) large left goiter. 4) left lower lobe opacity could represent aspiration. 5) low attenuation in the mid pole of the right kidney, incompletely characterized. this may represent sequelae of cortical scarring, but an ultrasound is recommended to exclude an underlying lesion. bilateral upper extremitiy ultrasound: impression: thrombosis in the right internal jugular vein. thyroid ultrasound: impression: successful ultrasound-guided aspiration of large heterogeneous left thyroid lobe which extends into the superior mediastinum. chest x-ray : tracheal stent remains in place with a distal portion of the stent just above the level of the clavicles. vascular catheter and permanent pacemaker are unchanged in position. cardiac silhouette is mildly enlarged but stable in size. vascular engorgement and perihilar haziness are slightly worse compared to the prior study. bibasilar opacities predominantly in the retrocardiac region with adjacent pleural effusions are unchanged allowing for lower lung volumes. there is increasing distension of bowel loops in the upper abdomen as compared to the previous study. this is incompletely assessed on this chest radiograph, and dedicated abdominal radiograph could be obtained for more complete evaluation if warranted clinically. chest x-ray : impression: increased lung volumes but overall no significant change in bilateral pleural effusions and bibasilar opacities that are concerning for pneumonia. 12:55 pm mrsa screen site: nasopharynx source: nasal swab. **final report ** mrsa screen (final ): no mrsa isolated. fna, thyroid, left nodule: atypical. the specimen consists of mostly blood and a single group of atypical cells. note: clinical follow-up is suggested. re-biopsy may be considered if clinically appropriate. cardiology report ecg study date of 4:56:10 pm atrial fibrillation ventricular premature complex intraventricular conduction delay with left axis deviation - may be atypical left bundle branch block delayed r wave progression - could be due in part to left axis deviation/intraventricular delay or possible prior septal myocardial infarction st-t wave abnormalities - could be in part intraventricular conduction delay since previous tracing of , atrial fibrillation absent general urine information type color appear sp 01:56pm straw clear 1.005 source: cvs dipstick urinalysis blood nitrite protein glucose ketone bilirub urobiln ph leuks 01:56pm tr neg neg neg neg neg neg 7.0 mod source: cvs microscopic urine examination rbc wbc bacteri yeast epi transe renalep 01:56pm 0-2 21-50* few none 0-2 source: cvs admission labs: wbc rbc hgb hct mcv mch mchc rdw plt ct 8.3 3.46* 10.2* 31.3* 90 29.4 32.5 14.9 445 glucose urean creat na k cl hco3 angap 109* 21* 0.9 144 4.3 108 28 12 calcium phos mg 8.9 3.0 2.4 caltibc ferritn trf 06:18pm 302 15 232 pituitary tsh 03:07am 0.84 discharge labs: complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 04:34am 9.8 3.13* 9.1* 27.9* 89 29.1 32.7 15.4 182 pt ptt plt ct inr(pt) 07:25am 14.4* 29.4 1.3* renal & glucose glucose urean creat na k cl hco3 angap 04:34am 102 9 0.6 142 3.5 102 36* 8 probnp 03:37am 6049*1 calcium phos mg uricacd iron 04:34am 9.4 3.0 2.2 brief hospital course: ms. presented with recurrent rectal prolapse and admitted to the surgical service for further management. a cardiology consult was placed for pre-operative clearance, which included, beta-blockade, diuresis, persantine mibi, echo, and ekg; she had no anginal symptoms or st segment changes and was cleared to proceed with surgical intervention. hd 3, she underwent a suture rectopexy without complication, post-operatively she required re-intubation x2 in recovery room secondary to respiratory distress, she was transferred to intensive care unit for close monitoring. pulm: pod 5, she underwent a ct scan of the chest secondary to failed weaning attempts despite intravenous steroids, bedside bronchoscopies, and nebulizer treatments, she was found to have focal tracheomalacia in the upper trachea and a large left goiter, thoracic surgery was consulted along with interventional pulmonary; she was taken back to the or on pod 7, and underwent a rigid bronchoscopy and placement of a metallic stent without complication. she was extubated without difficulty and was successfully weaned to 2 liters nasal cannula. at the time of discharge she had continued improvement in her oxygenation with the assistance of 2 liters nasal cannula, and nebulizer treatments; although she continued to experience an intermittent sensation of food being stuck without signs or symptoms of aspiration, a chest x-ray done on pod 12 demonstrated the stent to be in good position with overall improvement in her bibasilar pleural effusions, she was continued on daily diuresis of lasix which was to continue for 14 additional days. she was to follow-up on as an out-patient with ip for a bronchoscopy. cv: patient has a known atrial pacemaker placed for recurrent syncope. pod 5, she developed atrial fibrillation, her beta-blockade was increased with a good effect, she was transfused intra-operatively, and remained hemodynamically stable post-operatively. pod 7, an upper extremity ultrasound demonstrated a right internal jugular thrombus, anticoagulation was started. at time of discharge she was on subcutaneous lovenox and coumadin, her inr was 1.3, she was to receive daily pt/inr checks with coumadin dosing accordingly. at the time of discharge she had good rate control in the 70's, was normotensive, and was to continue on oral metoprolol. gi: npo with intravenous hydration until after tracheal stent placement. pod 8, her diet was advanced which she tolerated well, she had +flatus, a bowel movement after an enema. she had calorie counts which demonstrated adequate oral intake with ensure supplementation. at the time of discharge she was to continue on oral stool softeners and laxatives along with enemas as needed for optimal bowel management. gu/gyn: foley catheter removed on pod 11, she was voiding without difficulty at the time of discharge although she had periods of incontinence secondary to