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: levofloxacin attending: chief complaint: fevers to 101 and increased sob. major surgical or invasive procedure: flexible bronchoscopy with therapeutic aspiration of secretions. flexible bronchoscopy with bronchoalveolar lavage. history of present illness: ms. is a 46 year old female with history of breast cancer, thyroid cancer, and hodgkins status post xrt who first presented with a pleural effusion on . she had a thoracentesis and thorascopy with pleuradesis on . she had trapped lung following htis procedure, requiring decortication () and chest tube placement. she developed a post-operative fever and was treated for pneumonia with vancomycin/zosyn --> augmentin on discharge (completed ). she re-presented to on with fevers and shortness of breath and was discharged on with vancomycin for mrsa empyema. . she presented to yesterday with fevers to 101, hemoptysis with occasional clots, and increasing shortness of breath. there were blood clots present in her sputum. she denied chest pain, le edema. . patient is on anticoagulation with lovenox for mechanical aortic valve which was held last night. she was given vanco/zosyn for empiric treatment for pneumonia. she had a bronchoscopy today which showed diffuse bleeding on the right side. a small amount of bleeding that resolved was seen on the left side. . following bronchoscopy, patient went to bathroom and developed shorntess of breath patient was increased from 4 to 6lnc of oxygen. she was coughing, but denied hemoptysis. she reported shortness of breath. she denied chest pain, nausea, vomiting, abdominal pain, or any other symptoms. past medical history: left lower lobe effusion s/p pigtail catheter placement into the left pleural space pleuoscopy, drainage left pleural effusion, biopsy left video assisted thoracoscopy converted to left thoracotomy, decortication of lung, also placement of pneumoperitoneum catheter. hodgkin's disease, status post xrt and lymphadenectomy. breast cancer s/p bilateral mastectomy & bilateral reconstruction hypothyroidism s/p total thyroidectomy in for bilateral papillary carcinoma. s/p aortic replacement mechanical for radiation-induced valvular disease in . social history: the patient does not smoke. she drinks alcohol occasionally. she is married, but has no children. she owns a gift store. family history: family history is negative for breast cancer. physical exam: vs: t: 98.2 hr: 106 sr bp: 160/80 sats: 96% ra general: 46 year-old female in no apparent distress heent: normocephalic, mucus membranes moist neck: supple, no lymphadenopathy card: rrr good click, normal s1,s2 no murmur/gallop/rub resp: decreased breath sounds bilateral gi: benign extr: warm no edema incision: well healed, pigtail site no discharge neuro: non-focal pertinent results: chest ct: impression: 1. marked improvement of diffuse airspace consolidation and opacity in the right lung, consistent with resolving hemorrhage. 2. unchanged appearance of left-sided pigtail catheter; little decrease in small left pleural collection, probably hemorrhagic. 3. improving left lower lobe hematoma. cta chest/ abd/ pelvis: there is no evidence of any active bleeding or extravasation of contrast into the pleural space or into the abdomen. minimal free fluid in the abdomen is of a simple fluid attenuation and is not blood. it is not bloody in nature. ct: worsening of diffuse airspace opacities in the right lung from . these may represent worsening multifocal pneumonia. however, superimposed edema or hemorrhage can't be excluded. left lower lobe nodular opacities similar in appearance from prior study. left loculated pleural effusion is smaller with pigtail catheter centered in the effusion. assessment for empyema limited without iv contrast. cxr the right lung base shows a peribronchial area of consolidation that is likely to represent pneumonia. in the retrocardiac lung areas, sparse air bronchograms and a subtle pleural effusion is seen. here another consolidation could be present. no hilar or