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: codeine attending: chief complaint: shortness of breath major surgical or invasive procedure: none history of present illness: ms. is a 68 year old generally healthy lady who experienced shortness of breath since returning from 6 days prior to admission. she felt feverish but never checked her temperture. she has also experienced chills. she did not have cough, headache, focal neuro symtoms, chest pain, palpiations, abdominal pain, diarrhea, constipation, nausea, vomitting, dysuria or rash. she has not noticed any bleeding including not experiencing any blood in stool or urine. . in the ed her vitals were tmax 101.4 bp 123/63 hr 100 rr 30 86% in ra with 99% on 4lnc. according to the ed resident's verbal signout her oxygen sats improved to 99% on ra and was placed on 6l nc for comfort. her cxr was suspicous for pneumonia and she was given levofloxacin 750 mg iv once and combivent nebs. her hematocrit was found to be 14 and she received 1uprbc and 1lns. she was trace guaic positive. . on arrival to micu her vitals were t 99.6 hr 117 bp 161/59 rr 35 100% on nrb 100%. past medical history: history of pericarditis 4 years ago social history: lives alone by herself in collidge corner in a condominium. no known family members. lots of friends who live nearby. 1 pack cig per day active smoker for approx 50 years. family history: father passed away of pna. physical exam: admission: vitals: t 99.6 hr 117 bp 161/59 rr 35 100% on nrb 100%. gen: alert and awake, tacypnic, ? anxious heent: pale, mmm, op clear heart: s1s2 regular rhythm, tachycardia, no mrg lungs: bilateral diffuse rhonchi abdomen: bs present, soft ntnd, no appreciable mass/organomegaly. ext: wwp, no edema neuro: following commands, strength 5/5 b/l, cn iii/xii grossly intact . discharge: vs: afebrile, hr 70s, rr 20, o2 sat 95% on ra at rest, 90-93% on ra with ambulation gen: a&o, nad heent: mmm, op clear heart: rrr, normal s1 and s2, no m,r,g lungs: crackles at the bases bilaterally, no wheezes abd: soft, nt, nd, normoactive bs ext: no edema neuro: walks without difficulty pertinent results: admission labs: wbc-4.7# rbc-1.19*# hgb-4.9*# hct-14.2*# mcv-120*# mch-41.4*# mchc-34.6 rdw-23.4* plt ct-269 neuts-70 bands-4 lymphs-14* monos-9 eos-0 baso-1 atyps-1* metas-1* myelos-0 blood hypochr-normal anisocy-2+ poiklo-2+ macrocy-2+ microcy-2+ polychr-occasional schisto-occasional tear dr2+ pt-17.8* ptt-43.1* inr(pt)-1.6* blood glucose-130* urean-16 creat-1.0 na-135 k-3.8 cl-102 hco3-21* alt-36 ast-33 ck(cpk)-65 alkphos-66 totbili-1.4 lipase-13 ctropnt-<0.01 probnp-2858* calcium-7.8* phos-2.9 mg-1.7 iron-19* caltibc-159* vitb12-679 hapto-90 ferritn-936* trf-122* ret aut-3.4* type-art temp-37.1 rates-/30 po2-36* pco2-34* ph-7.40 caltco2-22 base xs--2 intubat-not intuba comment-o2 deliver blood lactate-3.1* other labs: tsh-4.1 iga-76, ttg-iga-2 discharge labs: wbc-5.3 hgb-9.2* hct-26.0* mcv-96 plt-186 glucose-92 urean-16 creat-0.7 na-142 k-3.8 cl-112* hco3-24 12:32 am urine site: not specified **final report ** urine culture (final ): no growth. 5:38 pm urine source: catheter. **final report ** legionella urinary antigen (final ): negative for legionella serogroup 1 antigen. (reference range-negative). performed by immunochromogenic assay. a negative result does not rule out infection due to other l. pneumophila serogroups or other legionella species. furthermore, in infected patients the excretion of antigen in urine may vary. studies: chest x-ray - retrocardiac opacity obscuring the left hemidiaphragm is most likely atelectasis, however early developing pneumonia not entirely excluded. correlate clinically. ekg: nsr, vent rate 100s, nl axis, nl intervals, no significant st-t changes compared 11/. cta chest - impression: 1. bilateral dense lower lobe pneumonias with small reactive pleural effusions (consolidation is denser on the left, however effusion is slightly larger on the right). additional scattered more ground-glass opacities as noted above, which may also be infectious or represent regions of alveolar edema in this patient with mild interstitial septal thickening suggestive of mild pulmonary edema. 2. scattered small right middle lobe nodular densities measuring up to 5 mm. in a patient at low risk for intrathoracic malignancy, a dedicated followup ct should be obtained in one year; if high risk, a dedicated followup can be obtained in 6 to 12 months. 3. no evidence of aortic dissection or pulmonary embolism. 4. cardiomegaly with prominent right atrium. ekg - technically difficult study. sinus rhythm late r wave progression - probable normal variant. t wave abnormalities. since previous tracing of , heart rate slower, and t wave abnormalities less. ttecho - the left atrium is mildly dilated. the right atrial pressure is indeterminate. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. impression: normal biventricular cavity sizes with preserved global and regional biventricular systolic function. moderate pulmonary artery systolic hypertension. mild mitral regurgitation. this constellation of findings suggests a primary pulmonary process (e.g.., copd, bronchospasm, pulmonary embolism, etc.) chest x-ray - impression: increasing right pleural effusion. essentially unchanged left lower lobe consolidation and associated effusion. empyema cannot be excluded on this examination and if there is continued clinical concern for empyema a dedicated chest ct with iv contrast is recommended. chest x-ray, lateral decubitus - impression: bilateral small pleural effusions. left side estimated to 1-200 ml. the right-sided effusion is less than that matches the small amount of pleural effusion demonstrated on chest ct performed on . brief hospital course: mrs. is a 68 year old female who was admitted with shortness of breath and fatigue and found to have pneumonia and anemia. # pneumonia - in the ed the patient was ruled out for a pe with a cta given her aa gradient. cta showed an impressive bilateral pneumonia. the patient was initially admitted to the micu as she was on a non-rebreather, but was weaned down to 3l nc overnight. she was transfered to the general medical floor the following day. she was continued on levofloxacin 750 mg for community acquired pneumonia and continued to improve clinically. urine legionella antigen was negative. she was given nebulized albuterol and an ipratropium mdi for wheezing. she also had an echo to evaluate for chf given an elevated bnp on admission. her echo was largely unremarkable except for an elevated pulmonary artery systolic pressure, likely secondary to pneumonia. the patient had an episode of acute chest pain during/immediately after the echo. ekg was unremarkable. her chest pain was most likely a result of movement and pleural irritation from her pneumonia. she was given morphine iv, tylenol, and ibuprofen with resolution of her chest pain and no further episodes. as a result of this episode, consideration was given to tapping her pleural effusions to rule out empyema and ap and decubitus chest x-rays were performed, however, it was felt that there was too little fluid to tap, the patient's chest pain resolved, and she continued to improve clinically. the patient was evaluated by physical therapy. on the morning of discharge the patient's room air o2 sat at rest was 95%. with ambulation it was mostly 92-93%, but did briefly dip to 90%. given the severity of the patient's pneumonia, it is recommended that she have a follow-up chest x-ray in two months to evaluate for resolution. in addition, given her smoking history and the pulmonary nodules that were noted on cta, the patient should have a repeat ct scan in months. # anemia - on arrival to the micu, the patient received 2 additional units of blood and her hematocrit increased appropriately to 20 and she remained hemodynamically stable. the anemia was also evaluated with haptoglobin (nl), nl folate, nl b12 and reticulocyte count which was appropriately elevated. iron studies demonstrated iron deficiency anemia but with an elevated ferritin. it should be noted, however, that these studies were performed after the patient had already received some blood and therefore, may not be entirely accurate. the patient was transfused an additional 2 units of prbcs on the medicine floor with an appropriate hematocrit increase to 26 that remained stable. gastroenterology was consulted. the patient has never had a colonoscopy previously and they recommended a colonoscopy as an outpatient given trace guaiac positive stools in the ed and the uncertainty around the acuity of the patient's anemia, though she denied melena or brbpr. per gi recs tsh was checked and was normal. serum iga and ttg-iga were also checked and did not indicate celiac sprue. the patient was instructed to call the clinic to schedule a colonoscopy sometime during . the patient was also advised to have her primary care physician check her hematocrit to ensure that it remains stable. medications on admission: asa 81 mg daily no otc/herbal medications discharge medications: 1. levofloxacin 750 mg tablet sig: one (1) tablet po once a day for 6 days. disp:*6 tablet(s)* refills:*0* 2. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed: do not drive if you are taking this medication. disp:*30 tablet(s)* refills:*2* 3. combivent 18-103 mcg/actuation aerosol sig: inhalation four times a day as needed for shortness of breath or wheezing for 4 weeks. disp:*1 inhaler* refills:*2* discharge disposition: home discharge diagnosis: primary diagnoses: 1. pneumonia 2. anemia discharge condition: stable. discharge instructions: you were admitted to the hospital with pneumonia and anemia. you were given an antibiotic for the pneumonia and five red blood cell transfusions because of the anemia. you will also need further evaluation of your anemia as an outpatient. please take the antibiotic levofloxacin for the next 6 days. it is important that you take all of it, even if you are feeling better, to get over your pneumonia. you were also given a prescription for an inhaler to help with shortness of breath and wheezing. you were also given a prescription for zolpidem to help you sleep at night. please do not drive if you take this medication. please follow-up with the providers outlined below. please call your physician or return to the hospital if you develop fevers, worsening shortness of breath, worsening cough, chest pain, or orther concerning symptoms. followup instructions: please follow-up with your primary care provider . on tuesday, at 9:00 am. his office phone number is . please follow-up with the gastroenterologists within the next month for a colonoscopy. please call and ask for a fellow booked procedure. md, procedure: transfusion of packed cells diagnoses: pneumonia, organism unspecified anemia, unspecified tobacco use disorder hypopotassemia other diseases of lung, not elsewhere classified other chest pain hypoxemia 

Answer: The patient is high likely exposed to