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: history of present illness: this is a 68-year-old woman with a history of chronic obstructive pulmonary disease, history of right upper lobe pneumonia, status post prolonged intubation with trache and peg placements from to , full exercise tolerance at baseline, chronic productive cough with thick-clear sputum, but otherwise not on home o2 or po prednisone, who has been in her usual state of health until about a week prior to admission when she started to experience increased fatigue, and shortness of breath, and productive cough. but otherwise no fevers, chills, no overt upper respiratory infection, urinary tract infection, or abdominal symptoms. two days prior to admission, her family noticed a dramatic worsening of shortness of breath and increased sputum production, but otherwise no change in the color or blood in the sputum. she also had significant worsening of appetite for two days. she fell at home the day prior to admission due to extreme weakness. she was on the floor for about 15 minutes, but no loss of consciousness. she was brought into the emergency room by her family. her head ct scan was negative for hemorrhage. her shortness of breath was much better with nebulizers and iv steroids. however, the next day while she was still in the emergency room, she was noticed to have increased lethargy, and was electively intubated for an arterial blood gas of ph 7.24, pco2 84, and po2 of 73. she became significantly hypotensive after intubation and required 10 liter normal saline resuscitation. she was started on neo-synephrine for blood pressure support. she was given a dose of levofloxacin and vancomycin for empiric coverage of possible sepsis. her chest x-ray and chest ct scan in the emergency department suggested right upper lobe pneumonia or other processes. past medical history: 1. chronic obstructive pulmonary disease. 2. severe emphysema and bronchitis. pulmonary function tests in showed a fvc of 1.85 liters, fev1 0.73 liters, and a fev1/fvc ratio 39%. 3. hypertension. 4. vitamin b12 deficiency. 5. alcohol and benzodiazepine dependency. 6. history of tuberculosis exposure versus infection. 7. osteoporosis. 8. status post right upper lobe pneumonia in to with prolonged intubation with trache and peg placement. allergies: 1. bactrim with nausea. 2. orajel with benzocaine with dermatitis. medications on admission: 1. combivent two puffs . 2. serevent two puffs . 3. vitamin b12 250 mcg po q day. 4. flovent two puffs . 5. klonopin 1 mg po bid. 6. atrovent. 7. remeron 30 mg q hs. 8. diltiazem 120 mg po bid. 9. multivitamins one tablet po q day. 10. stool softeners. 11. oxycodone 5 mg prn for pain. social history: two packs per day until last year after the pneumonia. still smokes now and then. regular alcohol use. lives with her son and grandson. exam on admission: temperature 97.0, heart rate 74, blood pressure 85/35, respiratory rate 16, o2 saturation 100% on fio2 100% with vent setting of tidal volume 350, rate of 16, peep of 5, fio2 1.0. general: she is intubated, but easily arousable, thin, chronically sick appearing, but otherwise in no acute distress. head and neck examination is anicteric. oropharynx is clear. cardiovascular: regular, rate, and rhythm. lungs: equal breath sounds bilaterally, significantly prolonged expiratory phases. abdomen is soft, normal bowel sounds. extremities no edema. neurologic: moves all extremities. lines with foley and et tube. laboratories upon admission: arterial blood gas 7.24, 84, 73 preintubation. after intubation, 7.07, 25, 459. complete blood count: white count of 34.3, hematocrit of 43.5, platelets 474. pt of 16.0, ptt 53.4, inr of 1.7. sodium 135, potassium 4.6, chloride 96, bicarb 31, bun 9, creatinine 0.5, glucose of 133. urinalysis is negative. chest x-ray showed increased capacity and pleural thickening at the right upper lobe concerning for infection, tuberculosis versus aspergillosis, versus actinomycosis, versus mucomycosis, and also need to rule out neoplasts. chest ct scan: diffuse emphysematous changes with bullae, right apical thick walled cavity suggesting semi-invasive aspergillus, versus tuberculosis, versus actinomycosis, versus mucomycosis, versus neoplasts, multilobular pneumonia, versus aspiration, multiple liver lesions. head ct scan: no evidence of intracranial hemorrhage. sputum gram stain showed + gram-positive cocci. culture was essentially negative. had some oral flora. urine culture negative. blood cultures were negative. hospital course: patient had remained relatively stable through her hospital stay. she finished a 10 day course of vancomycin for a possible mrsa pneumonia. she continued to have low grade temperatures, but her white counts came down significantly to her baseline around 16. since her initial hypertension was thought most likely secondary to intubation instead of sepsis, she was aggressively diuresed through her hospital stay, and she received 10 liters normal saline initially in the emergency room. although her respiratory status continued to improve significantly, she was not able to be weaned off vent at this time. she had a trache and peg placed so she can be discharged to rehab for slow weaning of ventilation. decision was made to discharge her to rehab with lasix drip in order to diurese her about 1 liter negative everyday until her weight is down back to her baseline or her bun or creatinine start to increase. discharge condition: stable. discharge status: rehab. discharge diagnoses: 1. respiratory failure. 2. right upper lobe pneumonia. 3. chronic obstructive pulmonary disease. 4. possible aspergillosis. 5. hypertension. discharge medications: 1. vitamin b12 250 mcg po q day. 2. flovent two puffs . 3. klonopin 1 mg po bid. 4. senna one tablet po bid. 5. subq heparin 5,000 units subq . 6. atrovent four puffs qid. 7. albuterol four puffs qid. 8. prevacid 30 mg po q day. 9. multivitamins 5 cc po q day. 10. colace 150 mg po bid. 11. nystatin swish and swallow qid prn. 12. ritalin 2.5 mg po q am. 13. remeron 30 mg po q hs. 14. dulcolax 10 mg po q day prn. 15. milk of magnesia 30 cc po qid prn. 16. lactulose 30 cc po qid prn. 17. tylenol prn. 18. lasix drip 0.25 mg/hour titrate to in and out's negative a liter per day until bun and creatinine start to increase for weight back to baseline. 19. insulin nph 6 units . 20. regular insulin-sliding scale qid. discharge followup: the patient will continue her outpatient followup with her primary care physician. will also need to be seen in the pulmonary clinic to followup the right upper lobe lesion. ct-guided aspiration versus biopsy might be considered. , m.d. dictated by: medquist36 procedure: fiber-optic bronchoscopy fiber-optic bronchoscopy percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy diagnoses: unspecified essential hypertension other b-complex deficiencies acute respiratory failure hypotension, unspecified osteoporosis, unspecified other emphysema methicillin susceptible pneumonia due to staphylococcus aureus aspergillosis pneumonia in aspergillosis 

Answer: The patient is high likely exposed to