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 an 86-year-old caucasian female with a history of diabetes, who presents with five days of "coughing up blood." the patient describes her blood as red, fresh and voluminous. the patient says that she was coughing in general for about five days prior to admission, and intermittently bringing up blood. on the night prior to admission, she said she had a lot of coughing, with blood each time. the patient also states that she has felt "cold" for the past four days, with a temperature of up to 103 per patient report. the patient states that she has never coughed up blood in the past. the patient denies any chest pain or any kind of prodromal symptoms. the patient denies any black, tarry stool or bright red blood per rectum. of note, the patient has a history of warm autoimmune hemolytic anemia, for which she takes 5 mg of prednisone a day, and 400 mg by mouth twice a day of danazol. she said that her last transfusion was one year ago. in the emergency department, the patient had a nasogastric lavage, which showed coffee grounds that cleared after one liter. her vitals there were a temperature of 98.1, pulse 106, blood pressure 182/81, and oxygen saturation of 92% on face mask. past medical history: 1. diabetes mellitus 2. chronic obstructive pulmonary disease 3. hocum 4. warm autoimmune hemolytic anemia, on prednisone and danazol 5. hypertension 6. recurrent urinary tract infections 7. appendectomy in 8. removal of duodenal adenoma 9. diverticular disease per colonoscopy in medications: verapamil 120 mg by mouth once daily, calcitonin nasal spray, fosamax 10 mg by mouth once daily, aspirin 325 mg by mouth once daily, folic acid 1 mg by mouth once daily, celebrex 200 mg by mouth once daily, levoxyl 0.25 mcg by mouth once daily, calcitriol 0.25 mg by mouth once daily, protonix 40 mg by mouth once daily, colace 100 mg by mouth twice a day, albuterol, glyburide 2.5 mg by mouth once daily, glucophage 500 mg by mouth once daily, prednisone 5 mg by mouth once daily, danazol 400 mg by mouth twice a day. allergies: penicillin, which leads to rash. social history: the patient lives at the home in . the patient is a 20 to 30 pack year smoker, quit ten years ago. the patient lives in with 24 hour help. family history: the patient states that she has lost nine siblings to cancer. physical examination: temperature afebrile, pulse 116, blood pressure 191/57, oxygen saturation 92% on nasal cannula. in general, the patient is a talkative, elderly woman, hard of hearing, in no apparent distress. head, eyes, ears, nose and throat examination: a small amount of dried crusted blood on lips. pulmonary: clear to auscultation on the left, right side with significant decreased breath sounds throughout, with some inspiratory wheeze. cardiovascular: tachycardic, normal s1 and s2, ii/vi systolic ejection murmur and fainter holosystolic murmur in the left lower sternal border. abdomen: soft, nontender, nondistended, normal active bowel sounds, no hepatosplenomegaly. extremities: no cyanosis, clubbing or edema. neurologic: alert and oriented x 3, no focal signs. laboratory data: white blood cell count 8.5, with a differential of 77.7 neutrophils, 0% bands, and 15.1% lymphocytes. hematocrit 35.6, platelets 218 . sodium 143, potassium 4.3, chloride 111, bicarbonate 22, bun 21, creatinine 0.9, glucose 155. pt 14, ptt 25, inr 1.3. studies: chest x-ray from showed right lower lobe and right upper lobe opacity which could represent atelectasis or consolidation. hospital course: this is an 86-year-old female with a history of diabetes, who presents with five days of hemoptysis. because the patient had voluminous hemoptysis, and new oxygen requirement, she was immediately brought to the medical intensive care unit. repeat nasogastric lavage was clear. the patient received a chest ct, which was notable for a right lower lobe mass, read as concerning for malignancy vs pneumonia. in addition, there was significant volume loss in the right lung, and atelectasis throughout the right lung. given that the patient gave a history of about a 30 pound weight loss over the past year, and new night sweats, the finding of a right lower lobe is quite ominous. the patient received a rigid bronchoscopy on . this did not show any clear central endobronchial lesions that could explain the hemoptysis, but did show complete obstruction of the right main stem bronchus secondary to blood clots. after the clots were evacuated, it was noted that the right lower lobe was being compressed by a process outside of the bronchial tree. endobronchial biopsy was performed, as well as lymph node sampling. given that the patient presented with this new mass in conjunction with fever, and given that an obstructive process was present with multiple blood clots, it is very likely that the patient developed a post-obstructive pneumonia. the patient was placed on a two week course of levofloxacin and flagyl. 