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 a 76-year-old female with previous history of hypertension, atrial fibrillation and sick sinus syndrome status post pacemaker who originally presented to an outside hospital with acute pancreatitis secondary to gallstone. she was treated at the outside hospital with intravenous fluids and was put npo for bowel rest. however, she subsequently developed worsening shortness of breath even though her pancreatitis was being adequately treated. the thinking at that point was congestive heart failure versus pneumonia versus ards. her hypoxia was slowly worsening and she was thus transferred to the on a regular floor. she was originally being managed with antibiotics and diuresis. however, on the second day of admission, the patient became severely hypoxic with o2 saturations of about 60% to 70% on 100 nonrebreather. she had a transthoracic echocardiogram which revealed an ejection fraction of 65%, thus leaving the most likely explanation to be ards. the patient was transferred to the medical intensive care unit where she was intubated. on the day of intubation, which was , she was also started on two pressors, levophed and vasopressin. at the same time, there was a rising suspicion of worsening of her pancreatitis which could have lead to her ards. because of this, she was started on a 10 day course of imipenem. on the following day, she was found to have a low cortisol a.m. level, so she was started on hydrocortisone 100 mg tid for renal insufficiency. imaging studies at this point revealed the following: head ct was negative for a bleed. chest ct showed ards and abdominal ct revealed no evidence of abscess or necrosis in the pancreas. on , the patient had urine culture and sputum cultures growing yeast and she was started on a five day course of fluconazole which she completed without complications. the patient's respiratory status slowly improved and after about 10 days of intubation, decision was made to try to extubate her. however, she appeared difficult to extubate and appeared sedated. this situation, however, improved and finally on , she was extubated. at this point, she was transferred to our care on the regular medical floor. past medical history: 1. hypertension 2. atrial fibrillation 3. sick sinus syndrome, status post pacemaker 4. status post mitral valve replacement home medications prior to admission to outside hospital: 1. atacand 2. lipitor 3. digoxin 4. zoloft 5. coumadin 6. lasix medications upon transfer to our floor: 1. coumadin 500 mg qd 2. digoxin 0.125 mg qd 3. zoloft 100 mg qd 4. erythropoietin 10,000 units 3x a week 5. heparin intravenous gtt 6. regular insulin sliding scale 7. lactulose 30 ml q6h prn 8. dulcolax pr q hs prn allergies: no known drug allergies. social history: she lives alone and is widowed. her son is very involved in her care. there is no use of tobacco or alcohol. family history: noncontributory. physical exam: vital signs: temperature 97.6??????, blood pressure 125/62, pulse 74, respiratory rate 20 with saturations 97 on 4 liters nasal cannula. general: this is a chronically ill appearing woman smiling. head, ears, eyes, nose and throat: pupils equal and reactive to light. extraocular movements intact. oropharynx is clear. mucous membranes appear dry. neck: there is no lymphadenopathy. jugular venous pressure elevated to about 9 cm. respiratory: difficult to fully assess secondary to deconditioning, however there are crackles about of the way up. cardiovascular: regular rate, 4/6 systolic ejection murmur best heard at the left upper sternal border. there is a also a holosystolic murmur best heard at the right upper sternal border. abdomen: soft, nontender, nondistended with hyperactive bowel sounds, no mass and no liver edge. extremities: lower extremities are puffy without pitting edema and 2+ pulses. neurologic: mental status alert and oriented to place, but not to time. comprehension appears intact. language is fluent. the patient is somewhat somnolent. cranial nerves are intact. motor and sensory difficult to test secondary to patient's noncompliance. there were no focal abnormalities. laboratories on transfer: white count 13.1, hematocrit 26.6, platelets 235. sodium 136, potassium 4.4, chloride 102, bicarbonate 27, bun 24, creatinine 0.5, glucose 128, pt 12.9 with inr of 1.2, ptt 50.2. alt 18, ast 31, alkaline phosphatase 73. total bilirubin 0.6, amylase 126, lipase 361, calcium 7.8, phosphorus 3.5, magnesium 1.4. her last arterial blood gas and fio2 of 50% showed ph 7.45, pco2 45, po2 109. brief hospital course upon transfer: 1. cardiovascular: the patient was deemed to be slightly volume overloaded. when she experienced the hypertensive episode in the medical intensive care unit, she received over 11 liters of fluid to maintain hemodynamic instability. as a consequence, she has been volume overloaded ever since then, but has been able to ............ diurese without requiring administration of lasix. we therefore continued this and patient was about 500 to 700 cc negative every day. her blood pressure remained in the range of systolic 110 to 130 and diastolic 60 to 70. we therefore did not restore her outpatient atacand. we continued her on lipitor and digoxin. her rhythm remained to be chronic atrial fibrillation. in this context, we also started coumadin. she was originally receiving 5 mg of coumadin, but after three days of that there was no significant improvement in her inr. we therefore increased the dose of coumadin to 7.5. she will require close follow up of her inr until it reached a therapeutic level between 2.5 and 3.5. 2. gastrointestinal: the patient's pancreatitis was considered clinically resolved by the time she was admitted to our service. she had no complaints of abdominal pain, nausea, vomiting or any other signs to indicate a recurrence of infection. she had received several days of tpn in the intensive care unit as well as a day of tube feeds. she was receiving the tube feeds through a catheter placed in her jejunum. for the first two hospital days on the floor, she continued to receive tube feeds through the jejunal tube. tpn, however was discontinued. on hospital day #3 on the regular medical floor, she was started on clear fluids after consultation with the gastroenterology service. she tolerated this very well with no episodes of nausea or vomiting. she was therefore advanced to full liquids and this subsequently was advanced to a diet as tolerated. the patient is very well on solid foods without complaints of nausea, vomiting, abdominal pain or diarrhea. in addition to this, she had a speech and swallow study which revealed intact swallowing apparatus. the study was performed given lengthy medical intensive care unit stay and possibility of damage to the swallowing apparatus following 12 days of intubation. 3. pulmonary: ards had resolved during her medical intensive care unit stay. the patient had a very low oxygen requirement and subsequently was saturating 97% to 98% on room air. her respiratory exam continued to have occasional crackles bilaterally at the bases which was attributed to a resolution of her ards. 4. anemia: the patient has been mildly anemic, however clear etiology for this anemia was not reached. her hematocrit slowly increased from about 25 to 30 without any transfusions. stool guaiac was checked and was negative. 5. neurology: the patient's mental status has been of concern following her extubation. she remains very somnolent most of the time, not oriented to be place. in addition, her speech was very labored, sometimes not intelligible. upon careful neurological examination, there was no focal weakness or any cranial nerve abnormalities that were detected. she received a non contrast ct of the head which showed no intracranial bleed. we therefore felt that her mental status was mostly resolved for prolonged intensive care unit stay and did not require further investigation at this point. it is quite likely that her mental status will slowly improve with time. discharge condition: stable discharge status: discharge to in acute care rehabilitation. discharge diagnoses: 1. pancreatitis 2. ards discharge medications: 1. zoloft 100 mg po qd 2. digoxin 0.125 po qd 3. lipitor 10 mg po qd 4. erythropoietin 10,000 units 3x a week 5. coumadin 7.5 mg po qd 6. tylenol 325 to 650 po q 4 to 6 hours prn 7. lactulose 30 ml po q6h prn 8. dulcolax 10 mg prn q hs 9. heparin intravenous ............ guideline scale , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances closed [endoscopic] biopsy of bronchus diagnoses: anemia, unspecified unspecified essential hypertension candidiasis of other urogenital sites atrial fibrillation heart valve replaced by other means alkalosis sinoatrial node dysfunction acute pancreatitis 

Answer: The patient is high likely exposed to