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: aspirin / demerol / penicillins / sulfa (sulfonamides) / ibuprofen attending: chief complaint: ptx after ct guided biopsy, rfa and fiducial seed placement major surgical or invasive procedure: - radiofreqency ablation of right lung nodule - pigtail placement -ct placement -extubated -reintubated for acidemia, hypercarbia 7.18/92 -extubated -talc pleurodesis - - reintubated; s/p pigtail ir radiofreqency ablation of right lung nodule chset tube and pigtail catheter placement w/ talc and doxy pleuradesis. intubated history of present illness: ms. is a 83 year old female who has a history of copd was admitted to in with fevers. a plain chest xray done as part of a workup revealed a suspicious right lung density. a chest ct showed a growing spiculated right upper lobe lesion, highly suspicious for primary lung cancer given its appearance and progression since . patient was seen by dr. of ct surgery for a consult in . they reviewed potential options for treatment of her lung lesion at that time including; lobectomy, radiofrequency ablation and radiation. ms. decided she was not interested in surgery or radiation and wanted to know more about radiofrequency ablation. we met with her in and discussed risks and benefits of the procedure. she decided that she wanted to take the summer to ??????gain back some strength?????? and would contact us in the fall. mrs. has now decided to move forward with ct guided right lung biopsy and radiofrequency ablation. past medical history: 1. asthma/copd, 2. htn 3. rectal ca (s/p radiation and colectomy with colostomy) 4. multiple sbos 5. osteoarthritis past surgical hx: 1. abdominoperineal resection 2. appendectomy 3. ovarian cyst removal 4. lysis of adhesions 5. colostomy 6. hernia repair 7. tonsillectomy 8. adenoidectomy social history: a former smoker, she used to smoke 2 packs a day for about 60 years. she quit 7 years ago. no alcohol. she is a retired nurse. family history: mother had an abdominal aortic aneurysm. no rectal cancer in her family and no other types of cancer in her family. physical exam: vs: t 99.1 hr 84 sr bp: 103/58 sats: 98% 2l general: frail appearing pale elderly female in no add'l distress beyond her chronic arthritic pain. heent: unremarkable chest: decreased breath sounds r>l faint bibasilar crackles cor: rrr s1, s2 abd: soft, nt, bs extrem: no edema. arthritis. pertinent results: wbc-10.4 rbc-3.06* hgb-7.9* hct-25.5* plt ct-406 wbc-8.6 rbc-2.79* hgb-7.2* hct-23.1* plt ct-363 wbc-10.8 rbc-2.95* hgb-7.9* hct-24.5* plt ct-332 wbc-11.8* rbc-3.47* hgb-9.0* hct-27.5* plt ct-282 wbc-9.0 rbc-3.31* hgb-8.6* hct-27.0* plt ct-264 wbc-10.8 rbc-3.44* hgb-8.8* hct-27.9* plt ct-236 wbc-9.4 rbc-3.46* hgb-9.0* hct-27.7* plt ct-229 neuts-86.0* lymphs-7.4* monos-4.3 eos-2.0 baso-0.2 glucose-103 urean-9 creat-0.6 na-139 k-4.3 cl-101 hco3-31 glucose-138* urean-14 creat-0.5 na-141 k-4.0 cl-104 hco3-32 glucose-107* urean-9 creat-0.7 na-135 k-4.7 cl-100 hco3-23 glucose-101 urean-8 creat-0.6 na-137 k-4.1 cl-100 hco3-26 ck(cpk)-20* #2 ck(cpk)-20* alt-8 ast-11 ck(cpk)-20* alkphos-73 totbili-0.5 calcium-9.0 phos-4.1# mg-2.0 albumin-2.6* calcium-8.1* phos-3.7 mg-1.8 vanco-20.2* vanco-10.8 cultures: urine site: catheter urine culture (final ): no growth. catheter tip-iv source: picc line. wound culture (final ): no significant growth. blood culture blood culture, routine (final ): staph aureus coag +. final sensitivities. oxacillin resistant staphylococci sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | erythromycin---------- =>8 r gentamicin------------ <=0.5 s levofloxacin---------- =>8 r oxacillin------------- =>4 r penicillin g---------- =>0.5 r rifampin-------------- =>32 r tetracycline---------- <=1 s trimethoprim/sulfa---- <=0.5 s vancomycin------------ <=1 s anaerobic bottle gram stain (final ): reported by phone to , 1:45pm. gram positive cocci in clusters. 7:29 am swab source: rectal swab colostomy. r/o vancomycin resistant enterococcus (final ): enterococcus sp.. moderate growth. sensitivities: mic expressed in mcg/ml _________________________________________________________ enterococcus sp. | vancomycin------------ >256 r 12:12 pm bronchoalveolar lavage 1200 specimen received at 1.16pm. gram stain (final ): 3+ (5-10 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. respiratory culture (final ): oropharyngeal flora absent. klebsiella pneumoniae. ~8ooo/ml. _____________________________________________ klebsiella pneumoniae | ampicillin/sulbactam-- 4 s cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 4 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s meropenem-------------<=0.25 