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: no known allergies / adverse drug reactions attending: chief complaint: sob major surgical or invasive procedure: none history of present illness: 72f afib, copd, h/o sbo, htn, breast and thyroid ca, s/p tracheostomy several years ago after breast cancer surgery and hysterectomy presenting from with respiratory distress found to have sigmoid volvulus. initially she was noted to be desatting to the 70s on 2l o2 at her . there is no other documentation of the details prior to being tot he ed and the patient is nonverbal and responds only by nodding or shaking head. her sister says that she usually does speak. she was brought into the ed where initial vitals were: 97.2 137 123/108 22 96% 15l. she was noted to have mucus plugging of her trach and was suctioning with improvement of her respiratory status and satting 100% on 15l trach mask. however in the ed she was noted to have a rigid abdomen and dilated bowel on initial cxr. a kub again demonstrated dilated loops of bowel with multiple air fluid levels very suggestive of sigmoid volvulus. ct abd was performed which again demonstrated volvulus. surgery was consulted and after discussion with the pt the decision is that the pt would not want to live with a colostomy which would be the outcome of the surgery but this was not definitive. notable labs were lactate 3.6, wbc count 14.9, elevated creatinine from baseline 0.7->1.3. she was given vanc and zosyn for possible evolving sepsis and was admitted to the micu. she was then admitted to the micu. vitals on transfer were: vitals on transfer were: 98.9 rectal, afib - low 100s, 122/72, 95% on trach mask rr 30. gi was consulted who recommended emergent sigmoidoscopy for decompression. the sister and hcp agreed with this plan and sigmoidoscopy was performed. she complains of moderate abd pain as well as sob. . of note the patient was recently admitted for multifocal pna treated with vancomycin, zosyn for 10 day course. . review of systems: (+) per hpi (-) unable to ellicit. past medical history: depression bilateral breast ca thyroid ca (had short term trach after this, was removed at age 29) movement disorder (blepharospasm) psychosis bilateral blindness (retinal detachments from trauma) htn atrial fibrillation hypercholesterolemia hypoparathyroidism s/p tracheostomy (complication of intubation from lumpectomy about 4 years ago) social history: lives at , sister and brother-in-law live nearby but spend the summers in . retired in , social worker. quit tobacco in . rare etoh. family history: maternal aunt with heart failure in his 60s physical exam: vitals: t98.9 110, 122/72, 95% on trach mask rr 30 general: daiphoretic, drowsy but arousable, does not speak without trach valve, nodding or shaking head in response to questions but somewhat slow to respond heent: sclera anicteric, dmm, oropharynx clear, both pupils dilated and nonresponsive (legally blind) neck: supple, jvp not elevated, no lad cv: tachy, irreg irreg, normal s1 + s2, no murmurs, rubs, gallops lungs: diminished breath sounds at bases, high pitched breath sounds from trach projecting throuighout otherwise clear abdomen: firm and rigid, no bowel sounds, breath sounds heard over abdomen. does not appear very tender but difficult to ascertain gu: no foley ext: warm, well perfused, no clubbing, cyanosis or edema pertinent results: 10:09pm blood wbc-3.9*# rbc-4.47 hgb-12.3 hct-40.8 mcv-91 mch-27.5 mchc-30.1* rdw-13.7 plt ct-162 11:50am blood wbc-14.9*# rbc-4.43 hgb-12.7 hct-41.8# mcv-94# mch-28.7 mchc-30.5*# rdw-14.1 plt ct-267 11:50am blood neuts-86.8* lymphs-8.2* monos-4.7 eos-0.1 baso-0.2 10:09pm blood glucose-122* urean-50* creat-1.4* na-138 k-6.3* cl-111* hco3-20* angap-13 11:50am blood glucose-147* urean-53* creat-1.3* na-143 k-3.5 cl-104 hco3-21* angap-22* 11:50am blood alt-50* ast-41* alkphos-81 totbili-0.4 10:09pm blood mg-6.5* 11:50am blood albumin-4.9 10:20pm blood type-art po2-52* pco2-39 ph-7.23* caltco2-17* base xs--10 10:20pm blood lactate-5.1* 12:12pm blood lactate-3.6* cxr 11:30am findings: lung volumes are very low likely due to severe abdominal distention from dilated large bowel. there are bibasilar opacities, which likely represents atelectasis; however, pneumonia cannot be ruled out. the patient has tracheostomy in appropriate position. no evidence of pneumothorax. no large pleural effusion identified. please see dedicated abdominal films for better characterization of the abdominal findings. . impression: 1. very low lung volumes, likely given distention of abdomen. this is causing bibasilar atelectasis, however, pneumonia or aspiration cannot be ruled out given the basilar opacities. no free air identified. . kub 11:30 am findings: the large bowel is dilated and filled with air. there is no definite air-fluid level seen. there is consolidation or atelectasis seen in the right lower lobe. no free air is identified. impression: dilated large bowel in a configuration that may represent a sigmoid volvulus, see subsequent ct. . ct abd 12:00pm impression: 1. sigmoid volvulus. markedly distended loops of large bowel with thin wall, can not exclude ischemia. lack of iv contrast; can not evaluate wall enhancement. 