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 the present illness: is a 74-year-old female with extensive past medical history including breast cancer, status post mastectomy, chronic obstructive pulmonary disease, coronary artery disease status post non-q-wave myocardial infarction in , and cardiac catheterization showing three-vessel disease status post stents times two. mrs. was diagnosed with squamous cell lung cancer in and underwent left upper lobectomy on , which was complicated by respiratory decompression secondary to mucous plugging as well as pseudomonas pneumonia and klebsiella pneumonia. hospital course was also complicated by methicillin resistant staphylococcus aureus pneumonia, atrial fibrillation, clostridium difficile colitis and ischemic colitis. she also previously was treated for cmv colitis with ganciclovir. she has had continuous difficulties with sections and mucous plugging requiring multiple bronchoscopies to clear the secretions and multiple course of antibiotics. she previously had an icu stay with failure to wean, complicated by sepsis and bacteremia requiring pressors. she is status post tracheostomy with passy-muir valve. she also has a history of partial small-bowel obstruction and she is tpn dependent. she was discharged to a rehabilitation facility (olympus) on . she was doing well until , when she suffered a cardiopulmonary arrest, felt to be secondary to a primary respiratory arrest in the setting of mucus plugging. during the arrest she was found to be pulseless and apneic. cpr with dc current electrocardioversion times one was initiated with good response and returned to hemodynamically stable. she had no neurologic sequela from the arrest. chest x-ray, status post cardiopulmonary arrest, showed a large left pleural effusion, left main-stem cutoff and opacification of the left lung which shifted the mediastinum with left lung collapse. she was transferred to the medical icu for further management of her respiratory failure. past medical history: 1. squamous cell lung cancer, status post left thoracotomy and left upper lobectomy, , status post mediastinal lymph node dissection . 2. squamous cell cancer of the lung. 3. status post tracheostomy, with passy-muir valve for respiratory failure. 4. hypothyroidism. 5. cmv colitis, status post treatment with ganciclovir. 6. ischemic colitis. 7. lower gi bleeding. 8. hypertension. 9. heparin-induced thrombocytopenia. 10. non-q-wave myocardial infarction . 11. coronary artery disease with three-vessel disease by cardiac catheterization status post stent. 12. intermittent atrial fibrillation. 13. history of asthma. 14. chronic obstructive pulmonary disease. 15. history of methicillin resistant staphylococcus aureus pneumonia. 16. pseudomonal pneumonia. 17. history of partial small-bowel obstruction. 18. history of recurrent clostridium difficile colitis. 19. history of right sided breast cancer status post mastectomy. 20. history of recurrent clostridium difficile colitis. 21. history of right sided breast cancer status post mastectomy. 22. tpn dependent. allergies: the patient has no known drug allergies. medications: 1. amiodarone 200 mg p.o.q.d. 2. synthroid. 3. tamoxifen. 4. paxil. 5. epogen. 6. captopril 50 mg t.i.d. 7. prevacid. 8. flovent. 9. atrovent. 10. ventolin. 11. aspirin. 12. regular insulin sliding scale. 13. prednisone 20 mg as part of a taper. current physical examination: examination revealed the patient to be afebrile with the heart rate of 80, blood pressure 120/60, respirations 18, oxygen saturation 99% on ventilator setting of pressor support of 15; peep 5, fi02 40%; observed tidal volumes ranging from 280 to 350. general: the patient is alert, awake, verbally responsive and in no distress. she has moist mucous membranes. pupils are unequal in size, which is a chronic findings. neck was supple without jugulovenous distention. heart: heart is regular without murmurs, gallops or rubs appreciated. lungs: lungs exhibit decreased breath sounds and bronchial breath sounds at the left base. there is intermittent scattered end-expiratory wheeze heard in both lung fields, both anteriorly and posteriorly, which varies with the timing of her respiratory treatments. abdomen: slightly distended, but nontender, with normoactive bowel sounds. neurological: she is awake and alert. she is responsive. neurology examination is nonfocal. laboratory data: the most recent labs revealed a white count of 11,000, hematocrit 33, platelet count 222,000, pt 13.8, ptt 26.4, inr 1.3, sodium 133, potassium 3.7, chloride 97, bicarbonate 30, bun 20, creatinine .5, glucose 147, alt 11, ast 17, alkaline phosphatase 69, total bilirubin 0.3, calcium 7.7, phosphorus 3.4, magnesium 1.8, albumin 2.6. radiology reports multiple chest x-rays, performed after admission, demonstrated tracheostomy tube in place 5-cm above the carina, total opacity of the left hemithorax with shift of the heart and the mediastinum to the left indicating total collapse of the left lung. chest x-ray on , showed some improved re-aeration of the left lung status post bronchoscopy, but persistent collapse and some shift of the heart and mediastinum to the left. the most recently chest x-ray on , showed slight interval improvement in the degree of atelectasis in the left lower lobe and a small left pleural effusion, unchanged when compared to prior films. there remains extensive left sided volume loss likely due to a combination of left upper lobectomy and partial collapse of the left lower lobe. however, there was some slight interval with improved aeration of the left lower lobe. chest ct performed on , showed again, slight interval improved aeration of the left lower lobe with persistent collapse of most of the left lower lobe, small left pleural effusion, which is stable in size, as well as a moderate right sided pleural effusion. note was made of a blood clot in the junction of the left pulmonary vein and left atrium, which had been noted on a prior ct scan and had been evaluated by echocardiography and felt to be a lower embolism given its location in a vein, which was then tied off during left upper lobectomy and not in communication with a dynamic