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 / clindamycin / motrin / toradol / augmentin / dicloxacillin / doxycycline / banana attending: chief complaint: transfer from osh for further characterization of her intersitial lung disease major surgical or invasive procedure: minithoracotomy bronchoscopy central line picc history of present illness: this is a 45 yo woman who has h/o interstial lung disease treated with steroids for 1.5 years. she was originally admitted to hospital for shortness of breath and was diuresed and her steroids were increased. she did not improve so she was transferred to on for biopsy of her lungs for further characterization of her interstial lung disease. . she originally underwent a planned vats procedure but it was converted to an open minithoracotomy with lul and lll wedge resection due to left lung collapse. her post-operative course was further complicated by a right-sided pneumothorax that requred a chest tube. then she became tachyneic and hypoxemic and was transferred to the micu where she was intubated. it was unclear whether her respiratory distress was from infection (aspiration, pnuemonia) or from worsening of her primary interstial lung disease. broad spectrum antibiotics (levo/vanv/flagyl) was started. there was also a concern for pcp given her high dose steroid course, so bactrim was started prophylactically. brochoscopy samples did not grow out pcp . she was eventually extubated and tranferred to the regular medicine floors for further care. . biopsy of her lungs revealed bronchilitis obliterans organizing pneumonia. past medical history: ild as outlined above ankylosing spondylitis dm obesity depression anxiety htn hypercholesterolemia gerd social history: divorced x 6 years. currently living with fiancee and 2 daughters in . she was a nursing and medical assistant, and most recently a teacher. she denies tobacco or alcohol use. family history: two brothers with alcohol abuse. physical exam: physical examination: vs: 98.1, 102/60, 90, 20, 95%-4lnc gen: a+ox3, nad, looks lethargic, speaks softly, looks somewhat sob heent mmm, op clear neck: no jvd cor: rrr, no mrg pulm: bibasilar crackles 1/3 up, no rhonchi, wheezes abd: obese, soft, active bs ext: trace edema neuro: nonfocal, mobilizes all extremities spontaneously pertinent results: 04:41pm blood wbc-12.0* rbc-3.46* hgb-10.5* hct-30.3* mcv-88 mch-30.3 mchc-34.6 rdw-16.6* plt ct-346 . 04:41pm blood neuts-92.1* lymphs-6.0* monos-1.7* eos-0.1 baso-0.1 . 04:41pm blood pt-11.9 ptt-20.9* inr(pt)-1.0 . 04:41pm blood glucose-288* urean-23* creat-0.8 na-138 k-4.5 cl-93* hco3-30 angap-20 . 04:41pm blood calcium-9.5 phos-3.7 mg-2.0 . . chest x ray admission: impression: prominent diffuse scattered interstitial opacities throughout both lungs, of indeterminate acuity. comparison with prior films would help to assess for any superimposed process. no pneumothorax or effusion is identified. . chest ct : findings: extensive ground-glass opacity compromising all lobes is worse in the right upper lobe, right middle lobe and right lower lobe, and mildly improved in the left upper lobe. there is mild bronchiectasis in the posterior basal segment of the right lower lobe. the airways are patent to the segmental level. there is no mediastinal, hilar or axillary lymphadenopathy; a few small prevascular, paratracheal and axillary lymph nodes are stable. the heart and great vessels are unremarkable. a pleuro-parenchymal seroma is adjacent to the surgical sutures in the left lower lobe measuring approximately 32 x 19 mm. there is no pericardial effusion. a calcified granuloma is in the right upper lobe (5:14). there are no bone findings of malignancy. the upper abdomen shows no abnormalities. impression: interval worsening of the interstitial lung abnormalities. . pathology: 1. lung, left upper lobe (biopsy) (a-f): bronchiolitis obliterans - organizing pneumonia (see note). 2. lung, left lower lobe (biopsy) (g-h): bronchiolitis obliterans - organizing pneumonia (see note). note: in specimen one , intraalveolar fibrinous exudate is present, which is unusual for boop (bronchiolitis obliterans - organizing pneumonia). brief hospital course: 46 yo woman with boop s/p thoracotomy bx complicated by ptx s/p chest tube and respiratory failure s/p micu + intubation. . # boop - she was on solumedrol 40mg iv bid, then switched to prednisone 60mg . she takes bactrim for pcp prophylaxis and she is on nystatin swish and swallow. . # intermittent respiratory distress - she was extubated and transferred to the medical floors on nasal cannula. at rest, her oxygen saturation is 95% on 4l nc. however, she frequently desaturated from mucous plugging. she becomes tachycardic to hr of 140 and her o2 saturations drops to 85%. she responded to oxygen with facemask and albuterol/ipratroprium nebs. she was given aggressive pulmonary toilet and frequent chest physical therapy. she uses guaifensin three times a day for mucous and mucumyst nebs as necessary. she was given an acapela spirometer for further therapy. . of note, she was on home o2 for a few months after diagnosis of her