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 88-year-old female with moderate to severe chronic obstructive pulmonary disease with an fev-1 measured at .66 liters, on home oxygen, who was admitted to the hospital for chronic obstructive pulmonary disease flare. she has multiple recent admissions over the past nine months for similar symptoms, requiring intensive care unit stays. the patient now presented following several days of lethargy and upper respiratory infection symptoms accompanied by increasing shortness of breath and declining mental status to the point of obtundation. on presentation to the emergency room, the patient was afebrile, with heart rate in the 110s and blood pressure in the 140s/50s, breathing at a rate of 45 breaths per minute, with oxygen saturations of 69% on room air. she appeared obtunded. her breath sounds were globally diminished. she had a white count to 13.7, with 90% neutrophils. electrocardiogram showed sinus tachycardia with an old right bundle branch block. an arterial blood gas performed on 100% non-rebreather showed a ph of 7.17, pco2 of 136, po2 of 73, with a calculated bicarbonate of 52. the patient was placed on bipap for a period of time. a repeat arterial blood gas showed a ph of 7.31, pco2 of 95, po2 of 67, with a calculated bicarbonate of 50. the patient had difficulty keeping a bipap mask on her face, and was subsequently intubated and transferred to the medical intensive care unit. past medical history: 1. chronic obstructive pulmonary disease with an fev-1 of 0.66 and fvc of 1.36, ratio measured 78% of predicted. she is on 3 liters of oxygen at home via nasal cannula. 2. colon cancer, stage a status post low anterior resection in 3. status post seizure in from hyponatremia, serum-inappropriate antidiuretic hormone 4. osteoarthritis 5. low back pain 6. osteoporosis 7. old lacunar infarct in the right corona radiata allergies: doxycycline medications: albuterol two puffs three times a day, atrovent two puffs three times a day, serevent two puffs twice a day, ranitidine 150 twice a day, klonopin twice daily, and ritalin. social history: the patient lives with her children. she has a history of smoking one pack per day for 20 years. she stopped 30 years ago. she has had no occupational exposures. she is followed by dr. , her pulmonologist is dr. . family history: positive for tuberculosis and lung cancer. physical examination: the patient arrived to the intensive care unit febrile and hypotensive. temperature was 101.8, heart rate 94, blood pressure 82/46. the patient was intubated on assist control ventilation 500 x 14, fio2 of 1.00, peep of 5. peak pressures measured 40, with plateau of 24. the skin was warm and dry. she was anicteric. there were no rashes noted. head, eyes, ears, nose and throat: the patient was intubated. pupils were reactive to light. the oropharynx appeared dry. the neck was supple. the neck veins were flat. the lungs were clear anteriorly bilaterally. no wheezes were appreciated. the heart was regular rate and rhythm, s1, s2, no murmurs, gallops or rubs. the abdomen had bowel sounds present, soft, nontender. extremities: no edema. neurologically, the patient moved all extremities. she withdrew to pain and blinked in response to voice. laboratory data: on admission, white count was 13.7, hematocrit 42.4, platelets 320, 90% neutrophils, 4.3% lymphocytes. sodium 138, potassium 4.4, chloride 87, bicarbonate 48, bun 22, creatinine 0.7, glucose 153. arterial blood gas on the above ventilator settings showed a ph of 7.48, pco2 of 45, and po2 of 435. calcium was 7.9, phosphate was 1.6, magnesium 1.6. electrocardiogram showed sinus tachycardia at 107 beats per minute with a right bundle branch block, left atrial abnormality, nonspecific st/t wave changes, overall stable compared to . urinalysis showed a specific gravity of 1.025, protein 30, trace ketones, ph 6.0, white blood cells, no bacteria, 0 red blood cells, 0-2 epithelial cells, hyaline casts, 0-2 granular casts, occasional calcium oxide crystals. chest x-ray showed emphysematous changes without focal consolidation, biapical pleural thickening, no focal consolidations. hospital course: the patient was admitted to the medical intensive care unit for further management. blood cultures were obtained, and the patient was started on levofloxacin empirically. the patient was bolused with fluids to manage her hypotension likely the result of volume redistribution in the setting of intubation and chronic obstructive pulmonary disease. her electrolytes were repleted, and she was maintained on metered dose inhalers as well as nebulizer treatments as needed. multiple blood cultures were drawn and grew positive for coagulase negative staphylococcus in two bottles from separate sites. she was treated with a short course of vancomycin. no skin source could be identified. the patient became afebrile. she was started on solu-medrol as adjunctive treatment for her chronic obstructive pulmonary disease, underwent diuresis and was successfully extubated on . she required mask bipap for several hours following the extubation for borderline oxygen saturations in the mid-80s. the patient continued to be diuresed and was eventually maintained on 3 liters nasal cannula, with oxygen saturations in the mid-90s. an echocardiogram was obtained, which showed a left ventricular ejection fraction greater than 55%, with moderate pulmonary hypertension and trace aortic regurgitation. her steroids were tapered. she demonstrated some restlessness and disorientation while in the intensive care unit, which waxed and waned and improved over time. she did demonstrate a run of multifocal atrial tachycardia during an albuterol nebulizer treatment, which responded to oral metoprolol. a baseline arterial blood gas on 3 liters nasal cannula was obtained, which showed a ph of 7.43, pco2 of 53, po2 of 87, with a calculated bicarbonate of 37. her steroids were tapered. she now awaits further evaluation by physical therapy and will likely require rehabilitation. discharge diagnosis: 1. chronic obstructive pulmonary disease flare discharge medications: 1. serevent two puffs twice a day 2. atrovent two puffs every six hours 3. albuterol two puffs every four hours as needed 4. ranitidine 150 mg by mouth twice a day 5. klonopin 0.25 mg by mouth twice a day 6. prednisone 30 mg by mouth for three days, then 20 mg by mouth for three days, then 10 mg by mouth for three days, then stop disposition: the patient will be discharged shortly from the hospital, likely to a rehabilitation facility. she is to follow up with dr. as well as her pulmonologist, dr. . , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube enteral infusion of concentrated nutritional substances arterial catheterization diagnoses: anemia, unspecified obstructive chronic bronchitis with (acute) exacerbation acute and chronic respiratory failure bacteremia osteoporosis, unspecified personal history of malignant neoplasm of large intestine 

Answer: The patient is high likely exposed to