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 / codeine / pork derived (porcine) attending: chief complaint: shortness of breath major surgical or invasive procedure: endotracheal intubation right internal jugular central venous line history of present illness: 55 year-old male with copd on home oxygen, cad s/p cabg admitted with dyspnea. he was discharged on after 2 hospital course for hypercarbic respiratory failure due to copd exacerbation requiring intubation. he felt "so-so" on discharge and this morning subsequently became more short of breath. he did not experience chest pain, palpitations, or fever. history otherwise limited as patient required urgent intubation on arrival to micu. . in he was intubated for mrsa pneumonia. . during /11 hospitalization he was intubated for hypercarbic respiratory failure. he received iv pulse steroids with po taper, broad-spectrum antibiotics narrowed to levofloxacin for total 7-day course and completed prior to discharge, and nebulizers with reinitiation of advair prior to discharge. hospital course was complicated by dvt in left brachial vein for which coumadin was initiated. discharging team attempted to admit patient to pulmonary rehabilitation program - claim was declined by insurance. . in the ed, 97.1 103 149/57 38 98% 4l nc. triggered for tachypnea. physical examination notable difficulty breathing. laboratory data significant for leukocytosis (17.1) with left-shift, hco3 35, lactate 1.5, inr 1.8. initial abg 7.31/77/254 on unknown settings (?after bipap initiated). ekg with sinus tachycardia 108, na/ni st depressions ii,iii, avf, v5-6 suspected to be rate related. cxr 1v without acute abnormality. received solumedrol 125mg iv x1, lorazepam 2mg iv x1, azithromycin 500mg iv x1, combivent neb x1. initiated on bipap with improved . on transfer to micu, 97.1, 101, 143/59, 21, 95% bipap. has 18g, 20g on right. . on arrival to micu, patient was in respiratory distress and required urgent intubation. . review of systems: unable to obtain - intubated. past medical history: 1) cad s/p mi and cabg pci : patent lima-->lad, rima-->rca, bms--> rca distal to rima touchdown. cath : widely patent lima and rima grafts; patent distal rca stent and known occluded native lad and rca. nuclear stress nuclear perfusion stress: no anginal symptoms or ischemic st segment changes. reveal rhythm analyzer placed in . 2) tobacco abuse - 1 ppd/3 days since age 21 3) hypercholesterolemia 4) hypertension 5) copd on 2l home o2 6) history of head trauma in from mva with post-traumatic grand mal seizure, now off antiepileptics 7) thoracic aortic anuerysm s/p repair 8) neurogenic claudication 9) s/p spinal stenosis surgery , on narcotics 10) mrsa pna with cavitation, tx with linezolid x 14 days social history: widower. patient lives with his sister-in-law and her children. -tobacco history: 30 pk/year hx, recently "quit" on previous discharge. has not smoked a cigarette since -etoh: previous hx of 16-30 beers/day, cut back a year ago, now occasional 1-2 beers. -drug: denies hx of ivdu family history: mother died of mi at 59. father died at 61 of "mi and cancer." cousin with mi at 41. paternal uncle died with mi at 41. sister with borderline diabetes. brother died of throat cancer. physical exam: 98.0, 94, 190/66, 17, 98% bipap -> after intubation, 81/40 99% ac 450 x18, peep 8, fio2 35% general: pre-intubation, in distress, using accessory muscles, bipap in place heent: sclera anicteric, dry mucous membranes neck: no appreciable jvd lungs: poor air movement, particularly on right; no appreciable wheezes, rales, or rhonchi cv: rrr, normal s1/s2, no murmrs abdomen: hypoactive bowel sounds, soft, nontender, not distended ext: warm, well-perfused, no lower extremity edema discharge exam: general: no acute distress, aaox3, responds appropriately to questions heent: sclera anicteric, dry mucous membranes neck: no appreciable jvd lungs: decreased air movement on right; no appreciable wheezes, rales, or rhonchi cv: rrr, ii-iii sem heard best over left upper sternal border abdomen: normoactive bowel sounds, soft, nontender (although sedated), not distended ext: warm, well-perfused, trace lower extremity edema to knees bilaterally; weak, symmetric radial, dp pulses; lue with notable swelling and pain to palpation pertinent results: 04:05pm wbc-17.1*# rbc-4.32* hgb-11.8* hct-36.6* mcv-85 mch-27.4 mchc-32.3 rdw-17.9* 04:05pm neuts-85.4* lymphs-11.0* monos-2.6 eos-0.6 basos-0.3 04:05pm plt count-267 04:05pm pt-19.8* ptt-23.1 inr(pt)-1.8* 04:05pm type-art po2-254* pco2-77* ph-7.31* total co2-41* base xs-9 04:05pm ctropnt-<0.01 04:14pm lactate-1.5 11:47pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg on discharge: 03:59am blood wbc-10.0 rbc-3.86* hgb-10.3* hct-32.6* mcv-85 mch-26.6* mchc-31.5 rdw-18.5* plt ct-203 03:59am blood pt-12.3 