daily lasix therapy. a urinalysis was positive for bacteria, bactrim ds was started on pod 12, and was to continue for a total of seven days. at time of admission for the rectal prolapse she was evaluated by the gyn service for a vaginal vault prolapse, a pessary was placed, there is a known foul odor associated with the pessary which was treated with a trimo-san cream kit. she was to follow-up in the gyn clinic on . skin: abdominal staples intact at time of discharge, small amount of drainage at lowest portion of incision, staples to be removed in 1 week at the rehab facility. groin folds and inner thighs with erythematous, excoriated, moist appearing areas, topical miconazole powder initiated and to be continued at time of discharge. pain: minimal incisional discomfort at time of discharge which responded well to oral tylenol as needed. endo: thyroid fine needle aspiration performed on pod 10, for left thyroid goiter found on ct scan, thyroid stimulating hormone within normal limits. blood glucose levels followed every six hours with a regular insulin sliding scale, glucose levels well controlled at time of discharge, with serum glucose levels in the 100 range. msk: followed by physical therapy throughout hospitalization with recommendation of transfer to rehabilitation facility for continued improvement in strength, functional mobility, and gait. id: remained afebrile without leukocytosis, bactrim ds started for a total of a seven day course for a urinary tract infection. patient was transferred in stable condition on to rehabilitation facility. medications on admission: lopressor senna colace discharge medications: 1. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed. 2. albuterol sulfate 0.083 % solution sig: one (1) inhalation q4h (every 4 hours) as needed for wheezes, sob. 3. lidocaine hcl 1 % solution sig: five (5) ml injection q1-2h () as needed for cough. 4. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 5. ipratropium bromide 17 mcg/actuation aerosol sig: two (2) puff inhalation q4-6h (every 4 to 6 hours) as needed. 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): hold for loose stool. 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day): hold for loose stool. 9. glycerin (adult) 3 g suppository sig: one (1) suppository rectal once a day as needed for constipation. 10. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po tid (3 times a day): hold for sbp < 90 hold for hr < 60. 11. furosemide 20 mg tablet sig: one (1) tablet po daily (daily) for 14 days. 12. enoxaparin 60 mg/0.6 ml syringe sig: one (1) subcutaneous q12h (every 12 hours): until inr between 2 and 3. 13. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day) as needed: be sure area cleaned and dried well before applying powder. 14. trimethoprim-sulfamethoxazole 80-400 mg tablet sig: one (1) tablet po bid (2 times a day) for 5 days. 15. guaifenesin 600 mg tablet sustained release sig: two (2) tablet sustained release po bid (2 times a day) as needed for stent management. 16. coumadin 5 mg tablet sig: one (1) tablet po once qhs . 17. coumadin dosing sig: one (1) once a day: will need daily dosing until inr between 2 and 3. 18. blood test sig: one (1) once a day: pt, inr once a day until inr between 2 and 3. 19. blood test sig: one (1) once a week: chemistry panel once a week while on oral lasix with electrolyte replacement as needed: sodium, potassium,chloride,bicarbonate,bun,creatinine and glucose. 20. mineral oil oil sig: thirty (30) ml po bid (2 times a day) for 2 days: hold for loose stool. 21. tylenol 325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. 22. trimo-san 0.025 % gel sig: one (1) vaginal once a day as needed for vaginal odor or itching. 23. regular insulin sliding scale sig: follow sliding scale every six (6) hours: breakfast,lunch, and dinner: glucose/ insulin dose 0-60 mg/dl amp d50 61-120 mg/dl 0 units 121-160 mg/dl 2 units 161-200 mg/dl 5 units 201-240 mg/dl 8 units 241-280 mg/dl 11 units 281-320 mg/dl 14 units 321-360 mg/dl 17 units < 360 mg/dl notify md bedtime 0-60 mg/dl amp d50 61-120 mg/dl 0 units 121-160 mg/dl 1 unit -200 mg/dl 3 units 201-240 mg/dl 5 units 241-280 mg/dl 7 units 281-320 mg/dl 9 units 321-360 mg/dl 11 units > 360 mg/dl notify md . 24. potassium chloride 20 meq packet sig: one (1) po once a day for 14 days: while on lasix only. discharge disposition: extended care facility: - discharge diagnosis: rectal and vaginal prolapse tracheomalacia left thyroid goiter urinary tract infection right internal jugular thrombus congestive heart failure post-operative atrial fibrillation pulmonary hypertension bilateral post-operative pleural effusions discharge condition: stable discharge instructions: notify md/np/pa/rn/aide at rehabilitation facility if you experience: *increased or persistent pain *fever > 101.5 *nausea, vomiting, diarrhea, or abdominal distention *inability to pass gas, stool, or urine *if incision develops redness or drainage *shortness of breath or chest pain *bleeding or bruising from any part of the body *any other symptoms concerning to you followup instructions: provider: ,ten date/time: 9:00 provider: ,ip proc ip procedures date/time: 10:00 provider: ,room one ip rooms date/time: 10:00 must be npo from 12 am until after procedure on follow-up in clinic on :00 8; call if needs to reschedule. follow-up with dr. in weeks, call for an appointment procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more fiber-optic bronchoscopy other intubation of respiratory tract other operations on trachea transfusion of packed cells closed [percutaneous] [needle] biopsy of thyroid gland insertion of other vaginal pessary abdominal proctopexy diagnoses: unspecified pleural effusion urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation other chronic pulmonary heart diseases other complications due to other vascular device, implant, and graft paralytic ileus cardiac pacemaker in situ other diseases of trachea and bronchus goiter, unspecified rectal prolapse prolapse of vaginal vault after hysterectomy 

Answer: The patient is high likely exposed to