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s cxr: right pleural effusion decreased, now small. small right pneumothorax is unchanged. feeding tube was removed. no other significant change. impression: ap chest compared to through : there has been no reaccumulation of right pleural effusion following removal of the right basal pleural drain where one can see persistent small pneumothorax. left lower lobe atelectasis is unchanged since while a small-to-moderate left pleural effusion has decreased since . left upper lung clear. right apical lung lesion, approximately 4 cm wide appears to have cavitated appearing after right upper lobe ablation, which may be a normal development following the procedure. feeding tube passes into the stomach and out of view. the et tube tip is 4.5 cm above the carina. the right chest tube and right pigtail catheter are in unchanged position. no interval change in currently small right apical pneumothorax is demonstrated. the rest of the findings are grossly unchanged as well. brief hospital course: consultations during admission sicu infectious disease procedures during admission ct guided r lung biopsy with rfa chest tube placement 20f insertion of new chest tube 24f attempted insertion of chest tube ct guided decompression of new right pneumothorax with pigtail placement pt was admitted on after ct guided right lung biopsy and radiofrequency ablation with resultant right ptx. right pigtail catheter placed to sxn. pt was maintain on sxn for 48hrs with continued air leak. each water seal trial pt developed ptx and was placed back to sxn w/ approp lung re-expansion. she was maintanied on po dilaudid for arthritic pain, which she also takes at home. on pt developed resp distress and hypercarbia and required icu transfer for intubation for resp acidosis. a bronchoscopy was done which was sent for bal. pt was fed via ngt tube. unable to psv and was maintained on assist control. klebsiella gew out of bal and levaquin was chnaged to aztreonam on . a right sided picc was placed. on the pigtail catheter in the right chest partially dislodged and was in the chest wall. a symptomatic tension ptx developed and a chest tube was placed. on pt was weaned and extubated. subsequently the pigtail partially dislodged and pt developed tension ptx and #20 chest tube was placed w/ resolution of tension ptx but w/o full lung re-expansion. on pt again developed resp distress and required re-intubation. apical ptx persisted and a #20 chest tube was d/c'd and and a #24 apical chest tube was placed w/ improved lung expansion. pt once again was weaned and extubated on on stress dose steriods for copd exaccerbation and was transffered from the icu on . she was started on reg diet and a pca was used for pian control w/ good effect. given ativan for anxiety but developed visual hallucinations. ativan was d/c'd w/ resolution of hallucinations. on pt was placed to water seal w/ slight increase in ptx but was placed back to sxn. on air leak was absent and chest tube was again placed to water seal w/ stable cxr. she was seen by pt and rehab recommended. the patient's steroids were weaned down and off by , which she tolerated well without any signs of adrenal insufficiency. on she complained of urinary frequency; a ua revealed significant pyuria with bacteriuria, and so she was seen by infectious disease, who felt that she had a persistent bacteriuria and pyuria secondary to a history of renal stones; renal u/s revealed stones in the left kidney but no hydronephrosis. the team started her on aztreonam for a low grade temp of 100.4. on , because the chest tube air leak persisted, along with significant subcutaneous air, she underwent talc pleurodesis of the right lung. she appeared improved with decreased leak, and so the chest tube was placed to pnemostat . unfortuantely, the air leak reappeared, and so her chest tube was palced back to suction , ws , and then back to suction because of a persistent leak. on she developed increasingly labored breathing, was tachypneic, and developed rapid atrial fibrillation. abg revealed 7.06/120/218/36. although the patient spontaneously converted to sinus tachycardia, her labored respirations persisted, and she was transferred to the sicu and intubated. repeat cxr and then ct scan revealed a large, new pneumothorax on the right. attempt at chest tube placement into this new, likely loculated ptx was unsuccessful given the present of the lung adjacent to the chest wall secondary to the pleurodesis, and so she underwent radiology ct guided pigtail placement for decompression of the new pneumothorax. on a repeat film revealed re-expansion of her