ptt-23.7 inr(pt)-1.0 03:59am blood glucose-100 urean-16 creat-0.4* na-142 k-4.3 cl-99 hco3-40* angap-7* cxr 1v (): in comparison with the earlier study of this date, there has been placement of an endotracheal tube with its tip approximately 5 cm above the carina. orogastric tube to at least the upper stomach, where it crosses the lower margin of the image. little change in the appearance of the heart and lungs with no evidence of acute cardiopulmonary disease. intact midline sternal wires relate to previous cabg procedure. brief hospital course: 55 year-old male with cad, copd s/p recent hospitalization for hypercarbic respiratory failure, admitted one-day post-discharge with recurrent dyspnea. hospital course was as follows. . #. acute on chronic hypercarbic respiratory failure. in the ed, 7.31/77/254; most recent abg 7.39/70/86 on face mask. he has chronic respiratoy acidosis based on hco3- 35 with likely baseline pco2 around 70. patient intubated for apneic episodes, fatigue shortly after arrival to micu. based on patient history and recent medical course, etiology likely copd exacerbation. trigger unclear - he has long history of medication/home oxygen noncompliance, and on arrival to micu he smelled of cigarette smoke. patient was given methylprednisolone 125mg iv q8 hours for first day and then weaned down to prednisone 40mg po daily with plan for prolonged taper. he was kept on standing ipratropium/albuterol nebs every 4 hours. he was initially started on azithromycin but was later discontinued as patient was afebrile, wbc returned to and his chest xray did not reveal any infiltrate. on , (day after admission) patient was successfully extubated and placed on his home o2 requirement of 2l. on , his sputum grew out pseudomonas, new to patient's respiratory flora per our prior microbiology; ciprofloxacin should continue for 3-4 weeks until his follow up appointment with dr. . also placed on prednisone taper which should continue until his appointment with dr. , his pulmonologist. of note, patient also had some improvement in symptoms with diuresis. he was given lasix 20mg iv x1 on with good response. he should continue to be weighed regularly and lasix dose adjusted as necessary. he has known mild systolic dysfunction, and is on an ace inhibitor, beta-blocker, and lasix as outpatient. . #. hypotension: patient became mildly hypotensive in setting of intubation. his pressures responded to ivf boluses; however based on poor access, a central line was placed. patient never required pressors and pressures remained normotensive throughout his hospital stay. home furosemide, metoprolol, lisinopril were held initially and resumed on discharge. . #. leukocytosis: last cbc with normal wbc 5.9. his leukocytosis normalized after first day and was thought to be stress response related. as above, his sputum cx grew out pseudomonas and he was started on ciprofloxacin. urine and blood cultures remained no growth. . #. left brachial vein dvt: inr 1.8 on admission. given urgent need to place cvl, he was reversed with ffp. anticoagulation was discontinued given (1) low risk for embolization and (2) patient's risk on coumadin given history of medication noncompliance. . #. cad: cycled cardiac markers x2 on admission due to possibility of dyspnea due to cardiogenic source, all negative. continued 325mg po daily and simvastatin 40mg po daily per home regimen. metoprolol, lisinopril restarted on discharge per home regimen. . #. chronic back pain: morphine, percocet on held initially given hypotension, they were restarted when hemodynamically stable (percocet 5/325mg 2 tablets q6 hours prn; ms contin 15mg po q12 hours). medications on admission: (per discharge summary) 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. sulfamethoxazole-trimethoprim 800-160 mg tablet sig: one (1) tablet po 3x/week (mo,we,fr): take this medication three times per week for as long as you are taking 20 mg or more per day of prednisone. 4. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 5. fluticasone-salmeterol 500-50 mcg/dose disk with device sig: one (1) inhallation/activation inhalation (2 times a day). 6. guaifenesin 100 mg/5 ml liquid sig: five (5) ml po every six (6) hours as needed for cough. 7. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). 8. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). 9. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours). 10. oxycodone-acetaminophen 5-325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain: as we discussed - do not drive or drink alcohol or operate machinery while taking this medication. 11. metoprolol succinate 100 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po daily (daily). 12. calcium carbonate 200 mg (500 mg) tablet, chewable sig: one (1) tablet, chewable po tidac (3 times a day (before meals)). disp:*180 tablet, chewable(s)* refills:*0* 13. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po once a day. 14. morphine 15 mg tablet extended release sig: one (1) tablet extended release po q12h (every 12 hours): as we discussed - do not drive or drink alcohol or operate machinery while taking this medication. 15. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 16. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily): take this medication once per day while you are taking prednisone. 17. warfarin 1 mg tablet sig: one (1) tablet po once a day for 3 months: your levels of this medication will need to be managed and dosed by dr (your primary care md). goal inr 2.0-3.0; do not take this medication until instructed to do so by your visiting nurse and your primary md (). 18. prednisone 10 mg tablet sig: as per taper regimen tablet po once a day for 22 days: : 4 tab/day : 2 tab/day : 1 tab/day then stop. discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. sulfamethoxazole-trimethoprim 800-160 mg tablet sig: one (1) tablet po qmowefr ( -wednesday-friday). 4. furosemide 40 mg tablet sig: one (1) tablet po once a day. 5. fluticasone-salmeterol 500-50 mcg/dose disk with device sig: one (1) inhalation inhalation twice a day. 6. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po once a day. 7. ipratropium bromide 0.02 % solution sig: one (1) nebulizer inhalation every six (6) hours. 8. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) nebulizer inhalation every six (6) hours. 9. percocet 5-325 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain: cause sedation. do not drive or operate machinery when taking this medication. 10. metoprolol succinate 100 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. 11. calcium carbonate 200 mg (500 mg) tablet, chewable sig: one (1) tablet, chewable po three times a day. 12. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po once a day. 13. morphine 15 mg tablet extended release sig: one (1) tablet extended release po every twelve (12) hours: cause sedation. do not drive or operate machinery when taking this medication. 14. lisinopril 20 mg tablet sig: one (1) tablet po once a day. 15. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 16. prednisone 5 mg tablet sig: as listed below. tablet po once a day for 1 months: 40mg daily for 4 days, then 35mg daily for 4 days, then 30mg daily for 4 days, then 25mg daily for 4 days, then 20mg daily for 4 days, then 15 daily for 4 days, then 10mg daily until seen by dr. on . 17. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 4 weeks. discharge disposition: extended care facility: healthcare center - discharge diagnosis: - acute copd exacerbation - bronchiectasis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. requires supplemental oxygen with ambulation and at rest. discharge instructions: you were admitted to the intensive care unit at for shortness of breath. you required intubation and treatment with a breathing machine for approximately 24 hours. we gave you steroids and lasix, a diuretic, and your symptoms improved. you also had a bacteria called pseudomonas in your sputum - you were started on ciprofloxacin for treatment of this. for your copd exacerbation, you were started on a new taper of prednisone. finally, your coumadin was held at this time. other than these medication changes, your medication regimen was not changed. please continue your other medications as you were prior to this hospitalization. please be sure to keep your appointments as listed below. followup instructions: department: when: at 11:30 am with: post clinic building: sc clinical ctr campus: east best parking: garage department: pulmonary function lab when: thursday at 9:10 am with: pulmonary function lab building: campus: east best parking: garage department: medical specialties when: thursday at 9:30 am with: , m.d. building: campus: east best parking: garage md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube diagnoses: tobacco use disorder unspecified essential hypertension aortocoronary bypass status other and unspecified hyperlipidemia acute and chronic respiratory failure old myocardial infarction long-term (current) use of anticoagulants other postprocedural status personal history of noncompliance with medical treatment, presenting hazards to health chronic obstructive asthma with (acute) exacerbation backache, unspecified bronchiectasis without acute exacerbation tachycardia, unspecified leukocytosis, unspecified pseudomonas infection in conditions classified elsewhere and of unspecified site other dependence on machines, supplemental oxygen personal history of methicillin resistant staphylococcus aureus chronic venous embolism and thrombosis of deep veins of upper extremity 

Answer: The patient is high likely exposed to