mediastinal enlargement. no evidence of pneumothorax. borderline size of the cardiac silhouette. cxr : b/l diffuse airspace opacities which may reflect worsed multifocal pna; superimposed pulm edema/hmg cant be ruled out/ no effussions. . these may represent worsening multifocal pneumonia.however, superimposed edema or hemorrhage can't be excluded. left lower lobe nodular opacities similar in appearance from prior study. left loculated pleural effusion is smaller with pigtail catheter centered in the effusion. labs: wbc-5.4 rbc-4.19* hgb-11.6* hct-35.7* plt ct-502* wbc-6.8 rbc-4.09* hgb-11.4* hct-34.5* plt ct-501* wbc-8.5 rbc-3.69* hgb-10.4* hct-31.3* plt ct-332 wbc-7.7 rbc-3.01* hgb-8.7* hct-24.8* plt ct-283 wbc-17.4*# rbc-2.75* hgb-7.6* hct-23.9* plt ct-397 wbc-7.7 rbc-3.03* hgb-8.0* hct-26.2* plt ct-340 wbc-10.8 rbc-2.66* hgb-7.4* hct-23.0* plt ct-390 neuts-85.3* bands-0 lymphs-10.0* monos-1.5* eos-3.1 baso-0.2 pt-15.1* ptt-33.3 inr(pt)-1.3* pt-14.2* ptt-34.8 inr(pt)-1.2* pt-15.4* ptt-36.4* inr(pt)-1.4* facviii-248* fibrino-674*# d-dimer-1665* vwf ag-181* vwf cof-160 glucose-89 urean-9 creat-0.6 na-138 k-4.3 cl-101 hco3-28 glucose-108* urean-14 creat-0.7 na-139 k-4.1 cl-106 hco3-23 alt-367* ast-114* ld(ldh)-326* alkphos-237* totbili-0.4 dirbili-0.1 indbili-0.3 alt-143* ast-113* ld(ldh)-417* alkphos-197* totbili-1.3 calcium-9.2 phos-4.8* mg-2.3 hapto-282* hbsag-negative hbsab-positive hbcab-negative hav ab-positive igm hbc-negative igm hav-negative anca-negative b dsdna-negative -negative rheufac-14 c3-176 c4-33 hcv ab-negative cultures: cmv viral load (final ): cmv dna not detected. varicella-zoster igg serology (final ): positive by eia. blood culture, routine (final ): no growth. gram stain (final ): no organisms seen. respiratory culture (final ): oropharyngeal flora absent. serratia marcescens. rare growth. gram stain (final ): 3+ (5-10 per 1000x field): polymorphonuclear leukocytes. 3+ (5-10 per 1000x field): gram positive cocci. in pairs and clusters. 2+ (1-5 per 1000x field): gram negative rod(s). fluid culture (final ): escherichia coli. heavy growth. staph aureus coag +. heavy growth. oxacillin resistant staphylococci escherichia coli | staph aureus coag + | | ampicillin------------ =>32 r ampicillin/sulbactam-- 8 s cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 4 s ciprofloxacin--------- =>4 r erythromycin---------- =>8 r gentamicin------------ =>16 r <=0.5 s levofloxacin---------- =>8 r meropenem-------------<=0.25 s oxacillin------------- =>4 r penicillin g---------- =>0.5 r piperacillin/tazo----- <=4 s rifampin-------------- <=0.5 s tetracycline---------- <=1 s tobramycin------------ 4 s trimethoprim/sulfa---- =>16 r <=0.5 s vancomycin------------ <=1 s anaerobic culture (final ): no anaerobes isolated. fungal culture (preliminary): no fungus isolated. acid fast smear (final ): no acid fast bacilli seen on concentrated smear. acid fast culture (preliminary): viral culture (preliminary): no virus isolated so pleural fluid : negative left lung tissue : negative, fungal, afb, nocardia brief hospital course: ms. is a 46 year old female with a histoy of hodgkin's lymphoma, breast cancer, thyroid cancer, s/p aortic valve replacement on lovenox, admitted with repiratory distress secondary to hemotpysis, multifocal pneumonia, polymicrobial empyema. . respiratory failure. patient was admitted to micu for increased oxygen requirements and respiratory distress following bronchoscopy. patient was intubated for airway protection and to manage patient secretions in setting of ongoing signicant hemoptysis. on bronchosopy, it appeared that pulmonary bleed was diffuse. etiology of hemopysis was thought to be secondary to multifocal pneumonia on top of radiation changes to lung in setting of anticoagulation. with treatment of pna and holding anticoagulation, hemoptysis resolved. patient intiially failed extubation, but after diuresis, she was able to be successfully extubation. a rheuamtology work up for diffuse alveolar hemorrhage was pursued, but was pending at time of discharge