lung and doxycline pleurodesis was sperformed with a stable small right apical pneumothorax. on her original chest tube was pulled as the pneumothorax was improved. she was extubated on and transferred to the floor. unfortunately, that evening she developed altered mental status and was transferred back to the sicu, of unclear etiology; abg was 7.43/53/89/36. she did undergo bronchoscopy at that time that revealed a mucus plug in the left lower lobe. she remained stable in the sicu; on sunday her pigtail and her foley were removed and she was transferred to the floor. on she continued improve. she tolerated a clear liquid diet and was advanced to regular without difficulty. the feeding tube was removed. her hct was 23 with a baseling hct of 27. on her repeat hct was 25. she has been accepted at rehab and they will follow the hct and transfuse as needed. infectious disease recommends completing a day day course of vancomycin and aztreonam. her oxygen saturations remained 98% on 2 liters. she continued to make steady progress and was discharged to . medications on admission: lopressor 12.5mg po bid advair diskus 100/50 1 puff dilaudid 4 mg every 4 to 6 hours colace senna tablet vitamin b12 monthly injections reglan 5mg po q4 prn discharge medications: 1. fluticasone-salmeterol 100-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 2. albuterol 90 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours) as needed. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 5. hydromorphone 4 mg tablet sig: four (4) mg po q4h (every 4 hours) as needed for pain. 6. metoclopramide 10 mg tablet sig: 0.5 tablet po q6h (every 6 hours). 7. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed. 8. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection (2 times a day). 9. aztreonam 1 gram recon soln sig: 1000 (1000) mg injection q8h (every 8 hours) for 2 days: end date (completion of 10 day course). 10. vancomycin 500 mg recon soln sig: seven y (750) mg intravenous q 12h (every 12 hours) for 2 days: end date to complete 10 day course. 11. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po tid (3 times a day). 12. metoclopramide 10 mg tablet sig: 0.5 tablet po qidachs (4 times a day (before meals and at bedtime)). 13. furosemide 10 mg/ml solution sig: ten (10) mg injection once (once) for 1 doses: w/ blood transfusion. 14. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 15. budesonide 0.5 mg/2 ml suspension for nebulization sig: one (1) inhalation twice a day. 16. transfusion pls transfuse one unit packed red blood cells on and give w/ 10mg ivp lasix. discharge disposition: extended care facility: & rehab center - discharge diagnosis: copd, asthma, hypertension, degenerative joint disease rectal cancer multiple episodes of small bowel obstruction right upper lobe lung nodule, radiation enteritis, osteoporosis scoliosis, mrsa, vre psh: aaa repair in exploratory laparotomy and lysis of adhesions abdominal peritoneal resection for rectal ca discharge condition: deconditioned discharge instructions: call dr. office if experience: fver >101.5, increased shortness of breath, chest pain or any symptoms that concern you.. followup instructions: follow-up with dr. :30 on the clinical center, . report to the radiology department for a chest x-ray 45 minutes before your appointment procedure: insertion of intercostal catheter for drainage insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube insertion of endotracheal tube insertion of endotracheal tube arterial catheterization arterial catheterization other intubation of respiratory tract other intubation of respiratory tract closed [endoscopic] biopsy of bronchus injection into thoracic cavity closed [percutaneous] [needle] biopsy of lung transfusion of packed cells percutaneous ablation of lung lesion or tissue diagnoses: acidosis anemia, unspecified coronary atherosclerosis of native coronary artery urinary tract infection, site not specified unspecified essential hypertension atherosclerosis of aorta acute respiratory failure iatrogenic pneumothorax bacteremia osteoarthrosis, unspecified whether generalized or localized, site unspecified other diseases of lung, not elsewhere classified methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site chronic obstructive asthma with (acute) exacerbation proteus (mirabilis) (morganii) infection in conditions classified elsewhere and of unspecified site colostomy status radiological procedure and radiotherapy as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure personal history of malignant neoplasm of rectum, rectosigmoid junction, and anus 

Answer: The patient is high likely exposed to