1. pulmonary: the patient has not had any further hemoptysis since admission. the patient's transbronchial biopsy results showed only inflammatory changes with atypia, and no signs of neoplasm. however, given that the patient is a smoker, with a one year history of weight loss and new night sweats, there is still much concern for a neoplastic process. of note, the patient had a negative ppd to rule out tuberculosis. because the transbronchial biopsy is not always effective in picking up lesions, the patient will need to be rescanned within one month's time. if the mass is the same size or has gotten larger, it will be necessary to do a more invasive sampling, such as a vats procedure. otherwise, if the mass shows some regression in size, it may be mostly attributed to an ill-defined pneumonia. on , the patient developed increasing shortness of breath, even though her oxygenation was steadily improving. the patient was being weaned from the oxygen nasal cannula. chest x-ray showed a new left lower lobe process, consistent with effusion and potential mild congestive heart failure, and/or atelectasis. the patient's fluids were stopped, and she was given 40 mg of oral lasix. the patient did not have any symptomatic improvement, nor did the chest x-ray change with the lasix. part of the patient's general shortness of breath was also attributed to her resolving pneumonia. the patient continued to saturate well off of oxygen. 2. infectious disease: as already noted, the patient was suspected to have a post-obstructive pneumonia, and was treated with levofloxacin and flagyl. the patient has been afebrile since admission, and her white blood cell count has decreased. the plan is to continue levofloxacin and flagyl for a total of 14 days. 3. hematology: the patient's hematocrit remained stable, after a small dip at the time of bleeding. the patient has a history of warm autoimmune hemolytic anemia, for which she takes prednisone and danazol. these medications were continued. 4. cardiovascular: the patient has a history of hypertrophic obstructive cardiomyopathy, for which she is preload and rate dependent. the patient was successfully kept on a regimen of verapamil. condition at discharge: good discharge medications: 1. protonix 40 mg by mouth once daily 2. danazol 400 mg by mouth twice a day 3. codeine phosphate 15 mg every four to six hours as needed for cough 4. norvasc 5 mg by mouth once daily 5. verapamil sr 180 mg by mouth every 24 hours 6. glucophage xr 500 mg by mouth once daily 7. glyburide 2.5 mg by mouth once daily 8. ativan 1 mg by mouth daily at bedtime as needed 9. tylenol 325 to 650 mg by mouth every four to six hours as needed 10. atrovent nebulizers, one nebulizer inhaled every six hours as needed 11. albuterol nebulizers, one nebulizer inhaled every four hours as needed 12. colace 100 mg by mouth twice a day 13. prednisone 5 mg by mouth once daily 14. bisacodyl 10 mg by mouth or per rectum once daily as needed 15. levofloxacin 250 mg by mouth once daily through 16. flagyl 500 mg by mouth three times a day through 17. regular insulin sliding scale discharge instructions: the patient is to go back to home. she will need the highest level of nursing available there. she will also need an active physical therapy regimen, as she has become weak lying in bed at the hospital. the patient is to follow up with pulmonary within one month in order to re-ct her chest. the number to call for an appointment is . discharge diagnosis: 1. hemoptysis, concern for lung cancer 2. diabetes 3. hocm 4. warm autoimmune hemolytic anemia , m.d. dictated by: medquist36 procedure: closed [endoscopic] biopsy of bronchus closed endoscopic biopsy of lung biopsy of lymphatic structure diagnoses: unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified pulmonary collapse malignant neoplasm of other parts of bronchus or lung autoimmune hemolytic anemias bronchopneumonia, organism unspecified 

Answer: The patient is high likely exposed to