from micu. anemia. patient had hemoptysis that resolved during hospital stay in setting of anticoagulation for mechanical valve. she remained anemic during micu course requiring 7 units of prbcs. she was guiaic negative and ct torso did not show any ongoing bleeding or hematoma. . s/p aortic valve replacement. patient was anticoagulated with lovenox at home and presented with hemoptysis. her lovenox was held and her bleeding resolved. she was resumed on heparin drip 4 days into hospital stay with goal ptt of 50-60. on the heparin was stopped and she restarted lovenox bidge to coumadin. on dishcarge her inr was 1.2. she continued her previous coumadin dosing. . transaminitis. patient had rising lfts after episode of prolonged hypotension following intubation. thought to be due to shock liver, but was evaluated for hepatitis as well. . empyema. patient with left pigtail in place until it was removed. infectious disease: sputum cultlures positive for serratia marscesens. pleural fluid positive e. coli (sensitive to cefepime) and mrsa. patient was treated with vanco/cefepime. infectious disease was consulted and they recommended 14 day course of cefepime and vancomycin and to removed left pigtail. hematologic/oncologic: seen on for hemoptysis and felt hemoptysis is related to infection and is resolving as infection is treated. in addition the lymphocyte predominance is likely related to this infection. she was discharged to home and will follow-up with dr. , dr. and infectious disease as an outpatient. medications on admission: meds: levothyroxin 150', lasix 20', toprol 25', zocor 20', oxycodone 5 mg', tylenol 325 prn, asa 81'; vancomycin discharge medications: 1. levothyroxine 150 mcg tablet sig: one (1) tablet po once a day. 2. enoxaparin 80 mg/0.8 ml syringe sig: one (1) subcutaneous (2 times a day): until inr 2.0 or greater. disp:*10 * refills:*2* 3. coumadin 5 mg tablet sig: as directed tablet po once a day: to maintain inr 2.0-3.0. 4. zocor 20 mg tablet sig: one (1) tablet po once a day. 5. iron (ferrous sulfate) 325 mg (65 mg iron) tablet sig: one (1) tablet po once a day: take with oj. 6. toprol xl 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 7. lasix 20 mg tablet sig: one (1) tablet po once a day: daily weights and take as previous. discharge disposition: home discharge diagnosis: left lower lobe effusion s/p pigtail catheter placement into the left pleural space pleuoscopy, drainage left pleural effusion, biopsy left video assisted thoracoscopy converted to left thoracotomy, decortication of lung, also placement of pneumoperitoneum catheter. hodgkin's disease, status post xrt and lymphadenectomy. breast cancer s/p bilateral mastectomy & bilateral reconstruction hypothyroidism s/p total thyroidectomy in for bilateral papillary carcinoma. s/p aortic replacement mechanical for radiation-induced valvular disease in . discharge condition: stable discharge instructions: call dr. office if experience: -fever > 101 or chills -increased chest pain, or shortness of breath, cough. continue lovenox until inr 2.0 or greater. coumadin as previous. followup instructions: follow-up with dr. and dr. in 2 weeks follow-up with infectious disease dr. in one month on :30am /basement, . procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified insertion of endotracheal tube insertion of endotracheal tube closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus diagnoses: anemia, unspecified unspecified septicemia severe sepsis infection with microorganisms resistant to penicillins personal history of malignant neoplasm of breast heart valve replaced by other means acute respiratory failure septic shock hodgkin's disease, unspecified type, unspecified site, extranodal and solid organ sites long-term (current) use of anticoagulants methicillin susceptible pneumonia due to staphylococcus aureus anticoagulants causing adverse effects in therapeutic use empyema without mention of fistula personal history of malignant neoplasm of thyroid 

Answer: The patient is high likely exposed to