2. bibasilar opacities may represent atelectasis or pneumonia/aspiration. 3. nonobstructing stone in the left renal pelvis. 4. stable hypodensities in the liver compared to . . kub 5:52 pm findings: two supine frontal views of the abdomen demonstrate increased lucency in the right abdomen and sign consistent with a large amount of intraperitoneal free air. massive dilatation of the large bowel is not improved from the preceding radiograph, consistent with sigmoid volvulus, better seen on ct performed at 13:50 p.m. the visualized osseous structures are within normal limits. impression: 1. large amount of free intraperitoneal air consistent with perforated viscus. 2. persistent massive dilatation of large bowel consistent with sigmoid volvulus, unchanged from preceding radiographs and ct. . cxr 9pm findings: large free pneumoperitoneum is present causing elevation of bilateral hemidiaphragms. left-sided subclavian line ends at mid svc. lung volumes are low. -basal atelectasis is present and upper lungs are clear. cardiomediastinal silhouette is normal. a tracheostomy tube is present in situ. the findings regarding the pneumoperitoneum and subclavian line was already communicated by dr. with dr. by phone at 10:54 p.m. on . brief hospital course: 72f afib, copd, h/o sbo, htn, breast and thyroid ca, s/p tracheostomy several years ago after breast cancer surgery and hysterectomy presenting from with respiratory distress found to have sigmoid volvulus. . #signoid volvulus: she presented with shortness of breath from sigmoid volvulus with massive distension causing lung compression. the surgical team recommended surgery for decompression and likely colectomy. there was a discussion with the patient and her sister who is her hcp with the decision that she would not want to live with a colostomy which would be the likely result of a surgery and that she would prefer less invasive option. they expressed understanding that her condition was very serious and that not undergoing surgery would expose her to the risk of death. the gi team was then consulted who performed a successul reduction by sigmoidoscopy. however, she became hypotensive and tachycardic later that evening and kub showed free air in the peritoneum. a central line was placed and vasopressor medications were started. a repeat cxr showed massive free air in the peritoneum from a ruptured viscous. despite aggressive iv fluids and multiple vasopressor medications she was unable to maintain an adequate blood pressure and she passed away. medications on admission: #. multivitamin tablet sig: one (1) tablet po daily (daily). #. prednisolone acetate 1 % drops, suspension sig: one (1) drop ophthalmic tid #. calcitriol 0.25 mcg capsule sig: one (1) capsule po daily #. anastrozole 1 mg tablet sig: one (1) tablet po daily (). #. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily #. dorzolamide-timolol 2-0.5 % drops sig: one (1) drop ophthalmic #. docusate sodium 100 mg capsule sig: one (1) capsule po bid #. perphenazine 8 mg tablet sig: two (2) tablet po bid #. levothyroxine 137 mcg capsule sig: one (1) capsule po daily #. metoprolol tartrate 50 mg tablet sig: two (2) tablet po bid #. diltiazem hcl 45 mg po qid #. famotidine 20 mg tablet sig: one (1) tablet po q12h #. bisacodyl 10mg pr qd prn #. milk of magnesia 30mls daily prn #. gabapentin 100mg tid discharge medications: patient expired discharge disposition: expired discharge diagnosis: patient expired discharge condition: patient expired discharge instructions: patient expired followup instructions: patient expired procedure: venous catheterization, not elsewhere classified dilation of intestine diagnoses: acidosis other pulmonary insufficiency, not elsewhere classified unspecified septicemia atrial fibrillation perforation of intestine personal history of malignant neoplasm of breast sepsis other diseases of lung, not elsewhere classified volvulus attention to tracheostomy other specified disorders of peritoneum personal history of malignant neoplasm of thyroid personal history of unspecified malignant neoplasm 

Answer: The patient is high likely exposed to