interstitial lung disease a year and a half ago: 2l nc at rest and 4l nc with exertion. she was eventually weaned off but her primary pulmonologist thinks she might have to go back on again. . # bacteremia - she had coag neg staph bacteremia and the central line cath tip also grew coag neg staph. she completed 14 days of iv vancomycin on . . # diarrhea - she has intermitted diarrhea without abdominal pain. stool cultures were negative as well as cdiff culture. this may be related to her recent antibiotic course. . # diabetes - she usees lantus 18u qhs and a sliding scale provided by our consultants from the clinic. . # htn - controlled with metoprolol and lasix. . # depression/anxiety - she is anxious which exacerbates her repiratory distress with she has mucous plugging. she was on klonipin 0.5mg po tid with ativan for breakthrough anxiety. social work gave her some counselling regarding her medical condition as she frequently became tearful on examination. she is on escitalopram for depression. . # gerd - protonix . # follow-up - she had a discussion with our primary medical team and the pulmonology consult team and she decides to follow up with dr. who is her primary pulmonologist in new . she was given the phone number of our pulmonologist and the attending pulmonologist who saw her as consultants here at . medications on admission: prednisone 40 daily combivent q6 albuterol neb q4prn montelukast 10 qhs diltiazem 60 lorazepam 0.5 q6 prn protonix 40 daily heparin 5000u tid insulin sliding scale tylenol colace discharge medications: 1. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po daily (daily). 2. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 3. escitalopram 10 mg tablet sig: two (2) tablet po daily (daily). 4. albuterol sulfate 0.083 % solution sig: one (1) neb inhalation q4-6h (every 4 to 6 hours) as needed. 5. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed. 6. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q4-6h (every 4 to 6 hours) as needed. 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 10. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 11. acetylcysteine 10 % (100 mg/ml) solution sig: one (1) neb miscell. three times a day as needed for mucous. 12. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day). 13. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 14. albuterol sulfate 0.083 % solution sig: one (1) neb inhalation q 8h (every 8 hours). 15. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q8h (every 8 hours). 16. guaifenesin 100 mg/5 ml syrup sig: ten (10) ml po tid (3 times a day). 17. clonazepam 0.5 mg tablet sig: one (1) tablet po tid (3 times a day). 18. lorazepam 0.5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 19. azithromycin 250 mg capsule sig: one (1) capsule po q24h (every 24 hours). 20. prednisone 20 mg tablet sig: three (3) tablet po daily (daily). 21. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 22. dolasetron 12.5 mg/0.625 ml solution sig: 12.5 mg intravenous q12h (every 12 hours) as needed. 23. heparin lock flush (porcine) 100 unit/ml syringe sig: two (2) ml intravenous daily (daily) as needed. 24. sodium chloride 0.9% flush 3 ml iv daily:prn peripheral iv - inspect site every shift 25. insulin sliding scale please give glargine 18u qhs and sliding scale per attached sheet discharge disposition: extended care facility: st hospital rehabilitation unit - , nh discharge diagnosis: bronchilitis obliterans organizing pneumonia ----------------- ankylosing spondylitis dm obesity depression anxiety htn hypercholesterolemia gerd discharge condition: hemodynamically stable, afebrile, ambulating discharge instructions: please take all medication as prescribed. keep all appointments listed below. if you have any acute shortness of breath or chest pain, please seek medical attention immediately. in general if you have any medical questions or concerns, please call your doctor or go to the emergency room. followup instructions: please follow up with your pcp as soon as you can make an appointment. , . our pulmonology team spoke with you and you have agreed to follow up with your primary pulmonologist dr. in new . please make an appointment with him as soon as possible. the pulmonoly team has given you their phone numbers should you need to contact them in the future. md, procedure: insertion of intercostal catheter for drainage insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances closed [endoscopic] biopsy of bronchus open biopsy of lung diagnoses: esophageal reflux pure hypercholesterolemia unspecified essential hypertension long-term (current) use of steroids diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled anxiety state, unspecified iatrogenic pneumothorax bacteremia long-term (current) use of insulin postinflammatory pulmonary fibrosis infection and inflammatory reaction due to other vascular device, implant, and graft obesity, unspecified thoracoscopic surgical procedure converted to open procedure other specified alveolar and parietoalveolar pneumonopathies ankylosing spondylitis 

Answer: The patient is high likely exposed to