contractile structure. multiple plain films of the abdomen were obtained to evaluate abdominal distention and diarrhea. abdominal films showed an ileus without evidence of small-bowel obstruction. serial abdominal films over the course of the hospitalization showed improvement of the ileus. hospital course: intensive care unit course by systems: #1. respiratory: little progress was achieved in reversing the patient's persistent left lower lobe collapse and subsequently weaning her off the ventilator. she currently remained on a low level of pressure support with adequate tidal volumes and no respiratory distress. she has required serial bronchoscopy for clearance of thick tenacious secretions. bronchoscopies have been notable for evidence of tracheomalacia in the airways. interventional pulmonary was consulted regarding possible stent placement for this tracheomalacia, however, this was not felt likely be of therapeutic advantage for this patient. consideration was also given to possible completion pneumonectomy on the left; however, consultation with dr. , the patient's thoracic surgeon was obtained and it was not felt to be a viable option at this time given the patient's overall poor nutritional status and questionable therapeutic benefit. throughout her intensive care unit stay, the patient was noted to have significant bronchospasm and she was treated aggressively with inhaled corticosteroids, beta agonist, atrovent, and a low-dose steroid taper, with subsequent improvement in her bronchospasm and overall improvement in respiratory function. she was also treated with a 14-day course of vancomycin for methicillin resistant staphylococcus aureus bronchitis with subsequent improvement in the amount and consistency of her secretions. it is felt that the patient will likely need serial bronchoscopies to manage her sections and control her ventilatory status. it is unclear at this point what the patient's prognosis is, as far as weaning off the ventilator. she has, over the course of her intensive care unit stay, shown significant improvement in re-aeration of the left lung; however, she has been slow to wean off the ventilator and has required repeated bronchoscopy several times a week. #2. cardiovascular: the patient required escalating doses of captopril in order to maintain her blood pressure in a normal range. she is currently hemodynamically stable on captopril 50 mg three times a day with blood pressures ranging in the range of systolic pressure of 110 to 140. she has been continued on her amiodarone for control of her intermittent atrial fibrillation; however, has not been in atrial fibrillation during her intensive care unit stay. #3. infectious disease: the patient completed a two-week course of vancomycin for methicillin resistant staphylococcus aureus bronchitis. she also completed a 10-day course of p.o. flagyl for clostridium difficile colitis. she currently remains off antibiotics. #4. gastrointestinal: the patient has a history of cmv colitis status post treatment with ganciclovir. she is also felt to have ischemic colitis. she was seen and evaluated by the surgical staff, dr. . she has failed feeding attempts both through the ng tube and oral, with episodes of ischemic colitis with each feeding attempt. the long-term plan, from a gi surgical standpoint is to resect her descending colon. it is felt that she has an area of water-shed ischemia in this area. she will not be able to undergo abdominal surgery until her nutrition status is optimized and the pulmonary status optimized. plan is for her to continue on tpn throughout pulmonary rehabilitation and return for colectomy at a later date. the patient is also felt to have a resolving abdominal ileus. the abdominal examination currently remains benign with slight distention and normal bowel sounds. #5. hematology: as previously mentioned the patient was noted on ct scan to have a clot in the left pulmonary vein at the junction of the entrance into the right atrium. this clot resides in a vessel that is tied off status post left upper lobectomy. the patient underwent both transthoracic and transesophageal echocardiogram to further evaluate the clot in this vessel. consultation with cardiology staff was obtained to determine the need for long-term anticoagulation. it is not felt that this clot represents a significant risk of thromboembolism because it resides in essentially a blind pouch, which is not communicating with blood flow or contractile organ. thus, the patient was not anticoagulated. #6. fluids, electrolytes, and nutrition: the patient has remained euvolemic. she continues on tpn with plans to continue this indefinitely until definitive bowel resection can be performed to treat her ischemic colitis. she has an indwelling picc line in the left arm for tpn and any needed iv medications. #7. the patient desires to be a full code. the patient and her family desire aggressive measures to attempt eventual weaning off the ventilator. #8. disposition: the screening process has been initiated for the patient to return to a pulmonary rehabilitation facility. further attempts to wean the patient off the ventilator will be undertaken at rehabilitation. she should continue on tpn at rehabilitation and return for bowel resection once nutritionally optimized. the patient's surgeon, dr. should be contact regarding the timing of returning for surgery. an addendum will follow this dictation listing the patient's final discharge diagnosis and discharge medications prior to transfer to the rehabilitation facility. , m.d.11-933 dictated by: medquist36 procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more diagnostic ultrasound of heart thoracentesis closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus bronchoscopy through artificial stoma bronchoscopy through artificial stoma diagnoses: unspecified pleural effusion personal history of malignant neoplasm of bronchus and lung pulmonary collapse acute respiratory failure methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site intestinal infection due to clostridium difficile acute bronchitis ulcer of heel and midfoot tracheostomy status 

Answer: The patient is high likely exposed to