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: thorazine / penicillins attending: chief complaint: sob major surgical or invasive procedure: none. history of present illness: 60f with schizoaffective disorder and copd presents with increased sob x1 day. patient has h/o chronic cough and sob (able to walk ~15 minutes on level ground, says she "can't climb stairs"). cough has been increasing over the last several days, worsened last evening. abdomen hurts with deep coughing. cough is productive, but patient hasn't noticed change in quality of sputum. has been wheezing as well, took friend's albuterol nebulizer which helped her sob. no sick contacts or recent travel, did not receive influenza vaccination this year. no leg pains, h/o thrombosis, recent travel. denies dizziness/lightheadedness, does feel thirsty. review of systems otherwise negative for fevers, chills, sweats, headache, rhinitis, sore throat, myalgias, diarrhea/constipation, dysuria. denies h/o cardiac disease, htn, high cholesterol, or family h/o cardiac disease. does have h/o chronic dysphagia with regurgitation. in the ed, vitals were t 98.5, p 88, bp 124/66, rr 38, o2 87% on ra. she was given solumedrol 125mg iv, azithromycin 500mg po, combivent, ceftriaxone, and asa 325mg once. she was put on cpap briefly with good effect. abg obtained showed 7.25/60/72. past medical history: * copd - patient denies h/o intubation, no pfts availble in omr * schizoaffective disorder, bipolar * chronic low back pain, followed at pain clinic * duodenal polyp, adenoma on bx * esophageal stricture s/p dilatation * h/o urinary retention * h/o ovarian cysts * s/p ccy social history: lives alone, long history of smoking ~1ppd since age 14, denies etoh or ilict drug use. family history: no h/o cardiac or pulmonary disease physical exam: vitals t 96f p 74 bp 142/45 rr 24 o2 92% 2l bp 110/60 p 80 supine and sitting without significant change general anxious appearing, tachypneic but able to speak in full sentences heent sclera white, conjunctiva pink, dry mucus membranes neck jvp flat pulm resonant to percussion, bilateral wheezing and few right sided crackles cv distant regular s1 s2 no m/r/g abd soft, nontender +bowel sounds extrem warm, no edema neuro/psych suspicious affect but answers appropriately pertinent results: data cbc 8.0>13.8/39.3<178 n88.7% l 7.2% m 3.8% e 0.1% baso 0.1% chem 122/4.1/86/27/11/0.9<168 ca 8.8, mg 1.9, phos 3.0 ck 748 mb 14 tropn <0.01 probnp 345 abg 7.25/60/72/28 lactate 1.9 micro blood cx ngtd imaging cxr chest, single view: heart size and mediastinal borders are normal. no focal consolidation, pneumothorax, or pleural effusion. no gross osseous abnormality. impression: no acute cardiopulmonary process. ekg noisy baseline but apparent sr @91bpm, normal axis and intervals, no s1/q3/t3, no evidence of acute ischemia or strain brief hospital course: 60 yo f longtime smoker with h/o copd and schizoaffective disorder per records presented with increased sob and cough x1 day without fever. 1. dyspnea: symptoms were most consistent with copd exacerbation. abg suggested acute respiratory acidosis. pneumonia was less likely in absence of fever. clinically did not appear volume overloaded, and bnp<450 making chf exacerbation less likely. chest cta ruled out pe. mi was ruled out by enzymes. she was treated with bipap and found to be optimal respiratory-wise with o2 saturation in the mid-to-high 80s. she finished a 7-day course of azithromycin and ceftriaxone. she was given nebulizers and started on prednisone, which was tapered by discharge. by discharge, she was breathing comfortably on room air with o2 saturation in mid-to-high 80s. she underwent pulmonary tests the results of which were still pending by discharge. 2. altered mental status: might be due to hypercarbic respiratory failure on admission versus worsening psychiatric disorder. she was continued on outpatient thioridazine and chlordiazepoxide. her mental status improved to orientation x 3 by discharge. medications on admission: meds (per patient): mellaril 50mg po bid topamax 25mg po bid librium 10mg po bid no inhalers discharge medications: 1. chlordiazepoxide hcl 10 mg capsule sig: one (1) capsule po once a day. 2. thioridazine 100 mg tablet sig: two (2) tablet po bid (2 times a day). 3. topiramate 100 mg tablet sig: one (1) tablet po bid (2 times a day). 4. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily) for 7 days. disp:*7 patch 24 hr(s)* refills:*0* 5. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. disp:*30 doses* refills:*0* 6. albuterol sulfate 2.5 mg/3 ml solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. disp:*30 doses* refills:*0* 7. prednisone 10 mg tablet sig: as directed tablet po once a day for 16 days: 40mg x 4 days 30mg x 4 days 20mg x 4 days 10mg x 4 days. disp:*42 tablet(s)* refills:*0* 8. oxygen titrate oxygen, via nasal cannula to 88-90%. 9. nebulizer one nebulizer machine. discharge disposition: home with service facility: caregroup home discharge diagnosis: primary: 1. chronic obstructive pulmonary disease 2. hypercarbic respiratory failure secondary: 1. schizoaffective disorder discharge condition: hemodynamically stable. oxygen saturation 88% on 2 liters of oxygen via nasal cannula. discharge instructions: you were admitted after experiencing a worsening of your copd. your oxygen levels are quite low and you would benefit from home oxygen therapy. for your safety, you must quit smoking. if you do continue smoking, you cannot use the oxygen, nor can you use the nicotine patch. if you continue to experience worsening shortness of breath with exertion, chest pains, wheezing, fevers/chills, please be sure to call your primary care doctor or go to an emergency room. followup instructions: please follow-up with dr. on monday at 11:15. you would also benefit from an outpatient sleep study. the phone number is . procedure: non-invasive mechanical ventilation diagnoses: acidosis other chronic pain tobacco use disorder hyposmolality and/or hyponatremia obstructive chronic bronchitis with (acute) exacerbation acute respiratory failure lumbago schizoaffective disorder, unspecified 

Answer: The patient is high likely exposed to